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Pharmaceutical Drugs - IARC Monographs on the Evaluation of Carcinogenic Risks to Humans (Paperback)
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Pharmaceutical Drugs - IARC Monographs on the Evaluation of Carcinogenic Risks to Humans (Paperback)
Series: IARC Monographs, v. 50
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Summary Reports the deliberations of a working group convened to
evaluate the carcinogenic risk to humans posed by the therapeutic
use of 15 pharmaceutical drugs. The volume features separate
monographs on five antineoplastic agents, four antimicrobial
agents, two diuretics, ciclosporin (an immunosuppressant),
cimetidine (used in the treatment of gastric and duodenal ulcers),
paracetamol (a popular analgesic and antipyretic drug), and dantron
(a laxative). Drugs were selected for inclusion on the basis of
published data suggesting carcinogenic effects in experimental
animals or in human patients treated with the drug. The working
group identified two of the drugs - ciclosporin and thiotepa - as
human carcinogens. Ciclosporin, an immunosuppressant, is widely
used in the prevention and treatment of graft-versus-host reactions
in bone-marrow transplantation and to prevent the rejection of
kidney, heart, and liver transplants. Often given to transplant
recipients for several months, ciclosporin has been linked to a
remarkably high occurrence of lymphomas, found predominantly in the
gastrointestinal tract, as well as to skin cancer and Kaposi's
sarcoma. The carcinogenicity of thiotepa, a cytostatic agent used
in the treatment of malignant lymphomas and solid tumours, has been
clearly demonstrated in both experimental animals and human
patients, where treatment with the drug has been linked to the
development of leukaemia. Azacitidine, chloramphenicol, and
chlorozotocin were judged to be probably carcinogenic to humans,
while dantron and trichlormethine were identified as possible human
carcinogens. The remaining substances could not be classified on
the basis of currently available evidence. The experts also noted
that long-term experiments with paracetamol, nitrofurantoin, and
nitrofural have shown reductions in tumour incidence at some sites
in some animal species.
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