Anti-cancer treatment Flashcards
Definition of neoadjuvant therapy
Administration of therapeutic agent before the definitive treatment to shrink the tumour
Definition of adjuvant therapy
Treatment after the definitive treatment to reduce risk of cancer recurrence
MoA of 5-fluorouracil
Inhibits thymidylate synthase
Inhibits thymidine synthesis
Inhibits DNA synthesis
MoA of alkylating agents
Form adducts with DNA
MoA of taxanes and vinca alkaloids
Inhibit function of microtubules
MoA of doxorubicin
Inhibits topoisomerase which inhibits DNA replication
Mechanisms of cancer cell resistance
Decreased influx Increased efflux Increased drug metabolism Alter drug target Impair apoptosis
What determines chemo dose
BMI
Performance status
Liver and renal function
Side effects of chemo
Nausea Alopecia Chemo-brain Peripheral neuropathy Mucositis Neutropenic sepsis Myelosuppression PE Diarrhoea Rash PPE Haemorrhagic cystitis AKI Electrolyte imbalance
Describe passive immunotherapy
Activated cells once found in the body compensate for missing or deficient immune function
Ex vivo
Describe active immunotherapy
Stimulates bodies immune system to mediate effector functions
In vivo
Examples of chemo monoclonal antibodies
Herceptin
VEGR inhibitors
EGFR inhibitors
Side effects of targeted therapies
Acneform rash Hair growth disorders Pruritis Myelosupression Nausea Diarrhoea Hypertension Proteinuria Delayed wound healing
Management of acneform rash
Grade 1: keep skin well hydrated
Grade 2: topical antibiotics
Grade 3: oral and topical antibiotics, hold treatment, steroids
Grade 4: stop treatment
How do PD-1 and PD-L1 inhibitors work
Prevent T cells from recognising cancer cells as foreign