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Chemo Facts

Facts on Drugs Used in Chemotherapy

Oncology drugs are the largest business sector of the trillion-dollar a year global pharmaceutical industry. The drugs used in chemotherapy kill cancer cells – but they also kill healthy cells too. That fact alone is bad enough, but it doesn’t stop there. Chemotherapy drugs also have side-effects, and many cause new cancers and new diseases. This leads to the use of yet more drugs, which in turn cause further side effects. It’s a vicious circle and a license to print money for the pharmaceutical industry.

What interest can the pharmaceutical industry possibly have in trying to prevent cancer if it earns revenues of around $80 billion a year from keeping it existing? The only reason that cancer remains a death verdict is the billions of dollars that drug companies make each year from selling chemotherapy drugs.

The information on these webpages contains extracts from the official "patient information leaflets" for chemotherapy drugs, as published by the drug manufacturers themselves.

The drugs marked with a * are listed in the “13th Report on Carcinogens” of the US National Toxicology Program as "cancerogenic", i.e. cancer-causing. In other words, the drugs prescribed to millions of cancer patients as a cure are, in fact, known to cause cancer.


Adriamycin *

Active substance: Doxorubicin
Active substance: Doxorubicin
Manufacturer: Teva Pharmaceuticals

Extract from the prescribing information:
"Myocardial toxicity manifested in its most severe form by potentially fatal congestive heart failure may occur either during therapy or months to years after termination of therapy."

"Secondary acute myelogenous leukemia (AML) or myelodysplastic syndrome (MDS) has been reported in patients treated with anthracyclines, including doxorubicin."

The above has been extracted from the Adriamycin prescribing information on the Teva webpages.

Alkeran *

Active substance: Melphalan
Active substance: Melphalan
Manufacturer: GlaxoSmithKline

Extract from the prescribing information:
"Secondary malignancies, including acute nonlymphocytic leukemia, myeloproliferative syndrome, and carcinoma, have been reported in patients with cancer treated with alkylating agents (including Melphalan). "

"Patients should be informed that the major acute toxicities of melphalan are related to bone marrow suppression, hypersensitivity reactions, gastrointestinal toxicity, and pulmonary toxicity."

"Patients should never be allowed to take the drug without close medical supervision"

The above has been extracted from the Alkeran prescribing information on the GSK webpages.

Amsa PD

Active substance: Melphalan
Active substance: Amsacrine
Manufacturer: Parke-Davis

Extract from the prescribing information:
"With intravenous administration, AMSA PD (base) had toxic effects on the liver, kidney, lymphoid tissue, bone marrow, gastrointestinal tract, and central nervous system."

"Patients receiving AMSA PD must be under close medical supervision by physicians skilled in cancer chemotherapy."

The above has been extracted from the Amsa PD prescribing information on the Parke-Davis webpages.

Avastin

Active substance: Bevacizumab
Active substance: Bevacizumab
Manufacturer: Genentech (USA) / Roche (Worldwide)

Extract from the prescribing information:
"AVASTIN administration can result in the development of gastrointestinal 8 perforation, in some instances resulting in fatality."

The above has been extracted from the Avastin prescribing information on the Genentech webpages.

BiCNU

Active substance: Carmustine
Active substance: Carmustine
Manufacturer: Bristol-Myers Squibb

Extract from the prescribing information:
"BiCNU is carcinogenic in rats and mice, producing a marked increase in tumor incidence in doses approximating those employed clinically."

"A frequent and serious toxicity of BiCNU is delayed myelosuppression."

"BiCNU (carmustine for injection) should be administered under the supervision of a qualified physician experienced in the use of cancer chemotherapeutic agents."

The above has been extracted from the BiCNU prescribing information on the Bristol-Myers Squibb webpages.

Blenoxane

Active substance: Blenoxane
Active substance: Bleomycin sulfate
Manufacturer: Bristol-Myers Squibb

Extract from the prescribing information:
"The carcinogenic potential of BLENOXANE in humans is unknown. A study in F344-type male rats demonstrated an increased incidence of nodular hyperplasia after induced lung carcinogenesis by nitrosamines, followed by treatment with bleomycin."

