2. Introduction to cancer therapy Flashcards
What are the six hallmarks of cancer?
plus two
Self-sufficiency in growth signals Insensitivity to anti-growth signals Evading apoptosis Limitless reproductive potential Sustained angiogenesis Tissue invasion and metastases
Deregulated metabolism
Evading the immune system
What are the different types of therapy available to treat cancer?
Surgery Radiation Chemotherapy Antibodies Small molecules Adjunctive
What are the different goals for cancer therapy?
Cure
Control
Palliation
What is meant by ‘cure’ in cancer therapy?
Prolonged absence of detectable disease
What is meant by ‘control’ in cancer therapy?
Where cure is unrealistic - prevent new cancer growth
What is meant by ‘palliation’ in cancer therapy?
For end stage disease
How might a tumour respond to therapy?
Complete response
Partial response
Stable disease
What cells will be affected by low radiation?
Nerve cells
Muscle cells
What cells will be affected by intermediate radiation?
Osteoblast
Endothelial cells
Fibroblast
Spermatids
What cells will be affected by high radiation?
Spermatogonia Lymphocytes Stem cells Intestinal mucosa cells Erythroblast
What are the different forms of radiation that can be used?
External beam radiation
Radioimmunoconjugates
Radioconjugates
Free isotopes
What neurones are involved in external beam radiation?
Gamma photons
Neutron beams
What is involved in radioimmunocojugates?
Antibody targeted radiation
What is involved in radioconjugates?
Isotopes tagged to bone seeking material
What is commonly used in free isotope therapy?
131 Gallium
What are the targets for radiation therapy?
DNA
Water
What was the first ever pharmaceutical treatment used for cancer and how did this occur?
Mustine
Mustard gas upon the SS John Harvey 1943
What is a common component of current cancer pharmaceuticals and why?
Antifolates
Folate is one of the structural components necessary for the synthesis of nucleic acids in DNA
What different agent types are used in chemotherapy?
Antimetabolites
Ankylators
Spindle poisons
Topoisomerase inhibitors
Give three antimetabolites
Antifolates
Purine nucleosides
Nucleoside synthase inhibitor
Give one ankylator
Platinum
Give two spindle poisons
Vinca alkaloids
Taxanes
Give two topoisomerase inhibitors
Anthracyclines
Etoposide
Why are chemotherapy agents often used in combinations?
To minimise resistance and reduced toxicity
Also to be able to target the different hallmarks of cancer - limit as many biological mechanisms as possible
Why are antibodies being used to treat cancer? - What are the advantages
Target the specific antigen
They are more specific
Have various mechanisms of actions by which they can work
Purine nucleosides are what type of chemotherapeutic agent: Alkylator Spindle poison Antimetabolite Topoisomerase inhibitor
Antimetabolite
Why are small molecules being used to treat cancer?What are the advantages of these?
These can target oncagene production
These can inhibit signalling at key steps
This is safer than chemotherapy
Give three examples of adjunctives that can be used to treat cancer
Glucocorticosteroids
Oestrogens/anti-androgens/SERMs
Bisphosphonates
Give three types of experimental therapy for cancer treatment
Gene therapy
Personalised therapy
Targeted therapy
What type of experimental therapy are small molecules and antibody usage?
Targeted therapy
Give three possible new targets that can be used for cancer therapy
Stroma
Blood vessels - angiogenesis inhibitors
Immune system
