Cancer chemotherapy hormonal agents

Finally, therapeutic sequencing of different hormonal agents is fast becoming a common clinical practice, and fulvestrant is a good treatment choice to extend the opportunity for using endocrine therapies before reliance upon cytotoxic chemotherapy is necessary. Further research is required in order to evaluate the optimal sequence, both in clinical practice as well as in the laboratory, to choose the correct treatment of breast cancer in each person after the appearance of tamoxifen-induced drug resistance (Robertson 2004 Osipo et al. 2004 Johnston 2004 Robertson et al. 2005). 

CHEMOTHERAPEUTICS. ANTICANCER. Cancer is second only to cardiovascular disease as the principal cause of human mortality. As the median age of populations has risen, total deaths from cancer have increased. Treatment of cancer includes surgery, radiation, and chemotherapy, die last encompassing the use of both cytotoxic agents and relatively nnntoxic hormonal agents for the control of tumor growth. 

Drugs used in cancer chemotherapy are cytotoxic drugs, hormones, plant derivatives, radioactive isotopes, and miscellaneous agents (e.g., procarbazine, hydroxyurea, mitotane). The plant-based drugs vincristine, vinblastine, vinorel-bine, etoposide, and campothecins. Radioactive isotopes, such as 131 iodine (131 I), are used in the treatment of thyroid tumors. Cytotoxic drugs (e.g., cis-platin, cyclophosphamide, 6-mercaptopurine, 5-fluorouracil, and methotrexate are used for the treatment of cancer. 

Traditional chemotherapeutic strategies, on the assumption that the majority of the cells within tumor are actively proliferating, have used a variety of drugs and hormonal agents that interfere with the basic cellular machinery (e.g., DNA synthesis and replication, cell cycle, and cytoskeleton) [57]. However, because cancer cells share many properties with their normal counterparts, the serious, sometimes life-threatening, side effects that arise from toxicities to sensitive normal cells limit the efficacy of cytotoxic chemotherapy [58]. Improved understanding of the molecular alterations present in the cancer cells has enabled the... 

Modem cancer therapy has been primarily dependent upon surgery, radiotherapy, chemotherapy, and hormonal therapy (72) (see Chemotherapeutics,anticancer Hormones Radiopharmaceuticals). Chemotherapeutic agents maybe able to retard the rate of growth, but are unable to eradicate the entire population of neoplastic cells without significant destmction of normal host tissue. This serious side effect limits general use. More recentiy, the immunotherapeutic approach to cancer has involved modification and exploitation of the cellular and molecular mechanisms in host defense, regulation of tissue proliferation, tissue differentiation, and tissue survival. The results have been more than encouraging. 

Additionally, MMPIs are not expected to replace currently used, proven-effective modalities of cancer treatment such as radiotherapy, hormonal/chemotherapy, or surgery. It is predicted that they will be clinically developed for use in combination with these agents. As expected, given nonoverlapping toxicities and differing mechanisms of action, MMPIs have been combined preclinically with radiation therapy (4), cytotoxic (5-9), resultant additive or supraadditive efficacy. With these data in mind, the ability to combine an MMPI with radiation therapy, chemotherapy, and hormonal therapy may become an important feature in the ultimate clinical success of these agents. 

Secondary therapies, including alternate hormonal therapies, antiandrogen withdrawal in a patient receiving CAB, chemotherapy, local radiotherapy, or supportive care can provide disease palliation. Continued efforts to develop new agents with novel mechanisms of action that prolong survival are ongoing. Further insight into the molecular basis for prostate cancer development may provide new therapeutic approaches. 

Murphy GP, Beckley S, Brady ME, et al. Treatment of newly diagnosed metastatic prostate cancer patients with chemotherapy agents in combination with hormones versus hormones alone. Cancer 1983 51 1264-1272. 

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