Topic overview

Start with the big picture

The central aim of combination therapy is to increase tumor control, reduce the chance of resistance, and preserve normal tissue function. Agents are selected for additive or synergistic effects, distinct mechanisms, and preferably non-overlapping dose-limiting toxicities; antagonistic drug interactions are avoided. Dosing near each agent’s maximally tolerated dose and choosing concurrent or sequential schedules require attention to toxicity and marrow recovery. Supportive care and monitoring help maintain planned treatment. Strategies also differ by intent, including neoadjuvant, adjuvant, and palliative treatment. The lesson connects these practical choices with theoretical foundations such as the log-kill and Goldie–Coldman hypotheses, and introduces classic regimens and biologic or targeted agents as examples of combination approaches.