Although old molecules, alkylating agents and platinum derivatives are still widely used in the treatment of various solid tumors. However, systemic toxicity and cellular resistance mechanisms impede their efficacy. Innovative strategies, including local administration, optimization of treatment schedule/dosage, synergistic combinations and encapsulation of bioactive molecules within smart multifunctional drug delivery systems, have shown promising results to potentiate anticancer activity while circumventing such hurdles. Furthermore, questioning the old paradigm according to which nuclear DNA is the critical target of their anticancer activity has shed light upon subcellular alternative and neglected targets that obviously participate in mediating cytotoxicity or resistance. Thus, rethinking the use of these pivotal antineoplastic agents appears critical to improve clinical outcomes in the management of solid tumors.