"Pulmonary toxicities occur in 10% of treated patients. In approximately 1%, the nonspecific pneumonitis induced by BLENOXANE progresses to pulmonary fibrosis, and death."

"It is recommended that BLENOXANE be administered under the supervision of a qualified physician experienced in the use of cancer chemotherapeutic agents."

The above has been extracted from the Blenoxane prescribing information on the Bristol-Myers Squibb webpages.

Busulfex

Active substance: Busulfan
Active substance: Busulfan
Manufacturer: PDL Biopharma

Extract from the prescribing information:
"Busulfan is a mutagen and a clastogen."

"Busulfan is a presumed human carcinogen."

"BUSULFEX should be administered under the supervision of a qualified physician experienced in hematopoietic stem cell transplantation."

The above has been extracted from the Busulfex prescribing information on the PDL Biopharma webpages.

Camptosar

Active substance: Irinotecan
Active substance: Irinotecan
Manufacturer: Pfizer

Extract from the prescribing information:
"Irinotecan was clastogenic both in vitro (chromosome aberrations in Chinese hamster ovary cells) and in vivo (micronucleus test in mice)."

"Patients and patients’ caregivers should be informed of the expected toxic effects of CAMPTOSAR, particularly of its gastrointestinal complications, such as nausea, vomiting, abdominal cramping, diarrhea, and infection."

The above has been extracted from the Camptosar prescribing information on the Pfizer webpages.

Cerubidine

Active substance: Daunorubicin
Active substance: Daunorubicin
Manufacturer: Bedford Laboratories

Extract from the prescribing information:
"Myocardial toxicity manifested in its most severe form by potentially fatal congestive heart failure may occur either during therapy or months to years after termination of therapy."

"Special attention must be given to the potential cardiac toxicity of Cerubidine, particularly in infants and children."

The above has been extracted from the Cerubidine prescribing information on the Bedford Laboratories webpages.

Cosmegen

Active substance: Dactinomycin
Active substance: Dactinomycin
Manufacturer: Merck & Co., Inc.

Extract from the prescribing information:
"This drug is HIGHLY TOXIC and both powder and solution must be handled and administered with care. Inhalation of dust or vapors and contact with skin or mucous membranes, especially those of the eyes, must be avoided."

"Reports indicate an increased incidence of second primary tumors (including leukemia) following treatment with radiation and antineoplastic agents, such as COSMEGEN."

The above has been extracted from the Cosmegen prescribing information on the Merck webpages.

Cytoxan *

Active substance: Cyclophosphamide
Active substance: Cyclophosphamide
Manufacturer: Bristol-Myers Squibb

Extract from the prescribing information:
"Second malignancies have developed in some patients treated with cyclophosphamide used alone or in association with other antineoplastic drugs and/or modalities. Most frequently, they have been urinary bladder, myeloproliferative, or lymphoproliferative malignancies."

"Acute cardiac toxicity has been reported with doses as low as 2.4 g/m2 to as high as 26 g/m2"

The above has been extracted from the Cytoxan prescribing information on the Bristol-Myers Squibb webpages.

Dacarbazine *

Active substance: Dacarbazine
Active substance: Dacarbazine
Manufacturer: Abraxis Pharmaceutical Products

Extract from the prescribing information:
"Hemopoietic depression is the most common toxicity with dacarbazine for injection and involves primarily the leukocytes and platelets, although, anemia may sometimes occur."

"Hepatic toxicity accompanied by hepatic vein thrombosis and hepatocellular necrosis resulting in death, has been reported."

The above has been extracted from the Dacarbazine prescribing information on the APP webpages.

Ellence

Active substance: Epirubicin
Active substance: Epirubicin
Manufacturer: Pfizer

Extract from the prescribing information:
"Myocardial toxicity, manifested in its most severe form by potentially fatal congestive heart failure (CHF), may occur either during therapy with epirubicin or months to years after termination of therapy."

"Secondary acute myelogenous leukemia (AML) has been reported in patients with breast cancer treated with anthracyclines, including epirubicin."

The above has been extracted from the Ellence prescribing information on the Pfizer webpages.

