[Second cancers associated with the cancer treatment and their possible control]

Area of Science:

• Oncology
• Genetics
• Pharmacology

Context:

• Chemotherapy is a cornerstone of cancer treatment, but it can induce secondary malignancies.
• Alkylating agents and topoisomerase II inhibitors are classes of chemotherapy drugs with known risks of secondary cancers.

Purpose:

• To review the distinct clinical features, incidences, and cumulative risks of second cancers induced by alkylating agents and topoisomerase II inhibitors.
• To explore the underlying molecular-genetic abnormalities and detoxifying enzyme polymorphisms associated with these secondary cancers.
• To discuss potential future strategies for controlling these devastating treatment-related adverse events.

Summary:

• This review synthesizes current knowledge on second cancers following treatment with alkylating agents and topoisomerase II inhibitors.
• It details their distinct clinical presentations, population-based incidences, and cumulative risks.
• The review also covers molecular-genetic factors, including enzyme polymorphisms, and discusses future control measures for these secondary malignancies.

Impact:

• Provides a comprehensive overview for clinicians and researchers managing cancer patients undergoing chemotherapy.
• Highlights the importance of understanding genetic predispositions and molecular mechanisms in secondary cancer development.
• Informs strategies for risk stratification, patient monitoring, and the development of safer chemotherapeutic agents or treatment protocols.