Cancer chemotherapy. Current status, coming innovations

A wide number of agents are now available for chemotherapeutic treatment of cancer. The agents fall into four categories: the alkylating agents, the antimetabolites, the anti-tumor antibiotics, and the mitotic inhibitors. Various combinations of the agents are used to gain greater treatment efficacy and reduce resistance, and chemotherapy used as an adjunct to surgery can give added benefit in some cases. Since successful chemotherapy depends on using active drugs, new assays to predict drug responsiveness are being developed. Toxicity of cytotoxic drugs remains a major problem, although attempts at modification hold promise. Clinical trials, the mainstay for evaluating efficacy and toxicity of chemotherapy, must be carefully analyzed to interpret results meaningfully.