Anti-cancer treatment Flashcards

1
Q

Definition of neoadjuvant therapy

A

Administration of therapeutic agent before the definitive treatment to shrink the tumour

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2
Q

Definition of adjuvant therapy

A

Treatment after the definitive treatment to reduce risk of cancer recurrence

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3
Q

MoA of 5-fluorouracil

A

Inhibits thymidylate synthase
Inhibits thymidine synthesis
Inhibits DNA synthesis

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4
Q

MoA of alkylating agents

A

Form adducts with DNA

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5
Q

MoA of taxanes and vinca alkaloids

A

Inhibit function of microtubules

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6
Q

MoA of doxorubicin

A

Inhibits topoisomerase which inhibits DNA replication

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7
Q

Mechanisms of cancer cell resistance

A
Decreased influx
Increased efflux
Increased drug metabolism
Alter drug target
Impair apoptosis
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8
Q

What determines chemo dose

A

BMI
Performance status
Liver and renal function

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9
Q

Side effects of chemo

A
Nausea
Alopecia
Chemo-brain
Peripheral neuropathy
Mucositis
Neutropenic sepsis
Myelosuppression 
PE
Diarrhoea
Rash
PPE
Haemorrhagic cystitis
AKI
Electrolyte imbalance
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10
Q

Describe passive immunotherapy

A

Activated cells once found in the body compensate for missing or deficient immune function
Ex vivo

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11
Q

Describe active immunotherapy

A

Stimulates bodies immune system to mediate effector functions
In vivo

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12
Q

Examples of chemo monoclonal antibodies

A

Herceptin
VEGR inhibitors
EGFR inhibitors

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13
Q

Side effects of targeted therapies

A
Acneform rash
Hair growth disorders 
Pruritis
Myelosupression 
Nausea 
Diarrhoea 
Hypertension
Proteinuria
Delayed wound healing
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14
Q

Management of acneform rash

A

Grade 1: keep skin well hydrated
Grade 2: topical antibiotics
Grade 3: oral and topical antibiotics, hold treatment, steroids
Grade 4: stop treatment

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15
Q

How do PD-1 and PD-L1 inhibitors work

A

Prevent T cells from recognising cancer cells as foreign

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16
Q

Side effects of immunotherapy

A
Diarrhoea
Ileus
GI perforation
Steven-Johnson syndrome 
Weakness and paresthesia 
Raised LFTs
17
Q

MoA of radiotherapy

A

Direct DNA damage leading to cell death

Generating free radicals causing DNA damage

18
Q

Types of radiotherapy

A

External beam
Brachytherapy
Systemic e.g swallowed or injected

19
Q

Difference in radiotherapy for radical vs palliative

A

Radical: small field of irradiation, low daily dose, high total dose

Palliative: larger field of irradiation, high daily dose, low total dose

20
Q

Early side effects of radiotherapy

A
Erythema
N+V
Lymphoedema 
Diarrhoea
Alopecia
21
Q

Late side effects of radiotherapy

A
Skin and bone necrosis
Mouth ulceration
Infertility
Bowel strictures
Cardiomyopathy 
Lung fibrosis