Erbitux

Active substance: Cetuximab
Active substance: Cetuximab
Manufacturer: Bristol-Myers Squibb and ImClone

Extract from the prescribing information:
"Serious infusion reactions occurred with the administration of Erbitux in approximately 3% of patients in clinical trials, with fatal outcome reported in less than 1 in 1000."

"Cardiopulmonary arrest and/or sudden death occurred in 2% of 208 patients with squamous cell carcinoma of the head and neck treated with radiation therapy and Erbitux."

The above has been extracted from the Erbitux prescribing information on the Bristol-Myers Squibb webpages.

Etopophos

Active substance: Etoposide phosphate
Active substance: Etoposide phosphate
Manufacturer: Bristol-Myers Squibb

Extract from the prescribing information:
"Myelosuppression resulting in death has been reported following etoposide administration. Dose-limiting bone marrow suppression is the most significant toxicity associated with ETOPOPHOS therapy."

"ETOPOPHOS should be considered a potential carcinogen in humans. The occurrence of acute leukemia with or without a preleukemic phase has been reported in rare instances in patients treated with etoposide alone or in association with other neoplastic agents."

The above has been extracted from the Etopophos prescribing information on the Bristol-Myers Squibb webpages.

Herceptin

Active substance: Trastuzumab
Active substance: Trastuzumab
Manufacturer: Genentech (USA) / Roche (Worldwide)

Extract from the prescribing information:
"Herceptin can result in sub-clinical and clinical cardiac failure manifesting as CHF and decreased LVEF."

"Herceptin administration can result in serious infusion reactions and pulmonary toxicity. Fatal infusion reactions have been reported."

The above has been extracted from the Herceptin prescribing information on the Genentech webpages.

Hexalen

Active substance: Altretamine
Active substance: Altretamine
Manufacturer: MGI Pharma

Extract from the prescribing information:
"HEXALEN capsules causes mild to moderate myelosuppression and neurotoxicity."

"The carcinogenic potential of HEXALEN capsules has not been studied in animals, but drugs with similar mechanisms of action have been shown to be carcinogenic."

The above has been extracted from the Hexalen prescribing information on the MGI Pharma webpages.

Hycamtin

Active substance: Topotecan
Active substance: Topotecan
Manufacturer: GlaxoSmithKline

Extract from the prescribing information:
"Bone marrow suppression (primarily neutropenia) is the dose-limiting toxicity of HYCAMTIN."

"Carcinogenicity testing of topotecan has not been performed. Topotecan, however, is known to be genotoxic to mammalian cells and is a probable carcinogen."

The above has been extracted from the Hycamtin prescribing information on the GlaxoSmithKline webpages.

Idamycin

Active substance: Idarubicin
Active substance: Topotecan
Manufacturer: Pfizer

Extract from the prescribing information:
"As is the case with other anthracyclines the use of IDAMYCIN can cause myocardial toxicity leading to congestive heart failure. Cardiac toxicity is more common in patients who have received prior anthracyclines or who have preexisting cardiac disease."

"IDAMYCIN is a potent bone marrow suppressant. IDAMYCIN should not be given to patients with pre-existing bone marrow suppression induced by previous drug therapy or radiotherapy unless the benefit warrants the risk."

"Formal long-term carcinogenicity studies have not been conducted with idarubicin. Idarubicin and related compounds have been shown to have mutagenic and carcinogenic properties when tested in experimental models"

The above has been extracted from the Idamycin prescribing information on the Pfizer webpages.

Ifex

Active substance: Ifosfamide
Active substance: Ifosfamide
Manufacturer: Bristol-Myers Squibb

Extract from the prescribing information:
"Urotoxic side effects, especially hemorrhagic cystitis, as well as CNS toxicities such as confusion and coma have been associated with the use of IFEX."

"Ifosfamide has been shown to be carcinogenic in rats, with female rats showing a significant incidence of leiomyosarcomas and mammary fibroadenomas."

The above has been extracted from the Ifex prescribing information on the Bristol-Myers Squibb webpages.

Leukeran *

Active substance: Chlorambuzil
Active substance: Chlorambuzil
Manufacturer: GlaxoSmithKline

Extract from the prescribing information:
"Chlorambucil is a carcinogen in humans. Chlorambucil is probably mutagenic and teratogenic in humans."

