Tablets from bowel cancer

Malignant intestinal tumors can occur in any part of the digestive tract. Neoplasms grow rapidly, affecting surrounding tissues and metastasizing to distant organs with a current of blood and lymph. Pathology most often occurs in people after 40 years. Tablets from bowel cancer - this is one of the methods of treatment, which is aimed at the destruction of cancer cells.

The disease has a classification, on the basis of which the tactics of treatment are:

1. The mucous membrane gradually disintegrates, pathological changes occur in the cells. In the stomach ulcers and densations are formed, intoxication begins. The patient complains of fever, headaches and general malaise. There are no metastases, lymph nodes are not affected.
2. The growth gradually increases, but does not block the channel. In this case, there are violations of the normal functioning of the intestine. In feces there are traces of blood, intoxication is increased. The tumor does not metastasize.
3. The tumor expands and presses on the neighboring organs. More than 1/2 the diameter of the intestine is blocked, the nearby lymph nodes are affected. Malignant cells spread throughout the circulatory system. The general condition of the patient deteriorates sharply.
4. The lymphatic system is infected with cancer cells that have penetrated into all organs and tissues. Metastases in the whole body, but most of all the liver is affected. This stage is the most dangerous for life, can cause death.

The effectiveness of treatment depends on early diagnosis of the disease. According to statistics, if treatment is started at the first stage, then the survival rate is 90%, the second 70%, the third 50% and the fourth 30-20%. As a therapy, conservative treatment and surgical methods are used. The first option is used in the early stages and to consolidate the results after the operation. The patient is given radiation or chemotherapy, and various pills and injections are prescribed.

Read also:

• Treatment of intestinal cancer in Israel
• Chemotherapy for bowel cancer
• Diet for bowel cancer

The course of treatment lasts from several days to months. The choice of the drug depends on the individual characteristics of the patient. Such treatment causes a number of adverse reactions: nausea, vomiting, general weakness, alopecia, anorexia. Very often chemotherapy is combined with surgical intervention. This method involves cutting off the diseased portion of the intestine and parts of the affected organs. The cut intestine is sewn, removing its ends outwards. This state is difficult, but not life threatening. After treatment, the patient is waiting for a long rehabilitation course aimed at restoring the body.

5-fluorouracil

The active substance of this chemotherapy is uracil antimetabolite-fluorouracil. The mechanism of action of 5-fluorouracil is based on changes in the structure of RNA and inhibition of the division of cancer cells by blockade of the enzyme thymidylate synthetase. Active metabolites penetrate into tumor cells and after a couple of hours their concentration in the tissues of the tumor is much higher than in healthy ones.

The drug is released as a concentrate for the preparation of infusions in ampoules of 250, 500, 1000 and 5000 mg of active ingredient. When administered intravenously, the drug quickly spreads through the fluids and tissues of organisms, penetrates the dorsal and brain. Metabolized to active metabolites, excreted through the lungs and kidneys.

• Indications for use: malignant intestinal and gastrointestinal lesions (liver, stomach, pancreas, esophagus), breast, adrenal, bladder, and neck and scalp tumors.
• Dosage and duration of therapy is determined by the attending physician, individually for each patient. The drug is administered intravenously struino, drip, intracavitary and intra-arterial. The standard dosage is 100 mg per m2 of the patient's body for 4-5 days.
• Side effects: nausea, vomiting, eating and eating disorders, inflammation and ulceration of the gastrointestinal mucosa, bleeding, confusion, thrombophlebitis, hypoxia, lowering of leukocytes, platelets and erythrocytes in the blood. Also, visual acuity disorders, skin allergic reactions, alopecia, azoospermia are possible.
• Contraindications: intolerance of the components of the remedy, renal and hepatic insufficiency, acute infections, cachexia, low level of leukocytes, erythrocytes and platelets. Pregnancy and lactation are absolute contraindications.
• Overdosing manifests symptoms of nausea and vomiting, possible diarrhea, bleeding from the gastrointestinal tract, ulceration of the oral cavity and oppression of hematopoiesis. There is no specific antidote, therefore, symptomatic therapy and monitoring of the body's condition and hematopoiesis are indicated.

