How Do Adjunct Chemoprotective Agents Work?

Adjunct chemoprotective agents are a class of drugs used to protect the kidneys from harmful effects of the chemotherapy drug “cisplatin” in patients receiving this medication for the treatment of ovarian cancer and moderate-to-severe xerostomia (dryness of the mouth) in patients undergoing postoperative radiation treatment for head and neck cancer.

They are cytoprotective adjuvants (also known as “cytoprotectants”) used to reduce or prevent the undesired side effects of certain chemotherapy agents and radiation treatment and to speed up the healing of severe sores in the mouth and throat that may be caused by chemotherapy and radiation therapy used to treat cancers of the blood or bone marrow (soft fatty material in the middle of bones which produces blood cells).

Adjunct chemoprotective agents are available as a powder to be mixed with liquid and injected intravenously (into a vein), typically given over 15 minutes starting 30 minutes before chemotherapy treatment.

Adjunct chemoprotective agents work in the following ways:

• They belong to a class known as "cytoprotectants" and work by protecting against the harmful effects of chemotherapy medications and radiation treatment.
• They belong to a class known as "human keratinocyte growth factors."
• They bind to the human keratinocyte growth factor receptor on the buccal cell surfaces and stimulate the growth of cells in the mouth and throat.

Adjunct chemoprotective agents are used to treat conditions such as:

• Nephrotoxicity (rapid deterioration in the kidney function due to the toxic effect of medications and chemicals): to reduce cumulative renal toxicity associated with repeated administration of cisplatin in patients with advanced ovarian cancer
• Xerostomia (dry mouth resulting from reduced or absent saliva flow): to reduce the incidence of moderate-to-severe xerostomia in patients undergoing postoperative radiation treatment for head and neck cancer
• Oral mucositis: in patients with hematologic (blood) malignancies receiving myelotoxic therapy requiring hematopoietic stem cell support

Some of the common side effects include:

• Nausea
• Vomiting
• Fever
• Rash
• Malaise (a feeling of weakness, overall discomfort, and illness)
• Arthralgia (joint pain)
• Flushing or feeling of warmth
• Sneezing
• Hiccups

Other rare side effects include:

• Hypotension (low blood pressure)
• Hypocalcemia (low blood calcium level)
• Stevens-Johnson syndrome (a rare, serious disorder that affects the skin, mucous membrane, genitals, and eyes)
• Elevated serum amylase
• Mouth/tongue thickness/discoloration
• Drowsiness (abnormally sleepy during the day)
• Shortness of breath
• Fast, slow, or pounding heartbeat
• Dizziness (feeling faint, weak, or unsteady)

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of adjunct chemoprotective agents include:

• Amifostine
• Ethyol
• Kepivance
• Palifermin