(A) biological response modifier interferon Interferon (interferon) includes alpha interferon (IFN-α), beta interferon (IFN-β), and gamma interferon (IFN-γ). Indications】 Hairy cell leukemia (HCL), chronic granulocytic leukemia (CML), non-Hodgkin’s lymphoma (NHL), multiple myeloma (MM), renal cancer, malignant melanoma, carcinoid tumor, cervical intraepithelial neoplasia, cancerous pleural effusion and pericardial effusion. Kuang Tang Hong, Department of Oncology, Hangzhou Third People’s Hospital 【Caution】 1. Patients often have flu-like symptoms during the first dose. If the symptoms are mild, they can be left untreated; if the symptoms are severe, some analgesics such as aspirin and anti-inflammatory pain should be taken. 2. Some patients may have gastrointestinal symptoms, skin allergy-like symptoms or psychiatric symptoms. 3, some patients with peripheral blood leukocytes and platelets decreased, pay attention to monitor the blood picture. 4, contraindications: ① known allergy to interferon products, products of E. coli origin; ② history of angina pectoris, myocardial infarction and other serious cardiovascular disease; ③ serious hepatic and renal impairment; ④ can not tolerate the product may have adverse reactions; ⑤ epilepsy and other central nervous system dysfunction; ⑥ pregnant women. Interleukin-2 (IL-2) [Indications] Malignant tumors such as renal cell carcinoma, melanoma, breast cancer, bladder cancer, liver cancer, rectal cancer, lymphoma, lung cancer and cancerous pleural and pericardial effusions. Precautions] 1. Drug overdose may cause capillary infiltration syndrome. 2.It can cause fever, chills and weakness. Giving appropriate drugs (such as indomethacin, pethidine, p-acetylaminophen, etc.) will effectively reduce the adverse reactions. 3.Some patients can develop liver and kidney function damage, should be monitored. Thymopeptide including thymopentin and thymopeptide α1 【Indications】 It is used as immune response enhancer for patients with malignant tumors, such as renal cell carcinoma, melanoma, breast cancer, bladder cancer, liver cancer, colorectal cancer, lymphoma, lung cancer, etc. Precautions】 1. Feverish reaction occurs in some patients, symptomatic treatment is sufficient. 2.For allergic patients, it is recommended to do intradermal sensitivity test. 3.Anaphylaxis may occur in very few patients. 4. Contraindications: ①It is contraindicated in patients with hypersensitivity to thymidine components; ②It is contraindicated in patients undergoing immunosuppressive therapy such as organ transplantation; ③It should be used with caution in pregnant and lactating women. Tumor Necrosis Factor (TNF) [Indications] Malignant tumors such as renal cell carcinoma, melanoma, breast cancer, bladder cancer, liver cancer, colorectal cancer, lymphoma and lung cancer. Precautions】 1. The most common adverse reactions are local reactions at the injection site, including erythema, itching, pain and swelling of the skin. 2.Recent adverse reactions are mainly fever and chills, the incidence of which is about 50%. 3.Other adverse reactions include changes in blood pressure, weakness, dizziness and headache, joint pain, skeletal muscle pain, nausea and vomiting, leukopenia, decreased platelets, decreased hemoglobin, abnormal liver function, etc. 4, Contraindications: ① serious liver and kidney function, abnormal heart and lung function; ② allergic to the ingredients contained in this product is prohibited. Levamisole [Indications] Used as immunomodulator. Precautions] 1. Granulocyte deficiency may be induced after taking this product. 2. Contraindicated in patients with poor hepatic or renal function, active hepatitis, early pregnancy or pre-existing schistosomiasis. COX inhibitors include celecoxib and aspirin. Indications】 For the adjuvant treatment of familial adenomatous polyposis (FAP) and adjuvant treatment of malignancy. Precautions】 1. There is a possibility of bronchospasm in asthmatic patients taking this product. 2, adverse reactions mainly headache, nausea, vomiting, constipation, arthralgia, low back pain, insomnia, myalgia. Long-term or high dose may have gastrointestinal bleeding or ulcers. (3) Contraindications: ① allergic to these drugs; ② known to be allergic to sulfonamide; ③ not to be used in patients with asthma, urticaria or allergic reactions induced by taking aspirin or other NSAIDs. (II) Monoclonal antibody rituximab [Indication] CD20 positive B-lymphocytic non-Hodgkin’s lymphoma. Precautions】 1. Transient hypotension and bronchospasm may occur during treatment. 2. Patients with a history of cardiac disease (such as angina pectoris, arrhythmia or heart failure) should be closely monitored when using this drug. 3.Patients can have allergic-like or hypersensitivity reactions when given protein products intravenously for treatment. 4. Regular observation of the complete blood count, including platelet count, should be observed during treatment. Trastuzumab [Indication] Her-2 overexpressed breast cancer. Precautions】 1. It should be used with caution in patients with cardiac insufficiency, and cardiac function should be closely checked. 2. The combination of this drug with anthracyclines (adriamycin or epi-amycin) is not recommended and will increase the risk of cardiac decompensation. 