Chemotherapy and Hormonal Therapies for Cancer: An Overview

Chemo-hormonal antineoplastic agents encompass cytotoxic chemotherapy and endocrine therapies used to treat malignancies.

Major Drug Classes

• Alkylating agents: Cyclophosphamide, cisplatin—DNA crosslinks → cell death.
• Antimetabolites: 5-FU, methotrexate, gemcitabine—mimic purines/pyrimidines → block DNA synthesis.
• Antimitotics (spindle poisons): Vinca alkaloids (vincristine), taxanes (paclitaxel)—disrupt microtubule dynamics → mitotic arrest.
• Topoisomerase inhibitors: Etoposide, irinotecan—block DNA unwinding.
• Hormonal agents: Tamoxifen, aromatase inhibitors (breast); androgen deprivation (prostate)—block hormone-driven growth.
• Targeted therapies: Kinase inhibitors, monoclonal antibodies, PARP inhibitors—target specific molecular alterations.

Common Side Effects

• Nausea/vomiting, alopecia, fatigue, myelosuppression, mucositis, diarrhea, neuropathy.
• Most are transient; supportive care (growth factors, antiemetics, dose adjustment) mitigates severity.

Role in Cancer Care

Used as neoadjuvant (pre-surgery), adjuvant (post-surgery), definitive (non-surgical), or palliative treatment. Combination regimens exploit synergistic mechanisms. Precision oncology increasingly matches therapy to tumor genomics.