Neoplastic Heterogeneity and Clinical Chemotherapy

Abstract

Cancer chemotherapy is a modality in transition. In its early days, chemotherapy was viewed with skepticism by many, and its pioneers were forced to emphasize its positives in an aggressively defensive manner. In the early 1970s, chemotherapy appeared poised to possibly become a dominant modality. This was caused by the concept of adjuvant chemotherapy which appeared validated by the early relapse-free survival gains reported in the treatment of primary breast cancer. A decade later it is obvious that adjuvant chemotherapy is not a dramatic breakthrough and that the modality itself has plateaued in its ability to cure and palliate malignant disease.