Chemoprotectants in cancer chemotherapy: An update

Abstract

Cancer chemotherapeutic agents play an integral part in the management of patients with malignancy. However, chemotherapy is associated with significant toxicity with an adverse impact on the health of the patients. As a result the therapeutic outcome is influenced due to the inability to deliver sufficient dose-intensive therapy leading to treatment delays or cessation. Chemoprotectants have been developed in order to mitigate the toxicity associated with chemotherapeutic agents by providing organ-specific protection to normal tissues, without compromising the antitumor efficacy. The current review highlights chemoprotectants in the management of chemotherapeutics-associated toxicity, such as: amifostine, aprepitant, dexrazoxane, filgrastim, sargramostim, mesna, oprelvekin, palifermin, recombinant human erythropoietin etc. Additionally, the present status on the concurrent use of chemoprotectants in combination with chemotherapeutic agents, with focus on their safety is included. The advantageous role of these cytoprotective agents combined with chemotherapy remains controversial in clinical studies due to moderate protective efficacy for normal tissues and organs, risk of concomitant tumor protection and adverse reactions. Besides, the number of successful agents is rather small. Therefore, identification of novel approaches and chemoprotectants holds potential for better management of cancer with chemotherapy.