"There are many reports of acute leukemia arising in patients with both malignant and non-malignant diseases following chlorambucil treatment."

The above has been extracted from the Leukeran prescribing information on the GlaxoSmithKline webpages.

Mustargen

Active substance: Mechlorethamine
Active substance: Mechlorethamine
Manufacturer: Merck & Co., Inc.

Extract from the prescribing information:
"This drug is HIGHLY TOXIC and both powder and solution must be handled and administered with care. Inhalation of dust or vapors and contact with skin or mucous membranes, especially those of the eyes, must be avoided."

"Extravasation of the drug into subcutaneous tissues results in a painful inflammation. The area usually becomes indurated and sloughing may occur."

"Therapy with alkylating agents such as MUSTARGEN may be associated with an increased incidence of a second malignant tumor, especially when such therapy is combined with other antineoplastic agents or radiation therapy."

The above has been extracted from the Mustargen prescribing information on the Merck webpages.

Mutamycin

Active substance: Mitomycin
Active substance: Mitomycin
Manufacturer: Bristol-Myers Squibb

Extract from the prescribing information:
"This was the most common and most serious toxicity, occurring in 605 of 937 patients (64.4%). Thrombocytopenia and/or leukopenia may occur anytime within 8 weeks after onset of therapy with an average time of 4 weeks."

"Patients should be advised of the potential toxicity of this drug, particularly bone marrow suppression. Deaths have been reported due to septicemia as a result of leukopenia due to the drug."

The above has been extracted from the Mutamycin prescribing information on the Bristol-Myers Squibb webpages.

Myleran *

Active substance: Busulfan
Active substance: Busulfan
Manufacturer: GlaxoSmithKline

Extract from the prescribing information:
"The most frequent, serious side effect of treatment with busulfan is the induction of bone marrow failure (which may or may not be anatomically hypoplastic) resulting in severe pancytopenia. The pancytopenia caused by busulfan may be more prolonged than that induced with other alkylating agents."

"Malignant tumors and acute leukemias have been reported in patients who have received busulfan therapy, and this drug may be a human carcinogen. The World Health Organization has concluded that there is a causal relationship between busulfan exposure and the development of secondary malignancies."

The above has been extracted from the Myleran prescribing information on the GlaxoSmithKline webpages.

Navelbine

Active substance: Vinorelbine
Active substance: Vinorelbine
Manufacturer: Pierre Fabre Pharmaceuticals

Extract from the prescribing information:
"Navelbine has been reported to cause severe constipation (e.g., Grade 3-4), paralytic ileus, intestinal obstruction, necrosis, and/or perforation. Some events have been fatal."

"Granulocytopenia is the major dose-limiting toxicity with Navelbine."

The above has been extracted from the Navelbine prescribing information on the Pierre Fabre Pharmaceuticals webpages.

Purinethol

Active substance: Mercaptopurine
Active substance: Mercaptopurine
Manufacturer: GlaxoSmithKline

Extract from the prescribing information:
"The most consistent, dose-related toxicity is bone marrow suppression. This may be manifest by anemia, leukopenia, thrombocytopenia, or any combination of these. Any of these findings may also reflect progression of the underlying disease."

"Mercaptopurine is hepatotoxic in animals and humans. A small number of deaths have been reported that may have been attributed to hepatic necrosis due to administration of mercaptopurine."

"Mercaptopurine causes chromosomal aberrations in animals and humans and induces dominant-lethal mutations in male mice."

The above has been extracted from the Purinethol prescribing information on the GlaxoSmithKline webpages.

Rituxan (USA) / Mabthera (Worldwide)

Active substance: Rituximab
Active substance: Rituximab
Manufacturer: Genentech (USA) / Roche (Worldwide)

Extract from the prescribing information:
"Rituxan administration can result in serious, including fatal infusion reactions. Deaths within 24 hours of Rituxan infusion have occurred. Approximately 80% of fatal infusion reactions occurred in association with the first infusion."

The above has been extracted from the Rituximab prescribing information on the Genentech webpages.

