Tumor therapy (surgical, radiation, chemo, targeted molecular and immunotherapy)

1. Overview

Cancer therapy is divided into local (surgery, radiotherapy) and systemic (chemotherapy, hormone, targeted, immunotherapy) modalities, increasingly guided by precision medicine (“right drug, right patient, right dose, right time”).

2. Local therapy

• Surgery — curative vs palliative; resection of regional lymph nodes; pathologist assesses margins.
• Radiotherapy — ionizing radiation causes DNA damage; used post-op or independently, often combined with chemo.

3. Chemotherapy

Cytostatic/cytotoxic drugs causing DNA damage / cell-cycle inhibition:

Class	Examples
Alkylating agents	Cyclophosphamide, ifosfamide
Platinum agents	Cisplatin, carboplatin
Antimetabolites	Methotrexate, 5-FU, gemcitabine
Anti-tumor antibiotics	Doxorubicin, bleomycin, dactinomycin
Plant alkaloids	Taxanes (paclitaxel), vinca alkaloids (vincristine)

4. Targeted therapy

• Monoclonal antibodies (“-mab”): Rituximab (anti-CD20, B-cell lymphoma), Trastuzumab (anti-HER2, breast), Cetuximab (anti-EGFR, colon).
• Small-molecule inhibitors (“-nib”): Erlotinib/Gefitinib (EGFR, NSCLC), Crizotinib (ALK, NSCLC), Vemurafenib (BRAF, melanoma), Imatinib (BCR-ABL, CML), Sunitinib (VEGF, renal), Venetoclax (BCL-2), Ibrutinib (BTK).

5. Hormone & immunotherapy

• Hormone therapy — tamoxifen (ER+ breast), anti-androgens (prostate).
• Immunotherapy — checkpoint inhibitors (anti-PD-1/PD-L1, anti-CTLA-4), CAR T-cells (anti-CD19 for B-cell malignancies), tumor vaccines.

💡 High-yield: Local (surgery, radiation) vs systemic. Chemo classes: alkylating, platinum, antimetabolites, antibiotics, plant alkaloids. Targeted: -mab = antibody (Rituximab/CD20, Trastuzumab/HER2, Cetuximab/EGFR), -nib = kinase inhibitor (Imatinib/BCR-ABL, Erlotinib/EGFR). Immuno: checkpoint inhibitors (PD-1/CTLA-4) + CAR-T (CD19).