Cancer Chemotherapy: Conventional Approaches and Recent Advances

Background: Cancer is a leading cause of global morbidity and mortality, characterised by uncontrolled cell proliferation, genomic instability, immune evasion, and metastasis. Chemotherapy remains a cornerstone of cancer management and is frequently combined with surgery, radiotherapy, immunotherapy, and targeted therapies. Recent advances in molecular biology and drug delivery systems have shifted treatment approaches toward precision oncology. Objectives: To review the historical evolution, pharmacological principles, conventional chemotherapeutic regimens, and recent advances in cancer chemotherapy. Methods: A narrative review of published literature, oncology guidelines, pharmacology textbooks, and recent clinical studies was conducted. Evidence regarding conventional chemotherapy, targeted therapies, toxicity profiles, and emerging therapeutic innovations was synthesised. Results: Cancer chemotherapy has evolved from nitrogen mustard derivatives to molecularly guided precision medicine. Conventional chemotherapy remains essential in the treatment of haematological and solid malignancies, including leukaemias, lymphomas, breast, lung, colorectal, ovarian, gastric, and other cancers. Recent advances include novel agents such as elacestrant, LiPyDau, pirtobrutinib, revumenib, and asciminib, which target resistant molecular pathways. Innovations in liposomal delivery systems, sustained-release formulations, immunochemotherapy, scalp cooling therapy, and metronomic chemotherapy have improved efficacy while reducing toxicity. Conclusion: The field of cancer chemotherapy is transitioning from non-specific cytotoxic therapy to personalised, targeted treatment strategies. Continued advances in molecular therapeutics and drug delivery technologies are expected to further improve survival outcomes and quality of life in cancer patients.