Top 10 Cancer-Fighting Medicines In India

Disclaimer: The information in this blog is based on various sources regarding cancer medicines commonly prescribed in India. We need confirmation of the current availability or price details of these medicines. We encourage readers to consult healthcare professionals before making any decisions about lifestyle changes or medication based solely on this article.

Have you ever wondered which medicines oncologists most commonly prescribe for cancer patients? It's a question that many people have, and it's understandable. After all, when dealing with such a serious condition, knowing about the available treatments can help achieve effective outcomes.

Whether you’re battling cancer yourself, caring for someone who is, or simply curious about medical advancements, this blog breaks down the top 10 cancer medicines. 

What are the 10 commonly prescribed cancer medicines?

The 10 most commonly prescribed cancer medicines in India are 

1. Pembrolizumab
 

• Pembrolizumab is an immunotherapy medicine which was first approved by the U.S. Food and Drug Administration (FDA) on August 5, 2016.
• A phase 3 trial was conducted in 2017 to assess the efficacy of pembrolizumab in treating metastatic head and neck squamous cell carcinoma (HNSCC). Thus, the study proved that pembrolizumab, both alone and in combination with chemotherapy, significantly enhanced the survival rate against the current conventional therapy.
• Specifically, patients treated with pembrolizumab had a median overall survival of 13.0 months, while those receiving the standard therapy had a median survival of 10.7 months.

How pembrolizumab works?

Pembrolizumab works by inhibiting a protein called PD-1 in the immune system. This protein assists the immune system in detecting and attacking tumour cells. 

What are the uses of pembrolizumab?

Pembrolizumab is used in the treatment of 

• Non-Small Cell Lung Cancer (NSCLC)
• Melanoma
• Head and Neck Squamous Cell Carcinoma (HNSCC)
• Hodgkin Lymphoma
• Gastric and Cervical Cancer

What are the common side effects of pembrolizumab?

Common side effects of pembrolizumab include:

• Headache & nausea
• Skin problems
• Muscle or joint pain
• Cough or shortness of breath
• Low blood cell counts

How much does pembrolizumab cost?

The pembrolizumab is available as a Keytruda 100mg injection that costs Rs 1,97,250 in India.

2. Nivolumab
 

• Nivolumab is an immunotherapy medicine which was first approved by the United States Food and Drug Administration (FDA) on December 22, 2014.
• A 2019 study conducted by the Bloomberg~Kimmel Institute for Cancer Immunotherapy showed favourable five-year survival rates for patients with renal cell carcinoma (RCC), or non-small cell lung cancer (NSCLC), advanced melanoma treated with Nivolumab after previous therapies failed.
• The study found that the five-year survival rates were 34.2% for melanoma, 27.7% for RCC, and 15.6% for NSCLC.

How do Nivolumab work?

Nivolumab improves the natural response of the immune system to fight cancer cells. Nivolumab inhibits the PD-1 protein in T-cells. This stops tumour cells from escaping immune detection, thereby allowing T-cells to detect and kill tumour cells more effectively.

What are the uses of Nivolumab?

Nivolumab is primarily used to treat:

• Hodgkin's and Non-Hodgkin's lymphoma
• Squamous cell carcinoma
• Cervical and Testicular  cancer
• Melanoma

What are the common side effects of Nivolumab?

The common side effects of nivolumab include:

• Headache & nausea
• Fatigue
• Skin problems
• Joint pain

How much does Nivolumab cost?

3. Trastuzumab

• Trastuzumab is a monoclonal antibody that was first approved by the U.S. Food and Drug Administration (FDA) on September 25, 19981
• A 2019 phase 3 clinical trial of Trastuzumab, known as the HannaH trial, assessed the efficacy and safety of subcutaneous versus intravenous administration in patients with HER2-positive early breast cancer. The result showed that trastuzumab had long-term efficacy and safety.
• The 6-year event-free survival rates were 65% for both subcutaneous and intravenous trastuzumab, and the overall survival rates were 84% in both groups.

How does Trastuzumab work?

Trastuzumab works by targeting and binding to the HER2 protein in cancer cells. It blocks cancer growth and division. It also helps the immune system to identify and kill these tumour cells, making it more effective in the treatment of HER2-positive breast and stomach cancers.

What are the uses of Trastuzumab?

Trastuzumab is used in the treatment of :

• HER2-Positive breast cancer
• HER2-Positive gastric cancer
• HER2-Positive Metastatic breast cancer

What are the common side effects of Trastuzumab?

The common side effects of trastuzumab are:

• Infection
• Insomnia
• Sudden weight loss
• Upper respiratory tract infection

How much does Trastuzumab cost in India?

