PRINCIPLES OF CHEMOTHERAPY IN CANCER TREATMENT

Chemotherapy is one of the principal methods of treating oncological diseases: the drugs spread through the bloodstream throughout the body and act on both the primary tumor and metastases. This article analyzes the mechanisms of action of the main groups of cytostatic agents, namely alkylating agents, antimetabolites, topoisomerase inhibitors, and antitubulin agents, in relation to the phases of the cell cycle. The principles of combination regimens and the aims and effectiveness of neoadjuvant and adjuvant chemotherapy are described. Particular attention is paid to the mechanisms of drug resistance in tumor cells, including the Goldie–Coldman hypothesis. The main toxic complications, such as bone marrow suppression, nausea, cardiotoxicity, and neurotoxicity, and ways of preventing them are also considered. The combination of chemotherapy with targeted therapy and immunotherapy is discussed. The findings may be useful for individualizing treatment.