6 - Targeted Therapies – CRC and Lung Flashcards

1
Q

What are two hallmarks that are targeted in lung cancer treatment

A

Avoiding immune destruction

Self-growth signals

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2
Q

What are two hallmarks targeted in CRC treatment

A

Self-growth signals

Inducing angiogenesis

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3
Q

What is EGFR

A

Membrane bound receptor

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4
Q

What does EGFR do in NSCLC

A

Regulate signalling pathways to increase cellular proliferation (RAF, PI3K, STAT3, NFKB, MAPK)

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5
Q

What is gefitinib

A

EGFR tyrosine kinase inhibitor

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6
Q

Where to TK inhibitors bind

A

Reversibly bind to ATP cleft in the EGRF TK domain

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7
Q

What were some of the mutations in the TK domain

A

Heterozygous mutations
In-frame delations that removed 4 amino acids
Leucine substitutions
Missense mutation

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8
Q

Will gefitinib or elortinib work in CRC

A

No

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9
Q

Why will gefitinib or elortininb work in CRC

A

TK mutations are not detected in the same rate as lung cancers
EGFR expression is upregulated in CRC

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10
Q

What are chimeric antibodies

A

Murine variable regions and human IgG1 constant regions

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11
Q

What is the target for cetuximab (Erbitux)

A

EGFR on normal and malignant cells

Overexpressed on a variety of cancer cells, including colorectal cancer cells

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12
Q

What are indications for cetuximab (2)

A

Metastatic colorectal cancer

Platinum resistant head and neck squamous cell cancer

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13
Q

What is the MOA of cetuximab (2)

A

Immunological - induces ADCC and CDCC to increase immune cell mediated cell death
Non-immunological - inhibiting EGFR signalling pathway to inhibit growth

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14
Q

What are non-immunological MOA of cetuximab (3)

A

Inhibits intracellular signalling required for cellular growth
Inhibits anti-apoptotic proteins
Reduces growth of cells or increases apoptosis

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15
Q

What is a side effect of cetuximab

A

Rash

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16
Q

What is a mutation that mainly causes non-response to cetuximab

A

K-ras

17
Q

What is K-ras

A

GTP-ase

18
Q

What to GAPs do

A

Inactivate GTP signalling by binding tightly to GTP

19
Q

How to mutations impair the K-Ras intrinsic activity

A

Blocking or interfering with finger loop of GAP in GTP hydrolysis to GTP

20
Q

What is the target of bevacizumab?

A

Soluble VEGF

21
Q

What is the biological significance of VEGF

A

Growth factor for endothelial cells

Major cytokine that regulates angiogenesis

22
Q

What are indications of bevacizumab

A

Colon cancer and NSCLC

23
Q

What are some non-immunological actions of bevacizumab

A

Inhibiting VEGF signalling pathway