Chemotherapy

Description

The promise of chemotherapeutic control in the field of oncology seemed, in the beginning, no less bright than it had proven in the field of bacterial disease, and, therefore, its failures were felt all the more. Despite the serendipitous discoveries and inspired insights which tantalized us with striking remissions, or the rare tumors which proved to be fully susceptible to a given agent, in the main, there has been either total failure or a painfully slow acquisition of an armamentarium against a limited number of malignancies. To expect more, however, was the result of ignorance of the malignant cell, for, as has been described in the previous volumes of this series, the exploitable differences between malignant and normal cells are few or undiscovered. "Differences" is the "numerator" in this formula, but "exploitable" is the operational term, for, although a great number of differences bet\\\een normal and malignant cells have been described, rarely are these differences observed in a vital metabolic pathway or a crucial macromolecu­ lar structure. Essentially, the basic metabolic pathways and nutritional require­ ments for :lOrmal and malignant cells are the same, resulting in the fact that no chemotherapeutic agent can successfully inhibit a function in the majority of malignant cells without adversely affecting a similar function in the normal cell. It was, therefore, naive to expect a "magic bullet" which would select the malignant cell and destroy it. Front Matter....Pages i-xxi Front Matter....Pages 1-1 Factors That Influence the Therapeutic Response....Pages 3-27 Applications of Cell Kinetic Techniques to Human Malignancies....Pages 29-58 Toxicity of Chemotherapeutic Agents....Pages 59-111 Clinical Aspects of Resistance to Antineoplastic Agents....Pages 113-143 Adjunctive Chemotherapy....Pages 145-162 Principles of Combination Chemotherapy....Pages 163-190 Intraarterial Chemotherapy....Pages 191-205 Treatment of Malignant Disease in Closed Spaces....Pages 207-222 Supportive Care in the Cancer Patient....Pages 223-282 Front Matter....Pages 283-283 Alkylating Agents and the Nitrosoureas....Pages 285-307 Purine Antagonists....Pages 309-326 Pyrimidine Antagonists....Pages 327-361 Folate Antagonists....Pages 363-377 Plant Alkaloids....Pages 379-425 Antibiotics: Nucleic Acids As Targets in Chemotherapy....Pages 427-456 Enzyme Therapy....Pages 457-487 Hydrazines and Triazenes....Pages 489-519 Antitumor Effects of Interferon....Pages 521-571 The Physiology of Endocrine Therapy....Pages 573-597 New Anticancer Drug Design: Past and Future Strategies....Pages 599-652 Back Matter....Pages 653-666