A major clinical trial confirms the value of giving carboplatin chemotherapy and standard radiation therapy together to patients with advanced oropharynx cancer. While the approach, called concurrent chemotherapy, causes more side effects than radiation treatment alone, patients receiving the concurrent therapy lived almost twice as long as the patients receiving radiation alone.

An analysis of data from more than 50 clinical trials sheds important new light on the benefits of chemotherapy for advanced non-small cell lung cancer, concluding that cisplatin chemotherapy, in addition to surgery, radiation therapy or supportive care, substantially extends survival. Prior to this analysis, there was significant concern that the risks and side effects of chemotherapy outweighed the limited benefits for patients with advanced disease. The authors of the analysis also suggest that giving chemotherapy following the surgical removal of lung tumors – adjuvant chemotherapy, considered a novel approach for lung cancer at the time – extends survival by as much as 5 percent. This finding prompts the launch of several large clinical trials to test this ultimately successful new treatment strategy.

Two studies show that treatment programs involving both radiation and chemotherapy are more effective than either approach alone for patients with "stage III" non-small cell lung cancer (including patients with larger tumors that may or may not have limited spread within the lungs and in nearby lymph nodes). This two-pronged treatment approach soon becomes the standard of care for this disease.

Researchers report successful results of a new approach for head and neck cancer therapy – so-called "chemoradiation." This approach involves giving cisplatin chemotherapy and radiation together (concurrently), rather than one after the other (sequentially). The two-pronged approach helps prevent the spread of advanced squamous cell cancers of the head and neck to other parts of the body and causes greater tumor shrinkage, compared to radiation therapy alone.

Several years later, another trial finds that a similar approach – combining radiation with both cisplatin and fluorouracil chemotherapy – helps reduce the size of tumors enough so that patients can eventually undergo surgery to remove them. This approach is proven to significantly extend survival and reduce the risk of recurrence.

Researchers identify the first multi-drug chemotherapy regimen to extend survival for patients with advanced bladder cancer, offering cures in some cases. The regimen – called MVAC – involves a combination of the drugs methotrexate, vinblastine, doxorubicin, and cisplatin. Researchers later confirm that MVAC is superior to single-drug chemotherapy with cisplatin, although the combination regimen causes more side effects.

This treatment is proven to lower the risk of recurrence following surgery for certain early-stage bladder cancers. To maximize its effectiveness, mitomycin is administered directly to the bladder using a tiny catheter (intravesical chemotherapy). Over time, researchers identify new strategies to increase the dose and potency of mitomycin treatment while limiting patients’ side effects.

The chemotherapy drug cisplatin becomes available as a treatment for newly-diagnosed ovarian cancer, as well as ovarian cancer that persists after initial therapy, after trials show the drug decreases the size of patients' tumors. Later research leads to the development of new and more effective combination chemotherapy regimens that utilize cisplatin, such as cyclophosphamide (Cytoxan) plus cisplatin and a regimen called CHAP, which combines the drugs doxorubicin (Adriamycin), hexamethylmelamine, cyclophosphamide and cisplatin.

Researchers report that advanced liver cancers respond to single-drug treatment with doxorubicin (Adriamycin). The study stirs substantial debate when other research teams are unable to consistently reproduce these initial results. Doxorubicin becomes accepted as a standard treatment for liver cancer, but with general agreement that better therapies are urgently needed.

Researchers led by Gianni Bonnadonna find that a new chemotherapy combination of doxorubicin (Adriamycin), bleomycin (Blenoxane), vinblastine (Velban, Velsar) and dacarbazine (known as ABVD) is more effective than the older MOPP combination regimen, and causes fewer side effects. Originally developed for use as a treatment when MOPP no longer worked, ABVD quickly becomes the standard of care when it's found to cure approximately 70 percent of patients with advanced stage Hodgkin lymphoma.

Bleomycin (Blenoxane), an anticancer antibiotic, is approved by the FDA, and soon becomes part of standard treatment for testicular cancer. The new drug is found to be an ideal component of combination chemotherapy because, unlike other anticancer drugs, it does not suppress the bone marrow's ability to produce red and white blood cells. Patients who are able to maintain higher blood cell counts are far less likely to experience treatment-related complications.

Researchers discover that giving high doses of methotrexate – a chemotherapy drug already used to treat leukemia – followed by "leucovorin rescue" can shrink the majority of head and neck tumors by as much as 50 to 75 percent. Such shrinkage makes it possible for more patients to have their tumors surgically removed, offering some a chance of cure.

Around this time, researchers explore the benefits of giving increasingly large doses of methotrexate for a range of cancers, finding that it is safe and effective as long as patients receive carefully timed supportive treatment with leucovorin, which helps protect the bone marrow and other healthy cells from the otherwise damaging effects of methotrexate.

A new approach known as isolated limb perfusion is introduced to help doctors deliver higher-than-usual doses of chemotherapy to an arm or leg where melanoma tumors have spread, without increasing the risk that the drugs will harm other parts of the body. During this procedure, the doctor temporarily stops the flow of blood to and from the affected limb, essentially isolating it with a tourniquet from the rest of the body, and then intravenously administers and circulates chemotherapy through the affected limb with the help of a special machine. The approach is further refined in the 1990s with the introduction of isolated limb infusion, which cuts procedure time, requires fewer specialized medical personnel and is less costly. Investigations continue to try to find better treatments using this technique.