What are cytostatic agents?

Author:  Gesche Tallen, MD, PhD, Editor:  Maria Yiallouros, Reviewer:  Prof. Dr. med. Dr. h.c. Günter Henze, English Translation:  Hannah McRae, Last modification: 2022/02/17 https://kinderkrebsinfo.de/doi/e75215

Cytostatic (or chemotherapeutic) agents (cytostatics) are plant-derived or synthetic substances that can cause death or inhibit growth and dividing of a cell. Cytostatics achieve these growth-inhibiting effects by specific mechanisms of action, which, in one way or another, affect the cells’ metabolism.

Various cell types display different levels of sensitivity to specific cytostatic drugs – particularly sensitive are those that divide frequently. Most cancers are sensitive to many chemotherapeutic agents, because they usually divide very often and in an uncontrolled way. Some cytostatics are not only used for cancer therapy, but also for the treatment of other illnesses characterised by high cell turnovers. For example, the cytostatic agent methotrexate is often given to patients with rheumatic disorders.

The majority of cytostatics have been classified into groups based on their characteristic mechanisms of action. These include, for example, the ways in which they exert their growth-inhibitory effects, how they are metabolized (i.e. broken down, excreted) by the patient's organism (pharmacokinetics), their most effective dosage and route of administration, how protective they are with regard to healthy tissue, and their most common side effects.

The substances of each group often differ slightly in their molecular structure and, thus, their anticancer effects. Due to their chemical structure, some substances are capable of passing the blood-brain barrier and can therefore be used for the treatment of central nervous system (CNS) tumours or other cancers involving the CNS.