AccScience Publishing / MI / Online First / DOI: 10.36922/MI025450119
Submit to MI
Cite this article
7
Download
39
Views
Related Info Links
Google Scholar
More by Authors Links
Murad Novruzov
Journal Browser
Volume | Year
Issue
Search
Forthcoming Issue
Current Issue
View All
News and Announcements
View All
REVIEW ARTICLE

Cancer treatment: A review of methods, drug combinations, availability, and ethical considerations

Murad Novruzov1,2,3* ,  Marziyya Mammadova3,4,5 ,  Waseem Ullah Khan6
Show Less
1 Murad Novruzov Biomedical Research, Baku, Azerbaijan
2 Health Science Program, University of The People, Pasadena, California, United States of America
3 Azerbaijan Science and Health Initiatives, Baku, Azerbaijan
4 Department of Neurology and Clinical Neurophysiology, Azerbaijan State Advanced Training Institute for Doctors named after Aziz Aliyev, Baku, Azerbaijan
5 Ministry of Health of Azerbaijan, Baku, Azerbaijan
6 National Institute of Health, Islamabad, Pakistan
MI, 025450119 https://doi.org/10.36922/MI025450119
Received: 30 December 2025 | Revised: 13 February 2026 | Accepted: 30 April 2026 | Published online: 10 July 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Download PDF
XML
Cite
Abstract

Cancer remains a major clinical challenge that requires adaptive strategies. This review synthesizes principal therapeutic modalities, with emphasis on drug resistance, how drugs are ordered, and dealing with side effects while keeping the patient in mind. Evidence from pivotal trials and real-world practice demonstrates that resistance affects the treatments selected. Side effects and patient situations are considered to find the right balance between the treatment’s effectiveness and the patient’s quality of life. This review also examines the sequencing of chemotherapy with immune checkpoint blockade, as well as new approaches such as messenger RNA vaccines and proteolysis-targeting chimeras. Cross-cutting issues—including treatment standards, ethical considerations, and economic barriers—are discussed to help shape future cancer care delivery.

Keywords
Cancer treatment
Therapeutic resistance
Treatment sequencing
Immunotherapy
Targeted therapy
Patient-reported outcomes
Global health equity
Funding
None.
Conflict of interest
The authors declare no conflicts of interest related to this work.
References
  1. Gandhi L, Rodríguez-Abreu D, Gadgeel S, et al. Pembrolizumab plus Chemotherapy in Metastatic Non- Small-Cell Lung Cancer. N Engl J Med. 2018;378(22):2078- 2092. doi: 10.1056/NEJMoa1801005

 

  1. Paz-Ares L, Luft A, Vicente D, et al. Pembrolizumab plus Chemotherapy for Squamous Non-Small-Cell Lung Cancer. N Engl J Med. 2018;379(21):2040-2051. doi: 10.1056/NEJMoa1810865

 

  1. Socinski MA, Jotte RM, Cappuzzo F, et al; IMpower150 Study Group. Atezolizumab for first-line treatment of metastatic nonsquamous NSCLC. N Engl J Med. 2018;378(24):2288- 2301. doi: 10.1056/NEJMoa1716948

 

  1. Larkin J, Chiarion-Sileni V, Gonzalez R, et al. Combined nivolumab and ipilimumab or monotherapy in untreated melanoma. N Engl J Med. 2015;373(1):23-34. doi: 10.1056/NEJMoa1504030

 

  1. Swain SM, Baselga J, Kim SB, et al. Pertuzumab, trastuzumab, and docetaxel in HER2-positive metastatic breast cancer. N Engl J Med. 2015;372(8):724-734. doi: 10.1056/NEJMoa1413513

 

  1. von Minckwitz G, Procter M, de Azambuja E, et al. Adjuvant Pertuzumab and Trastuzumab in Early HER2-Positive Breast Cancer. N Engl J Med. 2017;377(2):122-131. doi: 10.1056/NEJMoa1703643

 

  1. Pellino G, Alós R, Biondo S, et al. Trends and outcome of neoadjuvant treatment for rectal cancer: A retrospective analysis and critical assessment of a 10-year prospective national registry on behalf of the Spanish Rectal Cancer Project. Eur J Surg Oncol. 2021;47(2):276-284. doi: 10.1016/j.ejso.2020.04.056

 

  1. Needham MJ, Webb CE, Bryden DC. Postoperative cognitive dysfunction and dementia: what we need to know and do. Br J Anaesth. 2017;119(S1):i115-i125. doi: 10.1093/bja/aex354

 

  1. Soria JC, Ohe Y, Vansteenkiste J, et al. Osimertinib in Untreated EGFR-Mutated Advanced Non-Small-Cell Lung Cancer. N Engl J Med. 2018;378(2):113-125. doi: 10.1056/NEJMoa1713137

 

  1. Patel SR, Neal JW. Adjuvant osimertinib for resected EGFR-mutated non-small cell lung cancer: a game-changer? Transl Lung Cancer Res. 2023;12(7):1631-1635. doi: 10.21037/tlcr-23-273

 

  1. Wu YL, Tsuboi M, He J, et al. Osimertinib in Resected EGFR-Mutated Non-Small-Cell Lung Cancer. N Engl J Med. 2020;383(18):1711-1723. doi: 10.1056/NEJMoa2027071

 

  1. Planchard D, Smit EF, Groen HJM, et al. Dabrafenib plus trametinib in patients with previously untreated BRAFV600E-mutant metastatic non-small-cell lung cancer: an open-label, phase 2 trial. Lancet Oncol. 2017;18(10):1307- 1316. doi: 10.1016/S1470-2045(17)30679-4

 

  1. Diéras V, Miles D, Verma S, et al. Trastuzumab emtansine versus capecitabine plus lapatinib in patients with previously treated HER2-positive advanced breast cancer (EMILIA): a descriptive analysis of final overall survival results from a randomised, open-label, phase 3 trial. Lancet Oncol. 2017;18(6):732-742. doi: 10.1016/S1470-2045(17)30312-1

 

  1. Hurvitz SA, Kim SB, Chung WP, et al. Trastuzumab deruxtecan versus trastuzumab emtansine in HER2-positive metastatic breast cancer patients with brain metastases from the randomized DESTINY-Breast03 trial. ESMO Open. 2024;9(5):102924. doi: 10.1016/j.esmoop.2024.102924

 

  1. Neelapu SS, Locke FL, Bartlett NL, et al. Axicabtagene Ciloleucel CAR T-Cell Therapy in Refractory Large B-Cell Lymphoma. N Engl J Med. 2017;377(26):2531-2544. doi: 10.1056/NEJMoa1707447

 

  1. Bishop MR, Maziarz RT, Waller EK, et al. Tisagenlecleucel in relapsed/refractory diffuse large B-cell lymphoma patients without measurable disease at infusion. Blood Adv. 2019;3(14):2230-2236. doi: 10.1182/bloodadvances.2019000151

 

  1. Munshi NC, Anderson LD Jr, Shah N, et al. Idecabtagene Vicleucel in Relapsed and Refractory Multiple Myeloma. N Engl J Med. 2021;384(8):705-716. doi: 10.1056/NEJMoa2024850

 

  1. Abramson JS, Palomba ML, Gordon LI, et al. Lisocabtagene maraleucel for patients with relapsed or refractory large B-cell lymphomas (TRANSCEND NHL 001): a multicentre seamless design study. Lancet. 2020;396(10254):839-852. doi: 10.1016/S0140-6736(20)31366-0

 

  1. Lupo JM, Nelson SJ. Advanced magnetic resonance imaging methods for planning and monitoring radiation therapy in patients with high-grade glioma. Semin Radiat Oncol. 2014;24(4):248-258. doi: 10.1016/j.semradonc.2014.06.008

 

  1. Petroni G, Cantley LC, Santambrogio L, Formenti SC, Galluzzi L. Radiotherapy as a tool to elicit clinically actionable signalling pathways in cancer. Nat Rev Clin Oncol. 2022;19(2):114-131. doi: 10.1038/s41571-021-00579-w

 

  1. Bentzen SM, Constine LS, Deasy JO, et al. Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC): an introduction to the scientific issues. Int J Radiat Oncol Biol Phys. 2010;76(S3):S3-S9. doi: 10.1016/j.ijrobp.2009.09.040

 

  1. Chang JY, Senan S, Paul MA, et al. Stereotactic ablative radiotherapy versus lobectomy for operable stage I non-small-cell lung cancer: a pooled analysis of two randomised trials. Lancet Oncol. 2015;16(6):630-637. doi: 10.1016/S1470-2045(15)70168-3

 

  1. Kim N, Choi SH, Chang JS, et al. Use of bevacizumab before or after radiotherapy increases the risk of fistula formation in patients with cervical cancer. Int J Gynecol Cancer. 2021;31(1):59-65. doi: 10.1136/ijgc-2020-002031

 

  1. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-249. doi: 10.3322/caac.21660

 

  1. Prasanna PGS, Ahmed MM, Hong JA, Coleman CN. Best practices and novel approaches for the preclinical development of drug-radiotherapy combinations for cancer treatment. Lancet Oncol. 2024;25(10):e501-e511. doi: 10.1016/S1470-2045(24)00199-2

 

  1. Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018;391(10125):1023-1075. doi: 10.1016/S0140-6736(17)33326-3

 

  1. Modest DP, Stintzing S, von Weikersthal LF, et al. Impact of Subsequent Therapies on Outcome of the FIRE-3/AIO KRK0306 Trial: First-Line Therapy With FOLFIRI Plus Cetuximab or Bevacizumab in Patients With KRAS Wild- Type Tumors in Metastatic Colorectal Cancer. J Clin Oncol. 2015;33(32):3718-3726. doi: 10.1200/JCO.2015.61.2887

 

  1. Conroy T, Desseigne F, Ychou M, et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med. 2011;364(19):1817-1825. doi: 10.1056/NEJMoa1011923

 

  1. El Sayed R, El Jamal L, El Iskandarani S, Kort J, Abdel Salam M, Assi H. Endocrine and Targeted Therapy for Hormone- Receptor-Positive, HER2-Negative Advanced Breast Cancer: Insights to Sequencing Treatment and Overcoming Resistance Based on Clinical Trials. Front Oncol. 2019;9:510. doi: 10.3389/fonc.2019.00510

 

  1. Burstein HJ, Somerfield MR, Barton DL, et al. Endocrine Treatment and Targeted Therapy for Hormone Receptor- Positive, Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer: ASCO Guideline Update. J Clin Oncol. 2021;39(35):3959-3977. doi: 10.1200/JCO.21.01392

 

  1. Finn RS, Martin M, Rugo HS, et al. Palbociclib and Letrozole in Advanced Breast Cancer. N Engl J Med. 2016;375(20):1925-1936. doi: 10.1056/NEJMoa1607303

 

  1. Sledge GW Jr, Toi M, Neven P, et al. MONARCH 2: Abemaciclib in Combination With Fulvestrant in Women With HR+/HER2- Advanced Breast Cancer Who Had Progressed While Receiving Endocrine Therapy. J Clin Oncol. 2017;35(25):2875-2884. doi: 10.1200/JCO.2017.73.7585

 

  1. O’Shaughnessy J, Petrakova K, Sonke GS, et al. Ribociclib plus letrozole versus letrozole alone in patients with de novo HR+, HER2- advanced breast cancer in the randomized MONALEESA-2 trial. Breast Cancer Res Treat. 2018;168(1):127-134. doi: 10.1007/s10549-017-4518-8

 

  1. Fizazi K, Tran N, Fein L, et al. Abiraterone acetate plus prednisone in patients with newly diagnosed high-risk metastatic castration-sensitive prostate cancer (LATITUDE): final overall survival analysis of a randomised, double-blind, phase 3 trial. Lancet Oncol. 2019;20(5):686-700. doi: 10.1016/S1470-2045(19)30082-8

 

  1. Chi KN, Agarwal N, Bjartell A, et al. Apalutamide for Metastatic, Castration-Sensitive Prostate Cancer. N Engl J Med. 2019;381(1):13-24. doi: 10.1056/NEJMoa1903307

 

  1. Conroy T, Hammel P, Hebbar M, et al. FOLFIRINOX or Gemcitabine as Adjuvant Therapy for Pancreatic Cancer. N Engl J Med. 2018;379(25):2395-2406. doi: 10.1056/NEJMoa1809775