Taxol

Active substance: Paclitaxel
Active substance: Paclitaxel
Manufacturer: Bristol-Myers Squibb

Extract from the prescribing information:
"Anaphylaxis and severe hypersensitivity reactions characterized by dyspnea and hypotension requiring treatment, angioedema, and generalized urticaria have occurred in 2 to 4% of patients receiving TAXOL in clinical trials. Fatal reactions have occurred in patients despite premedication."

The above has been extracted from the Taxol prescribing information on the Bristol-Myers Squibb webpages.

Temodar

Active substance: Temozolomide
Active substance: Temozolomide
Manufacturer: Schering-Plough

Extract from the prescribing information:
"Patients treated with TEMODAR Capsules may experience myelosuppression."

"Temozolomide was mutagenic in vitro in bacteria (Ames assay) and clastogenic in mammalian cells (human peripheral blood lymphocyte assays)."

The above has been extracted from the Temodar prescribing information on the Schering-Plough webpages.

Thiotepa *

Active substance: Triethylenethiophosphoramide
Active substance: Triethylenethiophosphoramide
Manufacturer: Bedford Laboratories

Extract from the prescribing information:
"Death has occurred after intravesical administration, caused by bone-marrow depression from systematically absorbed drug."

"Death from septicemia and hemorrhage has occurred as a direct result of hematopoietic depression by thiotepa."

"Thiotepa is highly toxic to the hematopoietic system. A rapidly falling white blood cell or platelet count indicates the necessity for discontinuing or reducing the dosage of thiotepa."

"Like many alkylating agents, thiotepa has been reported to be carcinogenic when administered to laboratory animals. Carcinogenicity is shown most clearly in studies using mice, but there is some evidence of carcinogenicity in man. In patients treated with thiotepa, cases of myelodysplastic syndromes and acute non-lymphocytic leukemia have been reported."

The above has been extracted from the Thiotepa prescribing information on the Bedford Laboratories webpages.

Vinblastine

Active substance: Vinblastine sulfate
Active substance: Vinblastine sulfate
Manufacturer: Bedford Laboratories

Extract from the prescribing information:
"Aspermia has been reported in man. Animal studies suggest that teratogenic effects may occur."

"Patients treated for Hodgkin’s disease have developed leukemia following radiation therapy and administration of vinblastine sulfate in combination with other chemotherapy including agents known to intercalate with DNA."

The above has been extracted from the Vinblastine prescribing information on the Bedford Laboratories webpages.

Vincasar

Active substance: Vincristine sulfate
Active substance: Vincristine sulfate
Manufacturer: Sicor

Extract from the prescribing information:
"Acute uric acid nephropathy, which may occur after the administration of oncolytic agents, has also been reported with vincristine sulfate."

"Because dose-limiting clinical toxicity is manifested as neurotoxicity, clinical evaluation (eg, history, physical examination) is necessary to detect the need for dosage modification."

The above has been extracted from the Vincasar prescribing information on the Sicor webpages.

Vumon

Active substance: Teniposide
Active substance: Teniposide
Manufacturer: Bristol-Myers Squibb

Extract from the prescribing information:
"Severe myelosuppression with resulting infection or bleeding may occur."

"Dose-limiting bone marrow suppression is the most significant toxicity associated with VUMON therapy."

"Children at SJCRH with ALL in remission who received maintenance therapy with VUMON at weekly or twice weekly doses (plus other chemotherapeutic agents), had a relative risk of developing secondary acute nonlymphocytic leukemia (ANLL) approximately 12 times that of patients treated according to other less intensive schedules."

The above has been extracted from the Vumon prescribing information on the Bristol-Myers Squibb webpages.

Zanosar *

Streptozocin
Active substance: Streptozocin
Manufacturer: Sicor

Extract from the prescribing information:
"Renal toxicity is dose-related and cumulative and may be severe or fatal. Other major toxicities are nausea and vomiting which may be severe and at times treatment-limiting. In addition, liver dysfunction, diarrhea, and hematological changes have been observed in some patients."

"Streptozocin is mutagenic. When administered parenterally, it has been found to be tumorigenic or carcinogenic in some rodents."

"The physician must judge the possible benefit to the patient against the known toxic effects of this drug in considering the advisability of therapy with ZANOSAR."

The above has been extracted from the Zanosar prescribing information on the Sicor webpages.