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Corticosteroids, synthetic steroid drugs made from the natural hormone hydrocortisone, and particularly prednisone, are frequently used for combination therapy for treating severe and chronic lymphocyte leukemia, Hodgkin's and non-Hodgkin's lymphomas, multiple myeloma, and breast cancer. Corticosteroids exhibit an antitumor effect by binding with cor-ticosteroid receptors that exist in many cancerous lymphoma cells, which leads to inhibition of both glucose transport and phosphorylation, which reduces the amount of energy necessary for mitosis and protein synthesis, which, accordingly, leads to cell lysis.

30.5.5 Nonhormonal drugs

In addition to hormonal drugs, five other nonsteroids that have a direct relationship to this section are also used in cancer chemotherapy. They are aminoglutethimide, flutamide, mitotan, tamoxifen, and leuprolide.

Aminoglutethimide: Aminoglutethimide, (± )-2-(4-aminophenyl)-2-ethylglutarimide (30.5.4), is made by two methods, the first of which begins with glutethimide (4.3.6), which is nitrated to form 2-(4-nitrophenyl)-2-ethylglutarimide (30.5.3). Reducing the nitro group with hydrogen over a nickel catalyst gives the desired aminoglutethimide (30.5.4).

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