Cytotoxic drugs exhibit either cell cycle nonspecific (CCNS) or cell cycle specific (CCS) characteristics.
(a) Cell cycle nonspecific agents have the ability to kill both resting and dividing cells. Examples include mustine, cyclophosphamide, chlorambucil, carmustine, dacarbazine, busulfan, L-asparaginase, cisplatin, procarbazine, and actinomycin.
(b) Cell cycle specific drugs exclusively target actively dividing cells at different phases:
Utilizing cell cycle specific drugs in brief, intermittent courses of treatment is a rational approach. This strategy enables noncycling cells, which are typically less responsive to drugs, to re-enter the cell cycle during intervals between drug courses.
The scheduling of cell cycle specific (CCS) drugs commonly follows a course of cell cycle nonspecific (CCNS) drug(s) to enhance the overall cell elimination. CCS drugs demonstrate greater efficacy in hematological malignancies and solid tumors with a substantial growth fraction, whereas CCNS drugs exhibit effectiveness not only in these scenarios but also in solid cancers characterized by a limited growth fraction.
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