Narrative review explores therapeutic benefits and challenges of second and third generation drugs, highlighting drug resistance and health equity issues.
Second- and third-generation chemotherapeutic agents have reshaped modern oncology by offering enhanced therapeutic outcomes, improved tolerability, and increased potential for integration with targeted and immunotherapies. These innovations represent key advancements over first-generation agents, which were often limited by severe toxicity and broad, non-specific activity. However, the evolution of chemotherapy has not been without challenges, including drug resistance, chronic toxicity, long-term quality-of-life issues, and socioeconomic disparities. This narrative review critically examines the pharmacological progress, clinical performance, and broader implications of second and third-generation chemotherapies. Limitations of current practices and recommendations for future research—especially around personalized care, drug resistance, health equity, and evidence-based clinical guidance—are highlighted to foster a more effective and ethically grounded approach to cancer treatment.
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K.B. Misra (2025) studied this question.
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