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oncology > 1st lecture > Flashcards

1st lecture Flashcards

1
Q

normal cell prohibited from growing by ?

A

adjacent cells touching

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2
Q

tumor suppressors are?

A

susceptibility genes that survey the cell and prevents the cell from acquiring mutations

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3
Q

someone went to the doctor and they felt lump on their tongue and it wasnt there. last week. where did it come from?

A

it was there a long time and continued to get mutations because it takes a long time to accumulate mutations and getting the cancer

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4
Q

lead time bias

A

a flaw of many screening trials

catching cancers that are not going to kill people

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5
Q

lead time is

A

length of time btw detection of a disease and its clinical presentation and diagnosis

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6
Q

lead time bias is

A

the bias that occurs when 2 tests for disease are compared and one test diagnoses the disease earlier but no effect on outcome of the disease

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7
Q

telemerase

A

repeats of sequences where one sequence gets clipped off each time a cell divides

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8
Q

steps to turn. to a cancer

A

telemers are prolonged and keep divding forever not becoming scenescense by the hTERT gene

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9
Q

steps to turn. to a cancer

A

telemers are prolonged and keep divding forever not becoming scenescense by the hTERT gene
stops adhesion
inhibits apoptosis
invades

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10
Q

senescence cells

A

are flat cells that cannot replicate bc cannot put telomere at end of chromosome to replicate

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11
Q

carcinoma insitu

A

cancer fills the duct but cannot get out of duct

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12
Q

invasive cancer

A

when cancer learned how to make hole in basement membrane and go through

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13
Q

invasive phenotype is key to

A

metastasis and is what kills people

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14
Q

matrix metalloproteinases (MMPs)

A

are secreted by tumor and stromal cells
degrades extracellular matrix.
this degradation is key for metastatic and angiogenic processes

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15
Q

cell migration

A
  1. extension
  2. adhesion
  3. formaiton of actin filament
  4. traction
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16
Q

can you cure metastatic disease?

A

no it is a chronic disease so you live with your cancer

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17
Q

cancer stem cells stays if you give it ?

A

chemotherapy

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18
Q

cancer cells get into 100% serum and they live even though serum is

A

very toxic

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19
Q

the best place for a cancer to live is ?

A

where it was born because they live in a microenvironment where there is lots of support and nutrition

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20
Q

colonization

A

when cancer cell travels to another organ

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21
Q

angiogenesis

A

gives a cancer blood supply and is induced by hypoxia angiogenic factors FGF2 and VEGF. vascular cells grow into tumor

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22
Q

low vascular count =

A

live forever and makes difference in tumors

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23
Q

micrometastis

A

these cells travel to far places before you know you have cancer
makes you live less

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24
Q

patients with bone marrow micrometastases at diagnosis have

A

worse survival

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25
Q

frequency of cytokerative positive cells in bone marrow is ?

A

unaffected by chemotherapy

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26
Q

frequency of cytokerative positive cells in bone marrow is ?

A

unaffected by chemotherapy

27
Q

adjuvant chemotherapy

A

used against micrometastases

28
Q

cancer cells are not attacked by T cells because?

A

cancer cells have protein called PDL-1 that sends don’t eat me signal by blocking PD 1 (programmed death) receptor

29
Q

10^12 (1kg)

30
Q

10^9 (10g)

A

tumor causes first symptoms and is measurable and detectable

31
Q

10 divisions you get

A

1000 cells

32
Q

need 1 cubic cm tumor to?

A

see on xray

33
Q

need 1 cubic cm (1g) tumor to? 30 cell division

A

see on xray and if anything less than 1 cubic cm then not considered a cancer

34
Q

4 ways of getting chemotherapy

A
  1. induction treatment - no alternative therapy exists and is inoperable or metastic and to help pt live longer. use combo of drugs
  2. adjuvant chemo- cut out cancer and give treatment for less chance of cancer coming back. define response as complete, partial, stable or progression
  3. primary chemotherapy - to shrink tumor before surgery. and if you shrink it until looks gone, you must still do surgery to be 100% sure
  4. special use chemotherapy - highest concentration of drug against target tumor
35
Q

4 ways of getting chemotherapy

A
  1. induction treatment - no alternative therapy exists and is inoperable or metastic
  2. adjuvant chemo- cut out cancer and give treatment for less chance of cancer coming. back
  3. primary chemotherapy (neoadjuvant) - to shrink tumor before surgery.
  4. special use chemotherapy - highest concentration of drug against target tumor
36
Q

chemotherapy works best on ?

