The development of effective drugs for the treatment of cancer represents a significant achievement beginning with the discovery of the antimetabolites and alkylating agents in the 1940s and 1950s. The success of that effort can be attributed in large measure to the close collaboration and interaction between basic scientists, synthetic organic chemists, pharmacologists, and clinicians. This tradition continues to flourish, especially as we now enter the world of pharmacogenomics, genomics, proteomics, and other omics science along with the rapid identification of new molecular targets for drug design and development.

In this, the Twenty-Fourth Edition, we have condensed and summarized a wealth of information on chemotherapeutic and biologic agents in current clinical practice into a reference guide that presents essential information in a practical and readable format. The primary indications, drug doses and schedules, toxicities, and special considerations for each agent have been expanded and revised to take into account new information that has been gathered over the past year. In this edition, we have included 12 new agents and several new supplemental indications that have all been approved by the FDA for previously approved agents within the past year.

This drug manual is divided into five chapters. Chapter 1 provides a brief overview of the main principles of cancer chemotherapy and reviews the clinical settings where chemotherapy is used. Chapter 2 reviews individual chemotherapeutic and biologic agents that are in current clinical use; these agents are presented in alphabetical order according to their generic name. Specific details are provided regarding drug classification and category, key mechanisms of action and resistance, critical aspects of clinical pharmacology and pharmacokinetics, clinical indications, special precautions and considerations, and toxicity. Chapter 3 includes recommendations for dose modifications that are required in the setting of myelosuppression and/or liver and renal dysfunction. Relevant information is also provided highlighting the teratogenic potential of various agents. Chapter 4 presents a review of the combination drug regimens and selected single-agent regimens for solid tumors and hematologic malignancies that are used commonly in daily clinical practice. This section is organized alphabetically by specific cancer type. Finally, Chapter 5 reviews commonly used antiemetic agents and regimens used to treat chemotherapy-induced nausea and vomiting, which is a significant toxicity observed with many of the anticancer agents in current practice.

Our hope remains for this book to continue to serve as both an in-depth reference and an immediate source of practical information that can be used by physicians and other healthcare professionals actively involved in the daily care of cancer patients. This drug manual continues to be a work in progress, and our goal is to continue to provide new updates on an annual basis and to incorporate new drugs and treatment regimens that reflect the rapid advances in the field of cancer drug development.