11 Chemotherapy and Biotherapy

Question 1

Which 2 chemos were originally supposed to be antibiotics in the 50s?

Answer 1

dactino and dauno

Question 2

Dr. Farber noted leukemic children are usually deficient in this, and when they get supplements it accelerated leukemia.

Answer 2

folic acid. so he worked with folic acid antagonist precurser which was eventually methotrexate

Question 3

What are some examples of biotherapy?

Answer 3

tyrosine kinase inhibitors (-nibs), monoclonal antibodies (-mabs)

Question 4

What is ‘neoadjuvant’ chemo

Answer 4

used preoperatively to decrease tumor burden

Question 5

What are ‘sanctuary sites’?

Answer 5

places where cancer can hide- CNS, ovaries, testicles

Question 6

What is the significance of the ‘MDR gene’

Answer 6

Multidrug resistance- an intrinsic factor of resistance to chemo, even when not exposed to i yet.

Question 7

Which type of chemo is better given as a bolus - cell cycle specific or cell cycle non specific?

Answer 7

Non-specific. Works in any phase of cell division. The cell cycle specific chemo is better when divided doses or continuous infusion to hit more points in the cycle.

Question 8

Most chemos damage the DNA. Which class causes cell cycle phase arrest - keeping cell in one phase so division doesnt occur? which type interfers with protein synthesis?

Answer 8

Cycle phase arrest- plant alkaloids

Protein synth - hormonal agents

Question 9

What do angiogenesis inhibitors interfere with?

Answer 9

blood supply/development of blood vessels to the tumor cells.

Question 10

Examples of cell cycle specific agents? (most are nonspecific)

Answer 10

vinca alkaloids, antimetabolites and some misc agents like PEG and dacarbazine

Question 11

lomustine, cyclophos/ifos, mechlorethamine, carbo, temodar, cisplat - what category?

Answer 11

alkylating agents

Question 12

vincristine, etop, irinotecan, taxanes are what category?

Answer 12

plant alkaloids

Question 13

Dauno/doxo, dactino, bleo are which drug category? specific or not?

Answer 13

antitumor antibiotics, not specific. synthesized from bacteria or fungi.

Question 14

These chemo drugs are cell specific (s phase) and interfere with cell metabolism by inhibiting the production of a specific enzyme so it is none functioning. interrupts DNA/RNA synth

Answer 14

antimetabolites

Question 15

folic acid antagonists (methotrexate), purine antagonists (6mp, 6tg, clofarabine, nelarabine), Ribonucleotide reductase inhibs (hydroxyurea) and pyrimidine antagonists (5FU, ARAC, gemcitabine) are which category?

Answer 15

antimetabolites.

Question 16

Most common hormonal agent used in treating ALL?

Answer 16

corticosteroids. they destroy lymphoblasts and may have other side effects.

Question 17

Which category are avastin and PEG?

Answer 17

misc. unclear how it works but may prevent blood vessels?

Question 18

Three categories of action for biotherapies?

Answer 18

• agents that change or restore the hosts immune responses
• direct anti tumor activity
• other (cell transformation, changing ability to metastasize, etc)

Question 19

What is the basic definition of interferon?

Answer 19

a protein that can interfere with viral replication

Question 20

Which drug category is imatinib, to block proliferation of the philadelphia chromosome/BRCABL?

Answer 20

Tyrosine kinase inhibitors