4. Osimertinib

• Osimertinib is an anticancer medicine approved by the U.S. Food and Drug Administration on April 18, 2018, as a first-line therapy for patients with non-small cell lung cancer (NSLC) that have progressed to other regions and tumours with epidermal growth factor receptor (EGFR) mutations.
• Osimertinib got approval for its indication based on an overall response rate (ORR) of 59% among 411 patients in two single-arm clinical trials.

How does Osimertinib work? 

• Osimertinib is an oral epidermal growth factor receptor (EGFR) kinase inhibitor. It works by inhibiting the EGFR, which slows down the growth of tumour cells.
• It also works by limiting or slowing down the growth of lung cancer cells and shrinking tumour cells. It also prevents the recurrence of tumours after they have been surgically removed.

What are the uses of Osimertinib?

Osimertinib is used in the treatment of the following:

• Treatment of Non-Small Cell Lung Cancer (NSCLC) in adults
• First-line therapy for metastatic NSCLC with epidermal growth factor receptor (EGFR) mutations
• Adjuvant treatment after the removal of tumours by surgery in patients with EGFR mutation-positive NSCLC

What are the common side effects of Osimertinib?

The common side effects of osimertinib are :

• Anemia
• Muscle and joint pain
• Low white blood cell (WBC) & platelet count
• Inflamed and sore mouth

How much does Osimertinib cost in India?

5. Atezolizumab

• Atezolizumab is a monoclonal antibody approved by the U.S. Food and Drug Administration on October 18, 2016.
• This approval was based on two open-label clinical studies (OAK and POPLAR) that found consistent effectiveness and safety in NSCLC patients.
• Compared to other conventional therapies, Atezolizumab in the targeted patient group resulted in a 4.2 and a 2.9-month increase in overall survival (OS).

How does Atezolizumab work? 

Atezolizumab belongs to the category of programmed death ligand - 1 (PDL-1). This PDL-1 promotes the suppression of T-cells by binding with immune and tumour cells, which results in poor immune response against cancer cells. Atezolizumab injection acts against the signals of PDL-1 and improves the immune response by exhibiting specific cytotoxic activity.

What are the uses of Atezolizumab?

Atezolizumab is used in the treatment of the following:

• Urothelial carcinoma
• Liver cancer (hepatocellular carcinoma)
• Small cell lung cancer (SCLC)
• Non-small cell lung cancer (NSCLC)
• Melanoma

What are the common side effects of Atezolizumab?

The common side effects of atezolizumab include:

• Tiredness
• Decreased appetite
• Nausea & vomiting
• Cough & breathlessness

How much does Atezolizumab cost in India?

6. Ipilimumab

• Ipilimumab was approved by the US FDA (Food and Drug Administration) on March 25, 2011.
• In the CHECKMATE-743 trial, nivolumab plus Ipilimumab showed an improvement in overall survival (OS) compared to chemotherapy. The median OS was 18.1 months versus 14.1 months with chemotherapy.
• The overall response rate (ORR) was 40% with nivolumab plus ipilimumab, compared to 43% with chemotherapy.

How does Ipilimumab work?

Ipilimumab enhances the immune system's response to attack cancer cells. It blocks the CTLA-4 protein, which regulates immune cell activity, called T cells. By blocking CTLA-4, Ipilimumab makes the T cells more active and better able to recognise and destroy cancer cells. It shrinks the size of the tumour and improves survival in patients with advanced melanoma.

What are the uses of Ipilimumab?

Ipilimumab is used in the treatment of the following:

• Advanced melanoma
• Advanced lung and kidney cancer (when combined with other immunotherapies or chemotherapy)
• Colorectal and Liver cancer

What are the common side effects of Ipilimumab?

The common side effects of Ipilimumab are:

• Fatigue,
• Diarrhoea,
• Itching & rash

How much does Ipilimumab cost in India?

The Ipilimumab is available in the brand name Yervoi 50mg Injection that costs rupees 72,500.

7. Bevacizumab

• Bevacizumab was approved by the US FDA (Food and Drug Administration) on Feb 26, 2004.
• A randomised, open-label, multicenter, global trial that assessed the safety and efficacy of LONSURF with Bevacizumab to single-agent LONSURF in patients with metastatic colorectal cancer (mCRC) who had received a maximum of two prior chemotherapy treatments and had progressive disease or intolerance to the last treatment.

How does Bevacizumab work?

Bevacizumab is a biological agent that works as targeted drug therapy in cancer treatment. It is a monoclonal antibody belonging to the class VEGF inhibitors. 

VEGF-A is a factor that promotes the formation of blood vessels within tumours, providing necessary nutrition and oxygen for tumour growth. Bevacizumab particularly attaches to the tumour and inhibits its growth. It is frequently used in conjunction with other chemotherapeutic medicine. 

What are the uses of Bevacizumab?

Bevacizumab is used in the treatment of the following:

• Metastatic colorectal and breast cancer
• Non-small cell lung cancer
• Advanced kidney cancer
• Cervical cancer

What are the side effects of Bevacizumab?

