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Types of chemotherapy

Chemotherapy is the use of medicine to treat cancer. Chemotherapy kills cancer cells. It may be used to cure cancer, help keep it from spreading, or reduce symptoms.

In some cases, people are treated with a single type of chemotherapy. But often, people get more than one type of chemotherapy at a time. This helps attack the cancer in different ways.

Targeted therapy and immunotherapy are other cancer treatments that use medicine to treat cancer.

Standard chemotherapy works by killing cancer cells and some normal cells. Targeted treatment and immunotherapy zero in on specific targets (molecules) in or on cancer cells.

The type and dose of chemotherapy your health care provider gives you depends on many different things, including:

• The type of cancer you have
• Where the cancer first showed up in your body
• What the cancer cells look like under a microscope
• Whether the cancer has spread (metastasized)
• Your age and general health

All cells in the body grow by splitting into two cells, or dividing. Others divide to repair damage in the body. Cancer occurs when something causes cells to divide and grow out of control. They keep growing to form a mass of cells, or tumor.

Chemotherapy attacks dividing cells. This means that it is more likely to kill cancer cells than normal cells. Some types of chemotherapy damage the genetic material inside the cell that tells it how to copy or repair itself. Others types block chemicals the cell needs to divide.

Some normal cells in the body divide often, such as hair and skin cells. These cells also may be killed by chemo. That is why it can cause side effects like hair loss. But most normal cells can recover after treatment ends.

There are more than 100 different chemotherapy medicines. Below are the seven main types of chemotherapy, the types of cancer they treat, and examples. The caution includes things that differ from typical chemotherapy side effects.

ALKYLATING AGENTS

Used to treat:

• Leukemia
• Lymphoma
• Hodgkin disease
• Multiple myeloma
• Sarcoma
• Brain
• Cancers of the lung, breast, and ovary

Examples:

• Busulfan (Myleran)
• Cyclophosphamide
• Temozolomide (Temodar)

Caution:

• May damage bone marrow, which can lead to leukemia.

ANTIMETABOLITES

Used to treat:

• Leukemia
• Cancer of the breast, ovary, and intestinal tract

Examples:

• 5-fluorouracil (5-FU)
• 6-mercaptopurine (6-MP)
• Capecitabine (Xeloda)
• Gemcitabine

Caution: None

ANTI-TUMOR ANTIBIOTICS

Used to treat:

• Many types of cancer.

Examples:

• Dactinomycin (Cosmegen)
• Bleomycin
• Daunorubicin (Cerubidine, Rubidomycin)
• Doxorubicin (Adriamycin PFS, Adriamycin RDF)

Caution:

• High doses can damage the heart.

TOPOISOMERASE INHIBITORS

Used to treat:

• Leukemia
• Lung, ovarian, gastrointestinal, and other cancers

Examples:

• Etoposide
• Irinotecan (Camptosar)
• Topotecan (Hycamtin)

Caution:

• Some can make a person more likely to get a second cancer, called acute myeloid leukemia, within 2 to 3 years.

MITOTIC INHIBITORS

Used to treat:

• Myeloma
• Lymphomas
• Leukemias
• Breast or lung cancer

Examples:

• Docetaxel (Taxotere)
• Eribulin (Halaven)
• Ixabepilone (Ixempra)
• Paclitaxel (Taxol)
• Vinblastine

Caution:

• More likely than other types of chemotherapy to cause painful nerve damage.

American Cancer Society website. How chemotherapy drugs work. www.cancer.org/cancer/managing-cancer/treatment-types/chemotherapy/how-chemotherapy-drugs-work.html. Updated November 22, 2019. Accessed April 2, 2024.

Collins JM. Cancer pharmacology. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 25.

National Cancer Institute website. A to Z list of cancer drugs. www.cancer.gov/about-cancer/treatment/drugs. Accessed April 2, 2024.

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