[1], [2], [3]

Leucovorin

Metabolite tetrahydrofolic acid, that is, the chemical formula of folic acid. Leucovorin is involved in the biosynthesis of DNA and RNA, used as an antidote to cytotoxic drugs, causing the death of cancer cells. The drug has selective activity against healthy cells, so it can be combined with other chemotherapy drugs.

Leucovorin completely replaces folic acid in the metabolic processes of the body. It is available as a lyophilized powder for the preparation of a solution for intramuscular or intravenous administration. 1 bottle of the drug contains such substances: calcium folinat 25, sodium hydroxide and NaCl.

• The drug is used for conditions related to the relative or absolute deficiency of folic acid in the body. Prevention of toxic effects of cytostatics blocking dehydrofolate reductase, therapy of methotrexate lesions of the oral mucosa, intestinal cancer. The medication is prescribed for alimentary hypovitaminosis, folio-dependent anemia, malabsorption syndrome of folic acid.
• Intramuscular and intravenous injections are done for medical purposes. The dosage depends on the indications. For intestinal tumors in the thermal stages, the drug is administered at 200 mg per m2 in combination with fluorouracil 370 mg per m2.
• Contraindications: individual intolerance of drug components, anemia, folic acid hypervitaminosis, renal failure (chronic). Use of the drug during pregnancy is possible with the appropriate medical appointment.
• Side effects: skin allergic reactions, anaphylaxis. Because the drug has low toxicity, the symptoms of overdose are not fixed.

Capecitabine

An antitumor agent that is activated in the tissues of the tumor, providing a selective cytotoxic effect. Capecitabine entering the body, turns into 5-fluorouracil and is subjected to further metabolism. The substance penetrates into all tissues and organs, but does not have a pathological effect on healthy cells.

• Indications for use: cancer of the intestine (colon), breast tumors with metastases. It can be used as a monotherapy for the ineffectiveness of medications from the paclitaxel or anthracycline group.
• Dosing and Administration: The tablets are taken orally by washing with water. The recommended daily dose is 2500 mg / m2, divided into two doses. Treatment is carried out with weekly interruptions, the duration of treatment depends on the reaction of the body to the drug.
• Side effects: increased fatigue, headaches, paresthesia, visual and taste disorders, confusion, increased tearing. There may be abnormalities in the cardiovascular and respiratory systems, nausea, vomiting, skin allergic reactions, muscle aches and spasms.
• Contraindications: intolerance of the components of the drug, severe renal failure, combined therapy with docetaxel, lack of dihydropyrimidine dehydrogenase. With special care is used for metastatic liver damage, for the treatment of patients of elderly and children.
• Overdose: nausea, vomiting, irritation of the gastrointestinal tract, bleeding, mucositis, oppression of bone marrow function. To eliminate these reactions, symptomatic therapy is indicated.

[4], [5], [6], [7]

Oxaliplatin

An antitumor drug, in the structure of which there is a platinum atom, associated with oxalate. Oxaliplatin is formed by biotransformation in the DNA structure, suppressing its synthesis. Its effect is manifested by cytotoxic and antineoplastic effects.

Produced in glass bottles of 50 ml, in the form of lyophilized powder for the preparation of parenteral solution. 1 ml of the prepared solution contains 5 mg of active substance - oxaliplatinum. With an infusion of 15% of the drug falls into the total blood flow, 85% is redistributed in tissues. The active substance binds to plasma albumins and erythrocytes. Biotransformiruetsya forming metabolites, is excreted in the urine.

