Modern Strategies in Cancer Therapy: From Chemotherapy to Precision Oncology

Abstract

Cancer remains one of the leading causes of morbidity and mortality worldwide, necessitating continuous advances in therapeutic strategies to improve treatment efficacy and patient outcomes. Over recent decades, cancer management has evolved from conventional cytotoxic approaches toward more sophisticated, individualized interventions that target specific molecular alterations and harness the immune system. This review provides a comprehensive overview of the paradigm shift in cancer treatment, tracing the evolution from conventional chemotherapy to modern precision oncology and immunotherapy. We examine traditional diagnostic staging and highlight the integration of liquid biopsies and advanced biosensor technologies for real-time, non-invasive clinical monitoring. The review explores the mechanistic pillars of cell cycle-specific and non-specific chemotherapeutic agents, alongside the complex multidrug resistance pathways and metabolic rewiring that drive chemoresistance. We also evaluate the growing efficacy of targeted treatments, including small-molecule kinase inhibitors and antibody-drug conjugates, and detail the transformative clinical impact of immune checkpoint inhibitors, CAR-T cell therapies, and therapeutic vaccines. Emphasizing personalized medicine, we discuss the critical role of pharmacogenomics, biomarker-guided therapies, and the integration of artificial intelligence and quantitative systems pharmacology in optimizing dosing. Finally, we address future directions, including CRISPR-engineered cellular therapies and the modulation of the hypoxic tumor microenvironment using natural phytochemicals.

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