11. Cancer.ppt

Limitations of Cytotoxic Chemotherapy Narrow therapeutic index (tox cancer/tox normal cell 1) Primary resistance (some cancers never respond to drugs) Secondary resistance (most cancers become resistant after exposure to chemotherapy) Dose-limiting toxicities (can’t use higher doses due to lethality/morbidity of toxicities) Minimal residual disease Condition of the patient (health status, co-morbidities) Rationale for Combination Chemotherapy Partial or complete primary resistance is common, and emergence of secondary resistance upon exposure to one drug is rapid Multiple drugs given at once e