• Indications: complex therapy of colorectal cancer with metastases (using fluoropyrimidine pre-art), disseminated colorectal cancer, ovarian cancer. The drug can be used as a monotherapy or as part of a combined treatment regimen.
• Oxaliplatin is used to treat only adults. The drug is administered for 2-6 hours infusion at a dosage of 130 mg / m2 at intervals of 21 days or at a dosage of 85 mg / m2 at intervals of 14 days. With combined therapy with fluoropyrimidines, oxaliplatin is administered first. The number of cycles and dose adjustment is determined by the doctor.
• Side effects: myelosuppressive syndrome with oppression of all germs of hematopoiesis, nausea, vomiting, stomatitis, stool disorders. Possible violations of the central nervous system, seizures, headaches, skin dermatological reactions.
• Contraindications: hypersensitivity to the components of the drug, treatment of children, women in the gestation period and breastfeeding. It is not prescribed for patients with initial myelosuppression with neutropenia 2 x 10 ⁹ / L and / or thrombocytopenia <100 x 10 ⁹ / L, severe renal dysfunction.
• Overdosing manifests itself as an increase in adverse reactions. To eliminate it, symptomatic therapy and dynamic monitoring of hematological parameters are shown.

Irynotekan

Specific inhibitor of the cellular enzyme topoisomerase I. Irinotecan is a semisynthetic derivative of camptothecin. Getting into the body, it is metabolized, forming an active metabolite SN-38, which in its action is superior to irinotecan. Due to this, it is built into DNA and blocks its replication.

• Indications: cancer of the rectum or large intestine with metastases and locally advanced. Can be used in combination with fluorouracil, calcium folinate and for the treatment of patients who have not previously had chemotherapy. The drug is effective in monotherapy of patients with progression of oncology after standard antitumor treatment.
• Used to treat only patients older than 18 years. Dosage depends on the stage of the disease and other characteristics of the body. Irinotecan is administered in the form of infusions for 30-90 minutes. With monotherapy of 350 mg / m2 after 21 days. When preparing the solution for infusion, the preparation is diluted in 250 ml of a 0.5% dextrose solution or 0.9% sodium chloride solution. If after mixing in the vial appeared sediment, then the drug is recyclable.
• Contraindications: oppression of bone marrow hematopoiesis, inflammatory bowel disease of chronic nature, impaired intestinal obstruction, pregnancy and lactation, intolerance of drug components, child's age, bilirubin level is more than 1.5 times VNG. In particular, it is used for radiation therapy, leukocytosis and an increased risk of diarrhea.
• Overdose: diarrhea and neutropenia. There is no specific antidote, symptomatic therapy is indicated. In case of severe overdose symptoms, the patient must be hospitalized and monitor the functions of vital organs.

Bevacizumab

Preparation with recombinant hyperchimeric monoclonal IgG1 antibodies. Bevacizumab selectively binds and inhibits the biological activity of the vascular endothelial growth factor. The composition of the medicament includes the framework areas that bind to VEGF. The preparation was prepared by recombinant DNA.

• Application: metastatic colorectal cancer. Used in the first line of therapy and in combination with fluoropyrimidine-based chemotherapy. Bevacizumab is administered intravenously drip, jetting is contraindicated.
• The standard dosage is 5 mg per kg of patient weight in the form of a prolonged infusion every 14 days. The first dose is given within 90 minutes, after chemotherapy. The following procedures can be performed within 60-30 minutes. When side reactions occur, the dosage is not reduced. If necessary, the treatment is completely stopped.
• Contraindications: hypersensitivity to active components, renal or hepatic insufficiency, children's age of patients, metastases in the central nervous system, lactation. Application during pregnancy is possible in the event that the expected effect of treatment is higher than the potential risk to the fetus. With special care, the drug is used for arterial thromboembolism, for patients older than 65 years, with perforation of the LC, bleeding, arterial hypertension.
• Side effects: perforation of the gastrointestinal tract, hemorrhage, hypertensive crisis, neutropenia, congestive heart failure, pain of various localization, arterial hypertension, attacks of nausea and vomiting, stomatitis, upper respiratory tract infections, dermatological reactions.
• Overdosing manifests itself as an increase in adverse reactions. There is no specific antidote, symptomatic treatment is indicated.