The side effects of Bevacizumab are :

• Numbness in feet
• Extreme fatigue
• High blood pressure
• Formation of blood clots in blood vessels
• Muscle and joint pain

How much does Bevacizumab cost in India?

8. Ribociclib

• Ribociclib was approved by the US FDA (Food and Drug Administration) on March 13, 2017.
• A MONALEESA-2 trial assessed the efficacy of Ribociclib combined with letrozole for first-line treatment in postmenopausal women with hormone receptor-positive, HER2-negative recurrent or metastatic breast cancer.
• The study showed that the combination therapy improved progression-free survival and overall survival compared to letrozole alone.
• The median OS was 63.9 months with Ribociclib plus letrozole, compared to 51.4 months with letrozole alone, representing a clinically meaningful overall survival benefit.

How does Ribociclib work?

Ribociclib acts by reducing the activity of two proteins known as CDK4 and CDK6, which control cell proliferation and division. Ribociclib, which inhibits these proteins, can reduce or stop the development of cancer cells.

What are the uses of Ribociclib?

Ribociclib is used in the treatment of the following:

• Used as combination therapy with other anticancer medications to treat advanced or metastatic breast cancer.
• Used with fulvestrant for postmenopausal women with metastatic breast cancer.

What are the side effects of Ribociclib?

The side effects of Ribociclib include:

• Fatigue
• Nausea and vomiting
• Diarrhea
• Decreased appetite and hair loss

How much does Ribociclib cost in India?

The Ribociclib is available in the brand name Kryxana 200mg Tablet that costs rupees 23,625 in India.

 9. Sunitinib

• Sunitinib was approved by the U.S. Food and Drug Administration (FDA) on January 26, 2006
• An S-TRAC trial, which was a multi-centre, international, double-blind, placebo-controlled study, involved patients at high risk of recurrent renal cell carcinoma following nephrectomy.
• The trial showed that patients receiving Sunitinib experienced a significantly longer disease-free survival compared to those receiving a placebo.

How does Sunitinib work?

Sunitinib works by delaying or preventing the development and spread of tumour cells in the body, which reduces the size and number of tumours. It reduces the activity of tyrosine kinases, which are important in signalling pathways that regulate cell growth and division. Blocking these processes can help prevent cancer cells from growing and spreading.

What are the uses of Sunitinib?

Sunitinib is used in the treatment of the following:

• Advanced or metastatic kidney cancer
• Gastrointestinal stromal tumours (GIST)
• Types of Pancreatic Neuroendocrine Tumors (PNET)

What are the side effects of Sunitinib?

The common side effects of Sunitinib include:

• Fatigue
• Nausea and vomiting
• Skin problems
• Nose bleeds

 How much does Sunitinib cost in India?

10. Ibrutinib

• Ibrutinib was approved by the US FDA (Food and Drug Administration) on November 13, 2013.
• A SHINE trial assessed Ibrutinib combined with bendamustine-rituximab (BR) and rituximab maintenance in patients aged 65 or older newly diagnosed with mantle cell lymphoma.
• The study found that this combination significantly decreased the risk of disease progression or death by 25% compared to placebo plus BR and rituximab maintenance.

How does Ibrutinib work?

Ibrutinib is classified as a Bruton tyrosine kinase inhibitor. Bruton tyrosine kinase is a protein that promotes chronic lymphocytic leukaemia and other B-cell tumours. Ibrutinib inhibits the enzymatic activity of BTK, further reducing its signalling. As a result, the number of cancer cells decreases, causing the disease to advance slower. 

What are the uses of Ibrutinib?

Ibrutinib is used to treat:

• Chronic lymphocytic leukaemia (CLL)
• Mantle cell lymphoma
• Small lymphocytic lymphoma (SLL)

What are the side effects of Ibrutinib?

The common side effects of Ibrutinib are:

• Muscle and bone pain
• Pneumonia
• Rashes and other skin problems

How much does Ibrutinib cost in India?

Wrapping up

It is important that patients know the forms of cancer treatment that are most frequently used in the process of treatment. These drugs include chemotherapy drugs, hormone therapies, immune therapies, and other targeted therapies, which play an important role in filing different cancers. 

Each of the medications has its benefits and potential complications, and recognising them makes the treatment process more effective and enhances the patients’ well-being.

References

1. https://www.fda.gov/drugs/resources-information-approved-drugs/oncology-cancer-hematologic-malignancies-approval-notifications
2. https://www.cancer.gov/about-cancer/treatment/types/targeted-therapies/approved-drug-list
3. https://www.cancer.gov/about-cancer/treatment/drugs
4. https://www.anticancerfund.org/database-cancer-drugs

Note: The information provided in this blog is intended for general knowledge. It is important to remember that it should not replace professional medical advice. If you have any concerns about cancer or related symptoms, please consult a healthcare provider.