Antineoplastic drugs, alone or in combination, may be used in the management of cancer to achieve:1-3
- chemoprevention (the use of natural or synthetic products or antineoplastic agents to prevent or suppress carcinogenesis in people highly susceptible to certain cancers)
- cure (all cancer cells destroyed, life expectancy unchanged)
- control (preventing or slowing the growth of a tumour to prolong survival)
- palliation (management of symptoms).
A number of terms describe the role of antineoplastic agents in cancer control:2, 4
- Induction: initial therapy administered with the aim of achieving significant cytoreduction, and ideally, complete remission of disease.
- Consolidation / intensification: administered following induction to prolong freedom from disease and overall survival. While consolidation therapy uses the same agents as induction therapy, intensification therapy uses agents which are non-cross resistant to induction therapy.
- Adjuvant treatment: antineoplastic agents used in conjunction with another treatment modality i.e. biotherapy, radiation therapy or surgery, and aimed at treating micro-metastases and preventing local recurrence.
- Neo-adjuvant treatment: use of antineoplastic agents to reduce the size of a tumour before definitive treatment.
- Maintenance therapy: prolonged, low-dose therapy administered to extend the duration of remission and achieve cure.
- Primary therapy: antineoplastic agents administered as the definitive therapy.
- Combination therapy: use two or more agents to treat the disease.
- Myeloablative therapy: prepares individuals for haematopoietic stem cell transplantation.
- Salvage therapy: agents given after failure of other treatments to control disease or provide palliation.
Access a current text or evidence based clinical guidelines and describe clinical examples of the use of antineoplastic agents with the goals of: