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A Note on Treatment Regimens

Cancer treatment regimens change to reflect continuous advances in basic and clinical science: new drugs, both small molecules and biologicals; improved methods of targeting and timing of drug delivery; agents with altered pharmacokinetic properties and selectivities; the use of rational multidrug combinations; and greater knowledge of the basic cell biology of tumorigenesis, metastasis, and immune function, amongst other advances. As a consequence, this chapter presents relatively few detailed treatment regimens; rather, we refer the reader to the web-based resources of the U.S. FDA and the NCCN. Table 67–1 provides two examples of therapeutic regimens that illustrate the complexity of current cancer drug therapy.



ABC: ATP-binding cassette

ABVD: doxorubicin (adriamycin), bleomycin, vinblastine, dacarbazine

ADA: adenosine deaminase

ADME: absorption, distribution, metabolism, excretion

ALL: acute lymphoblastic leukemia

AML: acute myeloid leukemia; acute myelocytic leukemia

APL: acute promyelocytic leukemia

Ara-C: cytarabine, cytosine arabinoside

Ara-U: ara-uridine

ARDS: acute respiratory distress syndrome

L-ASP: L-asparaginase

ATO: arsenic trioxide

ATRA: all-trans retinoic acid

BCNU: carmustine [1,3-bis-(2-chloroethyl)-1-nitrosourea]

BCRP: breast cancer resistance protein

CCNU: 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (lomustine)

2CdA: 2-chlorodeoxyadenosine (cladribine)

CDK: cyclin-dependent kinase

C/EBP: CCAAT/enhancer binding protein

CHOP: cyclophosphamide, doxorubicin (H), vincristine (O) and prednisone

CLCr: creatinine clearance

CLL: chronic lymphocytic leukemia

CML: chronic myelocytic leukemia; chronic myelogenous leukemia

CNT1: concentrative nucleoside transporter 1

CTCL: cutaneous T-cell lymphoma

dCK: deoxycytidine kinase

dCTP: deoxycytidine 5′-triphosphate

DDD: dichlorodiphenyldichloroethane

dFdC: 2′,2′-difluorodeoxycytidine, gemcitabine

5′-dFdU: 5′-deoxyfluorodeoxyuridine

DHFR: dihydrofolate reductase

dNTP: deoxynucleotide triphosphate

DPD: dihydropyrimidine dehydrogenase

dTMP/TTP: deoxythymidine monophosphate/triphosphate

dUMP/FdUMP: deoxyuridine monophosphate/fluoro dUMP

ENT1: equilibrative nucleoside transporter 1

FdUMP: deoxynucleotide, fluorodeoxyuridine monophosphate

FH2Glun/FH4Glun: dihydro-/tetrahydrofolate polyglutamates

FOLFIRINOX: FOLFOX plus irinotecan

FOLFOX: folinic acid, 5FU and oxaliplatin

5FU: 5-fluorouracil

FUdR: fluorodeoxyuridine

G-CSF: granulocyte colony-stimulating factor

GI: gastrointestinal

GSH: glutathione

GST: glutathione S-transferase

Hb: hemoglobin

HbF: fetal hemoglobin

HDAC: histone deacetylase

HDM-L: high-dose MTX with leucovorin rescue

HGPRT: hypoxanthine guanine phosphoribosyl transferase

HMG: high-mobility group

HMM: hexamethylmelamine

HSV: herpes simplex virus

5HT: serotonin, 5-hydroxytryptamine

HU: hydroxyurea

IMP: inosine monophosphate

Jak2: Janus kinase 2

MAO: monoamine oxidase

MDS: myelodysplastic syndrome

MESNA: 2-mercaptoethanesulfonate-Na+

methyl-CCNU: semustine

MGMT: O6-alkyl, methyl guanine methyltransferase

MLL: mixed-lineage leukemia

MM: multiple myeloma

MMR: mismatch repair

MOPP: nitrogen mustard, oncovin (vincristine), procarbazine, and prednisone

6MP: 6-mercaptopurine

MRP: multidrug resistance-associated protein

MSH6: mutator S homologue 6

MTA: pemetrexed

MTIC: methyl-triazeno-imidazole-carboxamide

mTOR: mammalian target of rapamycin

MTX: methotrexate

Nab-paclitaxel: albumin-bound nanoparticle solution of paclitaxel

NCCN: National Comprehensive Cancer Network

NER: nucleotide excision repair

NHL: non-Hodgkin lymphoma

NSAID: nonsteroidal anti-inflammatory drug

PG: polyglutamate

Pgp: P-glycoprotein

PI3K: phosphoinositide 3-kinase

PML: promyelocytic leukemia

PN: peripheral neuropathy

PRPP: 5-phosphoribosyl-1-pyrophosphate

PVC: procarbazine, vincristine and CCNU

RAR: retinoic acid receptor

RNR: ribonucleoside diphosphate reductase

ROS: reactive oxygen species

SCC: squamous cell carcinoma

SHMT: serine hydroxymethyltransferase

TEM: triethylenemelamine


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