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Chemotherapeutic drugs are classified into alkylating substrates, antimetabolite agents, anti-tumor antibiotics, inhibitors of topoisomerase I and II, mitotic inhibitors, and corticosteroids.
Most of the chemotherapeutic drugs act in a dose-dependent manner; they either stimulate apoptosis or chemoresistance.
Two major complications during chemotherapy are chemoresistance and tumor relapse. We have discussed underlying intracellular signaling cascades responsible for these events.
Combination chemotherapies, targeted therapies, and immunotherapies have represented more promising responses than single chemotherapy applications.
The role of omics, next-generation sequencing (NGS), whole-exome sequencing (WES), and machine learning technologies in precision medicine are currently under investigations for overcoming chemoresistance and tumor relapse.