Chemotherapy

The main families are DNA-damaging agents (platinums such as cisplatin and carboplatin, alkylators such as cyclophosphamide), antimetabolites that poison DNA building blocks (5-fluorouracil, gemcitabine, methotrexate), topoisomerase inhibitors (irinotecan, etoposide, doxorubicin) and microtubule poisons that jam cell division (paclitaxel, docetaxel, vincristine). Given in cycles to let normal tissue recover, chemotherapy cures some cancers outright (testicular cancer, many lymphomas and childhood leukaemias), prevents recurrence after surgery, and controls advanced disease; it remains the backbone that newer drugs are added to. Its potency is also being repurposed: ADC payloads are chemotherapy agents far too toxic to give alone, delivered by antibody straight to the tumour.