A

cycling cells

37
Q

why give multiple drugs?

A

to hit different parts of the cancer cell metabolism bc made up of different clones of cancer

38
Q

goldie - coldman hypothesis

A

give multiple drugs at once or cycle non-crossresistant regimens to interact with the many different clones of cancer cells. each time it divides it acquires more mutations.

39
Q

combination chemotherapy

A

need combo of drugs for durable response

40
Q

how would you know which drug to use?

A

if it worked in clinical trial

41
Q

side effects of chemotherapy

A 
chemo brain
hair falls
N/V
cardiotoxicity
\
42
Q

side effects of chemotherapy

A 
chemo brain
hair falls
N/V
cardiotoxicity
bone marrow suppression
pulmonary toxicity
chemical cystitis
gonadal dysfunction - arrest of follicular maturation/destruction of ova and follicles
43
Q

severe acneiform rash of CI-1040 MEK inhibitor in phase 1 trial means?

A

that the treatment is working

44
Q

can measure treatment response by ?

A

biopsying the tumor

measuring lymphocytes in blood

45
Q

antitumor agents associated with ?

A

Testicular germ cell depletion

ovarian dysfunction

46
Q

alkylating agents caused?

A

ovarian failure

worse for testicular function too

47
Q

key to licensing?

A

compliance monitoring

48
Q

classification of chemotherapy cytotoxic agents

A

alkylating - full cell cycle and hits stem cells and affects dna
antimetabolites - work in s phase
mitotic inhibitors - m phase
anitibiotics - s phase and affects dna

49
Q

chemotherapy works best on

A

cycling cells

50
Q

what really hurts stem cells?

A

alkylating agent because works all throughout cycle and will modify dna and cause cell to die.

51
Q

drug resistance

A

stem cells are drug resistant
pump out drugs
binding drug to protein that inactivates it

52
Q

combination of chemotherapy accomplishes what 3 objectives?

A

maximal cell kill within range of tolerated toxicity
covers broad range of resistant cell lines
prevents or slows down new clone development

53
Q

what drugs can you use to treat cancer?

A

only those tested in clinical trial that shrank tumor

54
Q

the national research act of 1974 established?

A

the national comission -dentification of guidelines, ethical principles and regulation

55
Q

aim of combination therapy?

A

increased efficacy
different mechanisms of action
different mechanisms of resistance
compatible side effects

56
Q

micrometastatic

A

metastic tumor too small to be identified in scan

57
Q

patients with bone marrow micrometastases at diagnosis have ?

A

worse survival

58
Q

primary tumor metastasize to?

A

bone marrow

axillary lymph nodes

59
Q

effects of vascular count and EGFR on survival are?

A

having low vascular count means you live longer

60
Q

breast cancer progression

A
  1. genetic instability (mutation)
  2. loss of polarity
  3. loss of proliferative control by adjacent cells (adhesion molecule loss)
  4. exit from G0, entry to cell cycle- receptor, oncogene mutations
  5. Decreased ability to undergo apoptosis
  6. loss of scenscence, telomerase hTERT re-expression
  7. acquisition of invasive phenotype - key to metastasis
  8. acquisition of angiogenic phenotype, FGF2 VEG
61
Q

name targets for chemotherapy

A

oncogenes

tumor suppressor genes

62
Q

name cell cycle regulators

A

oncogenes

tumor supressor genes

63
Q

invasive cancer

A

made hole through basement membrane and leads to primary cancer to metastasize

64
Q

adverese effect assesment includes?

A

grade 0-4
was the event anticipiated
attribution or associatin to protocol therapy

oncology (7 decks)

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