Sinopsis
Cancer treatment requires the cooperative efforts of multiple medical specialties. Although surgeons traditionally have been the first specialists to treat the cancer patient, newer modalities have created important roles for the radiotherapist and medical oncologist in the initial management of cancer patients, and responsibility for care of the majority of patients with metastatic cancer is in the hands of these specialists. The array of alternatives for the treatment of cancer is constantly expanding. With the demonstration of effectiveness of new drugs and new biologics, and with the evolution of more effective strategies for integrating chemotherapy, surgery, and radiation, the development of a treatment plan becomes increasingly complex. The plan must be based on a thorough understanding of the potential for beneficial response and an awareness of the acute and later toxicities of each component of the treatment regimen. As a general rule, the medical oncologist is urged to use standard regimens as described in the Physician Data Query (PDQ) system of the National Cancer Institute (NCI).a PDQ contains information on state-ofthe- art treatments for each pathologic type of cancer, as well as a listing of experimental protocols for each disease. An important alternative to “standard” therapy is the clinical trial, which should be considered for every eligible patient. Such trials offer alternative treatment that is thought by a panel of experts to be at least as effective as the recognized standard of care. In phase III (randomized) trials, a standard regimen is compared with a new one that may represent an improvement. With either choice, standard therapy or a clinical trial, the medical oncologist must understand the potential benefits and risks of using specific drugs or combinations of drugs, or combinations of drugs and biologics, often integrated with surgery and irradiation. All these considerations enter into the choice of a treatment plan. Steps in the treatment decision-making process are discussed in this chapter to provide the reader with an understanding of the overall role of drugs in cancer treatment.
Content
- Clinical Strategies for Cancer Treatment: The Role of Drugs
- Preclinical Aspects of Cancer Drug Discovery and Development
- Pharmacokinetics
- Infertility After Cancer Chemotherapy
- Carcinogenesis of Anticancer Drugs
- Antifolates
- 5-Fluoropyrimidines
- Cytidine Analogues
- Purine Antimetabolites
- Hydroxyurea
- Antimicrotubule Agents
- Clinical and High-Dose Alkylating Agents
- Nonclassic Agents
- Cisplatin, Carboplatin, and Oxaliplatin
- Bleomycin
- Antitumor Antibiotics
- Topoisomerase I–Targeting Drugs
- Anthracyclines and Anthracenediones
- Topoisomerase II Inhibitors: The Epipodophyllotoxins, Acridines, and Ellipticines
- Asparaginase
- Delivering Anticancer Drugs to Brain Tumors
- Food and Drug Administration Role in Oncology Product Development
- Central Venous Catheters: Care and Complications
- Pharmacogenetics
- New Targets for Anticancer Therapeutics
- Bisphosphonates
- Thalidomide and Its Analogs for the Treatment of Hematologic Malignancies, Including Multiple Myeloma and Solid Tumors
- Inhibitors of Tumor Angiogenesis
- Proteasome Inhibitors
- Molecular Targeted Drugs and Growth Factor Receptor Inhibitors
- Antibody Therapies of Cancer
- Interferons
- Adoptive Cellular Therapies
- Cancer Vaccines
- Hematopoietic Growth Factors
- Interleukins
- Hormonal Therapy for Breast Cancer
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