 

  1. Holohan C, Van Schaeybroeck S, Longley DB, Johnston PG. Cancer drug resistance: an evolving paradigm. Nat Rev Cancer. 2013;13(10):714-726. doi: 10.1038/nrc3599

 

  1. Haanen JBAG, Carbonnel F, Robert C, et al. Management of toxicities from immunotherapy: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017;28(S4):iv119-iv142. doi: 10.1093/annonc/mdx225

 

  1. Hesketh PJ, Kris MG, Basch E, et al. Antiemetics: ASCO Guideline Update. J Clin Oncol. 2020;38(24):2782-2797. doi: 10.1200/JCO.20.01296

 

  1. Hurria A, Togawa K, Mohile SG, et al. Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study. J Clin Oncol. 2011;29(25):3457-3465. doi: 10.1200/JCO.2011.34.7625

 

  1. Caudle KE, Thorn CF, Klein TE, et al. Clinical Pharmacogenetics Implementation Consortium guidelines for dihydropyrimidine dehydrogenase genotype and fluoropyrimidine dosing. Clin Pharmacol Ther. 2013;94(6):640-645. doi: 10.1038/clpt.2013.172

 

  1. Salas-Vega S, Iliopoulos O, Mossialos E. Assessment of Overall Survival, Quality of Life, and Safety Benefits Associated With New Cancer Medicines. JAMA Oncol. 2017;3(3):382-390. doi: 10.1001/jamaoncol.2016.4166

 

  1. Prasad V, De Jesús K, Mailankody S. The high price of anticancer drugs: origins, implications, barriers, solutions. Nat Rev Clin Oncol. 2017;14(6):381-390. doi: 10.1038/nrclinonc.2017.31

 

  1. Motzer RJ, Tannir NM, McDermott DF, et al. Nivolumab plus Ipilimumab versus Sunitinib in Advanced Renal-Cell Carcinoma. N Engl J Med. 2018;378(14):1277-1290. doi: 10.1056/NEJMoa1712126

 

  1. Reck M, Rodríguez-Abreu D, Robinson AG, et al. Pembrolizumab versus Chemotherapy for PD-L1- Positive Non-Small-Cell Lung Cancer. N Engl J Med. 2016;375(19):1823-1833. doi: 10.1056/NEJMoa1606774

 

  1. Guckenberger M, Lievens Y, Bouma AB, et al. Characterisation and classification of oligometastatic disease: a European Society for Radiotherapy and Oncology and European Organisation for Research and Treatment of Cancer consensus recommendation. Lancet Oncol. 2020;21(1):e18-e28. doi: 10.1016/S1470-2045(19)30718-1

 

  1. de Gramont A, Figer A, Seymour M, et al. Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol. 2000;18(16):2938-2947. doi: 10.1200/JCO.2000.18.16.2938

 

  1. Gottesman MM. Mechanisms of cancer drug resistance. Annu Rev Med. 2002;53(1):615-627. doi: 10.1146/annurev.med.53.082901.103929

 

  1. Chabner BA, Roberts TG Jr. Timeline: Chemotherapy and the war on cancer. Nat Rev Cancer. 2005;5(1):65-72. doi: 10.1038/nrc1529

 

  1. Longley DB, Harkin DP, Johnston PG. 5-fluorouracil: mechanisms of action and clinical strategies. Nat Rev Cancer. 2003;3(5):330-338. doi: 10.1038/nrc1074

 

  1. Min HY, Lee HY. Molecular targeted therapy for anticancer treatment. Exp Mol Med. 2022;54(10):1670-1694. doi: 10.1038/s12276-022-00864-3

 

  1. Arafat Hossain M. A comprehensive review of immune checkpoint inhibitors for cancer treatment. Int Immunopharmacol. 2024;143(Pt 2):113365. doi: 10.1016/j.intimp.2024.113365

 

  1. Marabelle A, Le DT, Ascierto PA, et al. Efficacy of Pembrolizumab in Patients With Noncolorectal High Microsatellite Instability/Mismatch Repair-Deficient Cancer: Results From the Phase II KEYNOTE-158 Study. J Clin Oncol. 2020;38(1):1-10. doi: 10.1200/JCO.19.02105

