Cytostatika

Cytostatika, also known as cytotoxic chemotherapy drugs, are substances that inhibit cell division and proliferation. They are used primarily in cancer therapy to suppress tumor growth by damaging DNA, interfering with mitosis, or disrupting other essential processes in dividing cells. Some cytostatics are also employed as immunosuppressants in autoimmune diseases and transplant medicine.

Major classes include alkylating agents (such as cyclophosphamide, ifosfamide, and temozolomide), platinum compounds (cisplatin, carboplatin, oxaliplatin), antimetabolites (methotrexate, 5-fluorouracil, capecitabine, cytarabine), natural products (vinca alkaloids like vincristine and vinblastine; taxanes such as paclitaxel and docetaxel), antitumor antibiotics (doxorubicin, daunorubicin), and topoisomerase inhibitors (etoposide, topotecan). These drugs can act by crosslinking DNA, blocking DNA synthesis, inhibiting microtubule function, or interfering with enzymes essential for DNA replication.

Treatment is typically given in cycles to allow recovery of normal tissues, with routes including oral and various forms of intravenous administration, and sometimes intrathecal delivery for central nervous system involvement. Dosing is tailored to cancer type, stage, patient factors, and combined with supportive care. Combination regimens are common to enhance efficacy and reduce resistance.

Adverse effects are often broad and dose-dependent, reflecting toxicity to rapidly dividing tissues. Key risks include myelosuppression, nausea and vomiting, mucositis, alopecia, and fertility impairment, along with organ-specific toxicities such as nephrotoxicity, neurotoxicity, or cardiotoxicity, varying by drug and regimen. The development of cytostatics transformed oncology, spurring ongoing advances in dosing strategies, supportive care, and combination with targeted therapies.