The Current Status of Cancer Chemotherapy

Abstract

It is obviously preferable to prevent rather than cure any disease, and cancer is no exception; but, despite current efforts that will undoubtedly be rewarding in the long run, it seems unlikely that preventative measures will reduce the incidence of human cancer significantly in the foreseeable future, particularly since the median age of the human population continues to increase. At the same time, chemotherapy is today providing increasing cure rates in 10–15 forms of human cancer [1–3]; and recent developments, particularly in surgical adjuvant therapy in the management of breast cancer and osteogenic sarcoma, indicate that new diseases will be added to the list. An examination of the events leading to the current successes in chemotherapy shows that they have resulted from the development of a greater variety of agents, of superior agents, and from the improved use of both old and new agents, attributable to our better understanding of effects of drugs on cells, both normal and cancerous. Although continued improvements int he use of available agents (such as early treatment of presently refractory tumors that today are treated only terminally in desperation when failure is thus assured) can be expected, it is clear that there are limits to this approach. For the immediate future, the use of combination chemotherapy and combined modalities — surgical adjuvant therapy, radiation and chemotherapy — seems sure to provide better responses and response rates. but again there are limits to reasonable expectations.