 

  1. Drilon A, Laetsch TW, Kummar S, et al. Efficacy of Larotrectinib in TRK Fusion-Positive Cancers in Adults and Children. N Engl J Med. 2018;378(8):731-739. doi: 10.1056/NEJMoa1714448

 

  1. Sachdev E, Tabatabai R, Roy V, Rimel BJ, Mita MM. PARP Inhibition in Cancer: An Update on Clinical Development. Target Oncol. 2019;14(6):657-679. doi: 10.1007/s11523-019-00680-2

 

  1. Postow MA, Callahan MK, Wolchok JD. Immune Checkpoint Blockade in Cancer Therapy. J Clin Oncol. 2015;33(17):1974-1982. doi: 10.1200/JCO.2014.59.4358

 

  1. Schmid P, Cortes J, Pusztai L, et al. Pembrolizumab for Early Triple-Negative Breast Cancer. N Engl J Med. 2020;382(9):810-821. doi: 10.1056/NEJMoa1910549

 

  1. Schmid P, Cortes J, Dent R, et al. Event-free Survival with Pembrolizumab in Early Triple-Negative Breast Cancer. N Engl J Med. 2022;386(6):556-567. doi: 10.1056/NEJMoa2112651

 

  1. Nguyen PL, Alibhai SM, Basaria S, et al. Adverse effects of androgen deprivation therapy and strategies to mitigate them. Eur Urol. 2015;67(5):825-836. doi: 10.1016/j.eururo.2014.07.010

 

  1. Naldini L. Gene therapy returns to centre stage. Nature. 2015;526(7573):351-360. doi: 10.1038/nature15818

 

  1. Stadtmauer EA, Fraietta JA, Davis MM, et al. CRISPR-engineered T cells in patients with refractory cancer. Science. 2020;367(6481):eaba7365. doi: 10.1126/science.aba7365

 

  1. Dötsch S, Svec M, Schober K, et al. Long-term persistence and functionality of adoptively transferred antigen-specific T cells with genetically ablated PD-1 expression. Proc Natl Acad Sci USA. 2023;120(10):e2200626120. doi: 10.1073/pnas.2200626120

 

  1. Rojas LA, Sethna Z, Soares KC, et al. Personalized RNA neoantigen vaccines stimulate T cells in pancreatic cancer. Nature. 2023;618(7963):144-150. doi: 10.1038/s41586-023-06063-y

 

  1. Abdullah KM, Sharma G, Singh AP, et al. Nanomedicine in cancer therapeutics: current perspectives from bench to bedside. Mol Cancer. 2025;24(1):169. doi: 10.1186/s12943-025-02368-w

 

  1. Lai AC, Crews CM. Induced protein degradation: an emerging drug discovery paradigm. Nat Rev Drug Discov. 2017;16(2):101-114. doi: 10.1038/nrd.2016.211

 

  1. Andtbacka RH, Kaufman HL, Collichio F, et al. Talimogene Laherparepvec Improves Durable Response Rate in Patients With Advanced Melanoma. J Clin Oncol. 2015;33(25):2780- 2788. doi: 10.1200/JCO.2014.58.3377

 

  1. Doudna JA, Charpentier E. Genome editing. The new frontier of genome engineering with CRISPR-Cas9. Science. 2014;346(6213):1258096. doi: 10.1126/science.1258096

 

  1. Argentiero A, Solimando AG, Brunetti O, et al. Skeletal Metastases of Unknown Primary: Biological Landscape and Clinical Overview. Cancers. 2019;11(9):1270. doi: 10.3390/cancers11091270

 

  1. Nelson BE, Janku F, Fu S, et al. Phase Ib Study of Pembrolizumab in Combination with Intratumoral Injection of Clostridium novyi-NT in Patients with Advanced Solid Tumors. Clin Cancer Res. 2025;31(18):3864-3875. doi: 10.1158/1078-0432.CCR-24-3952=-3976
Share
Back to top
Microbes & Immunity, Electronic ISSN: 3029-2883 Print ISSN: 3041-0886, Published by AccScience Publishing
We use cookies on our website to ensure you get the best experience.
Read more about our cookies here
Accept