ABSTRACT
Before discussing the specific pharmacokinetics and pharmacodynamics of each class of antineoplastic agent, several fundamental concepts and therapeutic objectives will be considered first.
Because a single cancerous cell is capable of multiplying rapidly and eventually causing the host’s death, one of the therapeutic objectives is to eradicate the last neoplastic cell. Unlike normal cells, cancerous cells multiply ceaselessly, and, unless arrested, they will kill the host. In the early phase, cancerous cells grow exponentially. However, as the tumor grows in mass, the time needed for the number of cells to double also increases. The kinetics of cell multiplication are said to follow a
Gompertzian growth curve
. Tumor growth may be divided into three phases: (1) the subclinical phase, in which 10
×
cells are present, (2) the clinical phase, in which 10
× 10
cells (1-cm
nodule) are present, and (3) the fatal phase, in which the number of cancerous cells equals or exceeds 10
×
.
