Chemotherapy
Drugs that kill fast-dividing cells. Still the backbone of many cures, and now the warhead inside smarter drugs.
Cytotoxics (platinums, taxanes, anthracyclines, antimetabolites, topoisomerase inhibitors) remain curative in several cancers and are the payloads of antibody-drug conjugates. Progress is in dosing, sequencing, biomarker-guided de-escalation, and toxicity mitigation.
Collect the patient's own blood-forming stem cells, give a very high dose of chemotherapy that would otherwise destroy the marrow, then give the cells back to rebuild it.
Giving the same drug at a different time of day, because the body clock changes how much damage it does and how well the immune system responds.
Cytotoxic chemotherapy drugs kill rapidly dividing cells. They are still curative in testicular cancer, lymphoma, leukaemia, and many early-stage cancers, and they are the warhead inside ADCs.
Moderate exercise while on chemotherapy is safe and reduces fatigue, helps people finish their planned doses, and may protect the heart and nerves.
Eating very little for a few days around each chemotherapy dose might protect normal cells and sensitise the tumour. Early trials are intriguing but small, and it is not something to try without a dietitian.
Keeping cheap, essential chemotherapy drugs like cisplatin available; shortages in 2023 forced rationing in US hospitals.
Washing the abdominal cavity with heated chemotherapy during surgery to kill microscopic peritoneal deposits.
A harmless molecule that turns into a poison only where there is no oxygen, which in the body means inside a tumour.
Infusion devices are the implanted ports, smart pumps, and take-home pumps that deliver chemotherapy safely, including 46-hour infusions patients carry home.
Removing an amino acid or nutrient that certain tumours cannot make for themselves, while normal cells can.
Robots and closed systems that prepare chemotherapy doses safely, protecting pharmacists from hazardous drugs and patients from errors.
Scan after two cycles of chemotherapy; if the tumour has gone dark, give less treatment, and if not, give more. Hodgkin lymphoma pioneered this.
Platinum agents such as cisplatin and carboplatin work by crosslinking DNA. They are curative in testicular cancer and central to lung, ovarian, bladder, head and neck, and TNBC treatment.
Two rounds of very high-dose chemotherapy with stem-cell rescue, back to back, used in high-risk neuroblastoma in North America.
Topoisomerase-I inhibitors work by jamming the enzyme that untangles DNA during copying. They are weak as free drugs in many cancers, but devastating when delivered by an ADC.
A catheter threaded into the artery feeding a liver tumour delivers chemotherapy and then blocks the vessel, starving the tumour from inside.