22: Cancer Pharmacology

Question 1

Growth fraction

Answer 1

Ratio of proliferating to G0 cells; a major determinant of cancer’s responsiveness to chemo

Question 2

Cells with high growth fraction

Answer 2

Are most susceptible to chemo; includes cells of BM, GI, hair follicles, sperm-forming cells

Question 3

Log cell kill hypothesis

Answer 3

Anti-neoplastic therapy follows first order kinetics - a given dose destroys a constant fraction of cells

Question 4

Topoisomerase I vs II

Answer 4

I: cuts one strand of dsDNA, relax the strand, re-anneal strands
II: cut both strands of dsDNA simultaneously coil and uncoil DNA supercoiling

Question 5

Intracelllular vs extracellular tyrosine kinase cancer drug endings

Answer 5

Intracellular: nibs
Extracellular: mabs

Question 6

Biological response modifiers

Answer 6

Agents that act indirectly to mediate their anti-tumor effects by enhancing the immunologic response to neoplastic cells

Question 7

Examples of biological response modifiers

Answer 7

Interferons, IL-2

Question 8

Interferon mechanisms

Answer 8

Inhibit cellular growth, alter differentiation, interferes with oncogenes

Question 9

IL-2 Mechanism

Answer 9

Increases cytotoxic killing by T cells and NK cells

Question 10

Toxicity of interferons vs IL-2

Answer 10

1. Interferons: BM depression, neutropenia, anemia, renal toxicity, edema, arrhythmias
2. IL-2: capillary leak syndrome

Question 11

Three most effective drugs for malignant melanoma

Answer 11

Dacarbazine, temozolomide, cisplatin

Question 12

Two biological agents used to treat malignant melanoma

Answer 12

IFN-a, IL-2

Question 13

Two drugs approved for unresectable or metastatic melanoma

Answer 13

Nivolumab, pembrolizumab

Question 14

Major mutation in melanomas

Answer 14

BRAF V600E