3. When this drug is first infused, approximately 40% of patients will develop syndromes usually including chills and/or fever. Cetuximab [Indications] Colorectal cancer and head and neck squamous cell carcinoma. Precautions] 1. The incidence of acne-like papules is 88%, which can often cause varying degrees of skin toxicity. 2. Interstitial lung disease may occur in less than 0.5% of patients. In a few patients, severe fatal metabolic reactions may occur. 4, K-ras gene status on the application of cetuximab, has a guiding significance. 5, Cetuximab can be secreted through breast milk, so use with caution in lactating women. Nitrozumab [Indications] Stage III/IV nasopharyngeal carcinoma with positive expression of epidermal growth factor receptor (EGFR). Precautions】 1. Adverse reactions are mainly fever and blood pressure drop, which should be closely observed during use. 2. Use with caution in pregnant women or women who do not use adequate contraception. 3. Contraindication: It is prohibited to use if you are allergic to the drug or any of its components. Bevacizumab [Indications] Bevacizumab combined with 5-fluorouracil-based chemotherapy is indicated for the treatment of patients with metastatic colorectal cancer. Precautions】 1. The incidence of gastrointestinal perforation is 0.3%-2.4%. If abdominal pain occurs during treatment, the possibility of gastrointestinal perforation should be considered. 2, skin and mucous membrane bleeding: nasal bleeding is common, and fatal pulmonary bleeding can occur. 3, hypertension: half of the patients have elevated diastolic blood pressure. 4, nephrotic syndrome: mainly manifested as proteinuria. 5.Congestive heart failure. 6, Surgical and wound healing complications: Bevacizumab should not be used for 28 days before and after surgery. 131 Iodine [131I] tumor cell nucleus human-mouse chimeric monoclonal antibody [Indications] Trial use in the radioimmunotherapy of advanced lung cancer that cannot be controlled by radiotherapy or recurrence. Precautions】 1. This product is a radioactive preparation and must be used in a unit with an open nuclide work permit and a nuclear medicine physician’s license. 2. Doctors should administer the drug according to the dosage recommended in this manual to prevent overdose. 3.Patients should pay attention to the follow-up of thyroid function after discontinuing this drug. 4. Contraindications: ① abnormal liver and kidney function, myocardial damage or congestive heart failure; ② pregnant women, lactating women, underage patients; ③ patients with iodine allergy or positive anti-TNT antibody reaction; ④ those who have used mouse-derived antibodies; ⑤ those with poor hematopoietic function. Patients with recent chemotherapy or radiotherapy, patients who need to rely on hematopoietic restorative drugs to maintain peripheral blood. Patients with blood cell counts such as white blood cells and platelets below the normal range; ⑥Patients with significant thoracic and ascitic fluid, or red, swollen and hot mass surface with white blood cells >10×109/L; ⑦Patients with various acute or chronic inflammatory diseases. Methotrexate [Indications] Primary hepatocellular carcinoma that cannot be surgically resected or recurred after surgery, as well as advanced hepatocellular carcinoma that is not suitable for arterial catheterization chemoembolization (TACE) or is ineffective or recurred after TACE. Precautions】 1. This product can only be used in qualified hospitals, and the process of use should be carried out in strict accordance with the relevant provisions of GB/8703-88 “Radiation Protection Regulations”. 2. It is not recommended for use in pregnant and lactating women, and not recommended for use in children. There is a lack of research on the safety and efficacy for elderly patients. 3. Contraindicated: ① hypersensitivity to this product and its components; ② positive HAMA reaction; ③ those who have used mouse-derived antibodies; ④ patients who cannot tolerate thyroid closure drugs. (iii) Cell differentiation inducer all-trans retinoic acid, arsenic trioxide [Indications] Acute promyelocytic leukemia, myelodysplasia, acute promyelocytic leukemia. Precautions】 1. This product can produce headache, dizziness (more under 50 years old than the elderly), dry mouth, skin flaking and other side effects when taken internally, so pay attention to dose control. 2, can cause liver damage, liver and kidney insufficiency, use with caution. 3, please do not use with tetracycline, vitamin A at the same time. 4.Contraindicated: It is prohibited to use if you are allergic to the drug or any of its components. (D) Apoptosis inducer bortezomib [Indications] This product is used for the treatment of patients with multiple myeloma. Precautions】 1. The treatment process can lead to peripheral neuropathy, mainly sensory nerves. 2.It can lead to hypotension and heart failure, which should be monitored closely. 3.Complete blood count should be closely monitored during treatment. 4, Contraindicated: Contraindicated in patients with hypersensitivity to bortezomib, boron or mannitol. Arsenic trioxide [Indications] is indicated for acute promyelocytic leukemia. Precautions】 1. The main adverse reactions are dry skin, papules, erythema or hyperpigmentation, nausea, gastrointestinal distention, numbness of fingertips, and elevated serum transaminases. 2. Use with caution if you have liver or kidney function impairment. 3, Contraindicated: Pregnant and lactating women are prohibited. Decitabine [Indications] Myelodysplastic syndrome (MDS). Precautions】 1. Neutropenia and thrombocytopenia can occur during treatment, and regular blood tests must be performed. 