Agents of Choice in Neoplastic Disease

Abstract

A few cancers are highly responsive to drugs and a few are virtually unresponsive. In an intermediate class are a large number of cancers that are partially sensitive to chemotherapy, either in the sense that a sizeable number of patients show some degree of regression of disease, or that a few patients will show a substantial degree of regression. There are now over 30 drugs that are available for the chemotherapy of cancer. Even though some of these are analogs, there are at least 20 different chemical entities capable of causing significant regression of cancer in man. The pathologist recognizes a hundred or more different types of cancer, and chemotherapy is used in about 30 to 40 of these. Finally, intensive research in chemotherapy is continually turning up new drugs and new ways of using old drugs. There is then a vast and heterogeneous body of knowledge governing the choice of drug — a body of knowledge that is evolving rather dynamically. This chapter is written with the objective of providing a general framework for the detailed discussions to follow, so that the reader, should he have the need, may find an orientation to current usage of antitumor drugs. With this in mind, I have not documented the assertions made, nor attempted to provide a text for the treatment of cancer. The references are limited to general reviews.