INTERNATIONAL CONGRESS OF
PharmacoGenetics
Chemotherapy: Evolving Strategies for Effective Cancer Treatment
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Fatemeh Sadat Shojaeddin,1 Safura Pakizehkar,2,*
1. Bachelor’s student. Department of Microbiology, Faculty of Modern Science and Technologies, Tehran Medical Science, Islamic Azad University, Tehran
2. Cellular and Molecular Endocrine Research Center (CMERC), Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Introduction: The advent of chemotherapy has transformed the prognosis of cancer from a uniformly fatal disease to one that can be effectively treated and, in some cases, cured when administered correctly. The objective of chemotherapy is to impede the proliferation and multiplication of cells, thereby preventing the invasion and metastasis that are hallmarks of cancer. However, this approach inevitably results in toxic effects on normal cells as well. Chemotherapy may be divided into two principal categories: traditional chemotherapy and combination chemotherapy. Traditional chemotherapy agents exert their effects on neoplastic cells by interfering with the synthesis and functioning of macromolecules, including nucleic acids (DNA and RNA) and proteins. This can either disrupt the appropriate functioning of preformed molecules or affect the synthesis of new macromolecules. Consequently, the death of the cells may be delayed, depending on the agent and the treatment regimen used. The use of combination chemotherapy is a common approach to achieving adequate responses, as well as preventing the emergence of resistant clones, by promoting cell death in both resting and dividing cells. Combination therapy, also known as multitargeted therapy, has been demonstrated to have superior efficacy compared to traditional single-agent therapies in the majority of cancer treatments. This is attributed to the diverse mechanisms of action of these combination therapies, which can lead to a more optimal therapeutic ratio compared to traditional chemotherapy. The potential for decreased resistance and reduced toxicities associated with these therapies can be further exploited through the strategic selection of agents. It is a common assumption that chemotherapeutic agents are associated with a range of side effects. The side effects of chemotherapy are typically a reflection of the mechanism of action of the agents used. For example, agents that are metabolized and excreted by the liver or kidneys can lead to increase toxic levels that can cause dysfunction of these organs and others. Therefore, dose adjustments are essential for patients with organ failure. For instance, the dosage of capecitabine must be modified for patients with renal disease. Moreover, the majority of chemotherapy drugs demonstrate efficacy against rapidly dividing cells, resulting in rapid impact on proliferating cells, including those in the bone marrow, gastrointestinal tract, and hair follicles. The most commonly observed adverse effects associated with these agents include myelosuppression, mucositis, nausea, vomiting, diarrhea, alopecia, fatigue, sterility, infertility, and infusion reactions.
- Methods: The research methodology entailed an extensive search across PubMed, Google Scholar, and NCBI databases to locate articles pertinent to Chemotherapy. A comprehensive literature review was conducted to identify studies investigating Chemotherapy: Evolving Strategies for Effective Cancer Treatment. Electronic databases were searched using relevant keywords, and studies published between 2023 and 2016 were included. The review encompassed clinical trials to provide a comprehensive understanding of the topic.
- Results: While many strategies focus on modifying the native tumor microenvironment by chemotherapy, there is an alternative strategy. Injecting oncolytic viruses directly into the tumor microenvironment is an alternative technique for improving tumor antigen recognition and strengthening T cell responses. Talimogene laherparepvec (T-VEC) is a modified herpes simplex virus that is injected intra-lesionally into the melanoma tumor in individuals who have failed to get their tumor removed. It induces immediate lysis of tumor cells and the production of granulocyte-macrophage colony-stimulating factor (GM-CSF).
- Conclusion: It can be concluded that clinical practice in the area of cancer chemotherapy has achieved considerable success; however, there are still opportunities for further improvement, particularly in terms of the efficacy and safety of the chemotherapeutic regimes used. A team-based approach to monitoring is essential for patients undergoing chemotherapy, given the potential for adverse events. The role of nursing and allied health professionals is to provide supportive care, prevent infections, monitor for adequate nutrition and hydration, and monitor patient safety. Handwashing and infection precautions, such as isolation protocols, require strict adherence. Given the necessity for frequent laboratory monitoring in patients, it is of the utmost importance for them to possess a comprehensive understanding of the infusion protocols and to be able to identify any abnormalities in the parameters. In such instances, it is imperative that they promptly alert the treating clinicians. The implementation of early nursing interventions has the potential to prevent adverse outcomes in patients. It is of paramount importance to identify the most common causes of errors associated with cancer chemotherapy and to quantify their impact. Interventions aimed at enhancing communication, standardizing protocols, and implementing measures such as read back and verification of dosages can collectively contribute to reducing medical errors in a multidisciplinary setting. Collaborating with and consulting pharmacists also plays an important role in ensuring the accuracy and safety of medication administration.
- Keywords: Chemotherapy, Cancer, Traditional Chemotherapy, Traditional Chemotherapy, side effects
