Chemotherapy: Anti-tumor Antibiotics

Reviewed by: HU Medical Review Board | Last reviewed: November 2023

Anti-tumor antibiotics are a type of chemotherapy used to treat many cancers. One type used to treat lung cancer is Adriamycin® (doxorubicin). It may be used with other chemotherapy medicines to treat small-cell lung cancer.1,2

Anti-tumor antibiotics can cause serious side effects, including heart damage with some of these medicines. Talk to your doctor about the risks and benefits of these drugs. They can help you understand what to expect during treatment.1,3

How do anti-tumor antibiotics work?

Anti-tumor antibiotics do not work like antibiotics that treat infections. They are called antibiotics because they are made from chemicals produced by bacteria. This type of antibiotic blocks uncontrolled growth and division of cancer cells.2-4

Many anti-tumor antibiotics are anthracyclines. This means they bind to DNA in your cells and interfere with its structure. As a result, cells cannot grow and make copies of themselves. This process kills cells that divide quickly. Cancer cells divide very quickly, so anthracyclines are able to damage cancer cells.2,3

Examples of anti-tumor antibiotics

Generally, the only anti-tumor antibiotic used to treat certain forms of lung cancer is Adriamycin (doxorubicin). Doxorubicin is an anthracycline. It can be used to treat a specific form of small-cell lung cancer (SCLC).1,3

What are the possible side effects?

Along with cancer cells, anti-tumor antibiotics can harm healthy cells that divide quickly. This causes side effects. Side effects can vary depending on the specific drug you are taking.3

Common side effects of certain anti-tumor antibiotics include:2,5

  • Hair loss
  • Nausea
  • Vomiting
  • Fatigue
  • Mouth sores
  • Red urine
  • Fertility problems

Severe side effects are possible. Doxorubicin has a boxed warning, the strictest warning from the US Food and Drug Administration (FDA). It has this warning because of an increased risk of heart muscle damage. This can lead to heart failure. For this reason, your doctor will monitor your heart function before and during treatment and may limit how much of the medicine you receive over your lifetime.1-3,5

Talk to your doctor if you notice any symptoms of heart failure, including:1-3,5

  • Extreme tiredness or weakness
  • Shortness of breath
  • Fast heartbeat
  • Swelling of feet and ankles

Doxorubicin also has boxed warnings related to an increased risk of:5

  • Certain new blood cancers
  • Skin and tissue damage near the injection site
  • Very low blood cell counts, which can lead to serious infections

In addition, cancers can become resistant to anti-cancer drugs like anti-tumor antibiotics. This means that cancer cells can change in order to survive these drugs, and this may occur in some people with lung cancer. Taking combinations of different treatments can help lower the risk of resistance.4,6,7

These are not all the possible side effects of anti-tumor antibiotics. Talk to your doctor about what to expect when taking these drugs. You should also call your doctor if you have any changes that concern you when taking an anti-tumor antibiotic.

Other things to know

Anti-tumor antibiotics are typically given into your vein through an intravenous (IV) line. Your doctor will perform tests to check for side effects during treatment. They may stop treatment or change your dose or schedule if you have side effects.2,5

Before beginning treatment for lung cancer, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs. Tell them about:5

  • History of heart problems and heart failure
  • Any current radiation therapy or history of radiation therapy
  • History of liver problems
  • Pregnancy or plans to become pregnant
  • Breastfeeding or plans to breastfeed

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