The present state of development of cancer chemotherapy.

Cancer chemotherapy has evolved through 3 decades of remarkable progress. At the present time over 40 drugs and biologicals are employed in the treatment of cancer, and hundreds of promising compounds and analogs await their turn in the clinic. The medical management of cancer patients with chemotherapy has developed into a recognized subspecialty--medical oncology, a discipline that now works closely and effectively with surgery and radiotherapy in planning treatment strategies. Major areas of progress to date include the concept of combination chemotherapy, the development of hematologic and microbiologic supportive care, and the demonstration of effective adjuvant chemotherapy. Further progress is anticipated in a number of areas: rational selection of anticancer compounds based on metabolic or kinetic vulnerability; increased attention to biologic substances that modify neoplastic cell behavior; continued refinement of doses and schedules of active compounds to optimize therapeutic benefit and minimize toxicity; awareness of novel methods of drug delivery; and development of physical or chemical modifications to enhance drug effects.