2. Use with caution in patients with hepatic or renal dysfunction. Liver biochemistry and serum creatinine should be tested before starting treatment. 3. Use with caution in pregnant and lactating women. 4, Contraindicated: contraindicated in patients with known hypersensitivity to decitabine. (E) Neovascularization inhibitor thalidomide [Indications] can be used in the treatment of multiple myeloma (MM), but also in kidney cancer, sarcoma, lung cancer, glioma, skin cancer and breast cancer and other malignant tumors with certain efficacy. The main side effects are dizziness, lethargy, drowsiness, nausea, abdominal pain, constipation, facial swelling, facial erythema, allergic reactions and polyneuritis, etc. 2, contraindications: ① pregnant and lactating women are prohibited; ② children are prohibited; ③ allergy to this product is prohibited; ④ drivers, machine operators are prohibited. Recombinant human vascular endothelial inhibitor [Indications] This product is used in combination with vincristine and cisplatin chemotherapy regimen for the treatment of patients with primary or revascularized stage III/IV non-small cell lung cancer. Precautions】 1. Use with caution if you are allergic or have a history of hypersensitivity to protein-based biologics. 2. Regular monitoring of electrocardiogram is required during clinical use. 3. Contraindicated: use with caution in patients with cardiac or renal insufficiency. (vi) Epidermal growth factor receptor inhibitors gefitinib and erlotinib [Indications] For the treatment of locally advanced or metastatic non-small cell lung cancer (NSCLC) that has received prior chemotherapy or is not amenable to chemotherapy. Erlotinib in combination with gemcitabine can be used for the first-line treatment of locally advanced, unresectable or metastatic pancreatic cancer. Precautions] 1. The most common adverse reactions are skin rash and diarrhea. 2. Acute interstitial lung lesions may occasionally occur, and some patients may die as a result. 3. Asymptomatic elevation of hepatic transaminases has been observed. Therefore, regular liver function testing is recommended. 4, Patients taking warfarin should be monitored regularly for changes in prothrombin time or INR. 5, EGFR mutation detection, can guide the use of the drug. 6, Contraindications: ① allergy to the product and ingredients is prohibited; ② pregnant and lactating women are prohibited. (VII) Gene therapy recombinant human p53 adenovirus injection [Indications] can be used in combination with radiation therapy for patients with advanced nasopharyngeal carcinoma for whom existing therapies are ineffective. Precautions】 1. Some patients develop self-limiting fever of degree I/II after administration. Some patients may experience chills, injection site pain and bleeding. Other adverse reactions that may occur occasionally are nausea, vomiting, diarrhea, gastrointestinal bleeding and stress allergic reaction. 2. This product is for intratumoral injection, and the possibility of tumor metastasis should be fully considered when using it. 3. Contraindications: ① prohibited when the patient has systemic infection, fever and other toxic symptoms; ② prohibited for those who are allergic to the product; ③ prohibited for pregnant and lactating women. (H) Multi-targeted small molecule inhibitor sorafenib mesylate [Indications] inoperable advanced renal cell carcinoma; inoperable or distant metastatic primary hepatocellular carcinoma. Precautions] 1. Hand and foot skin reactions and rash are the most common adverse reactions. 2. The incidence of hypertension increases in patients after taking the drug, mostly mild to moderate, and blood pressure should be routinely monitored. Temporary or long-term termination of sorafenib treatment should be considered for patients who develop myocardial ischemia and/or myocardial infarction. 3. Patients who are co-administered with warfarin should be routinely tested for prothrombin time, INR values and noted for clinical bleeding tendencies. 4. Suspension of sorafenib is recommended in patients requiring major surgery. Sunitinib malate [Indications] 1. Gastrointestinal mesenchymal tumors (GIST) that have failed or are intolerant to treatment with imatinib mesylate. 2, inoperable advanced renal cell carcinoma (RCC). 3.Treatment of advanced pancreatic and other endocrine tumors. Precautions] 1. The most common adverse reactions include fatigue, loss of appetite, nausea, diarrhea, and rash, hand-foot syndrome, skin discoloration, and taste changes also occur frequently. 2.If clinical manifestations of congestive heart failure occur, it is recommended to discontinue the drug. Patients with cardiac ejection fraction <50% and those with ejection fraction below 20% of baseline should discontinue and/or reduce the dose. 3. This product may prolong the Q-T interval in a dose-dependent manner. It should be used with caution in patients with a known history of Q-T interval prolongation, in patients taking antiarrhythmic drugs, or in patients with appropriate underlying cardiac disease, bradycardia and electrolyte disturbances. 4. If severe hypertension occurs during use, use should be suspended until the hypertension is controlled. 5.Contraindication: It is prohibited for those who are allergic to any of the components of this product.