[8], [9], [10]

Cetuximab

The drug is a chimeric monoclonal antibody IgG1 directed against the epidermal growth factor receptor (EGFR). Cetuximab binds to EGFR, blocks the binding of endogenous ligands, and inhibits receptor function. This leads to sensitization of cytotoxic immune effector cells to tumor cells.

With intravenous infusions, a dose-dependent pharmacokinetics is observed when a dose of 5 to 500 mg / m2 is administered. Stable concentration of active components in the blood is achieved through 21 applications as monotherapy. Metabolized in several ways, including by means of biodegradation of antibodies to small molecules, amino acids and peptides. It is excreted in urine and feces.

• Indications: colorectal cancer with metastases with standard chemotherapy, monotherapy of malignant intestinal tumors, locally advanced, recurrent and metastatic squamous cell carcinoma of the neck and head.
• Cetuximab is used as an intravenous infusion at a rate of 10 mg / min. Before use, premedication with antihistamines is required. Regardless of the indications, the drug is administered 1 time per 7 days at a dosage of 400 mg / m2 of the body surface of the patient for 120 minutes. Subsequent infusions are carried out for 60 minutes at a dose of 250 mg / m2.
• The severity of adverse reactions depends on the dosage used. Most often, patients experience such symptoms: febrile condition, nausea and vomiting, dizziness and headaches, infusion reactions, urticaria, lowering of blood pressure, loss of consciousness, airway obstruction. There is no evidence of an overdose.
• Contraindications: pregnancy and breastfeeding, child age, expressed intolerance of the components of the drug. With caution is prescribed for violations of kidney or liver, oppression of bone marrow hematopoiesis, lung or heart disease, for the treatment of elderly patients.

[11], [12], [13], [14]

Panitumumab

A medicinal product used for malignant lesions of the body. Panitumumab is a monoclonal antibody identical to human Ig G2. When ingested, it binds to epidermal growth receptors. By transformation, the active substances activate the proto-oncogene KRAS. This leads to inhibition of the growth of cancer cells, a decrease in the production of proinflammatory cytokines and the growth factor of blood vessels.

• Indications: EGFR-expressed metastatic colorectal cancer with non-mutating proto-oncogene KRAS. Used to treat patients in whom the disease began to progress after applying fluoropyrimidine, oxaliplatin and irinotecan.
• The medication is administered as an intravenous infusion by means of an infusion pump. The standard dosage is 6 mg / kg once every 14 days. When dermatological reactions appear, the dosage is adjusted or the treatment is canceled. Therapy is performed until stable positive results are achieved.
• Side effects: toxic effects on the skin, nails and hair, allergic reactions of varying severity, abdominal pain, nausea, vomiting, diarrhea / constipation, stomatitis, peripheral edema, cardiovascular and respiratory system disorders.
• Contraindications: hypersensitivity to the drug, pregnancy and lactation, children's age of patients.

Regoraphanib

A new drug for the treatment of inoperable or metastatically termal GI tumors with the progression or intolerance of other antitumor agents. Regorafenib is an oral multi-kinase inhibitor. Its action is based on the inhibition of receptor tyrosine kinases, which take part in the tumor formation of blood vessels.

• The tablet improves survival in metastatic colorectal cancer after progression and the use of a standard treatment regimen. Reduces the risk of death by 23% even at the thermal stages of the disease.
• Dosage: tablets take 40 mg (4 pcs.) Once a day for 21 days. After each cycle of treatment, a 7-day rest period should be observed. The duration of therapy and the number of cycles will be determined by the attending physician.
• Side effects: infections, a decrease in the number of platelets, anemia, decreased appetite, severe head and muscle pains, skin allergic reactions, increased fatigue, general weakness, severe weight loss, stomatitis, speech disorders.
• Contraindications: hypersensitivity to the drug components, renal and hepatic insufficiency, pregnancy and lactation, tumors with KRAS mutations in the genetic material, bleeding, taking blood thinners, metabolic diseases, recent operations, high blood pressure, prolonged wound healing.