Anti-tumor agents Flashcards
What is Primary Induction Chemotherapy?
no surgery or radiation is used. The Goal is just to palliate tumor-related symptoms and extend life a little longer.
What is neoadjuvant chemotherapy and when would you use it?
This is used for localized cancer before surgery/radiation where surgery/radiation is not completely effective. The goal is to make surgery/radiation more effective
What are some benefits of neoadjuvant chemo?
- can spare vital organs,
- may kill (micro)metastatic disease
- easy to measure the response because can remove the tumor mass and characterize.
What is adjuvant chemo and when do you use it?
Used after surgery/radiation. The goal is to kill micrometastases and increase the effectiveness of surgery/radiation by increasing relapse-free survival
It is easy to measure the response of adjuvant chemo, T or F?
F. It is hard because the tumor has been removed. Instead survival is measured.
What diseases would you treat with Primary induction chemo?
Hodgkins and non-hodgkins lymphoma, germ cell cancers, ALL, Wilms tumor, embryonal rhabdosarcoma.
What diseaseswould you treat with Neoadjuvant chemo?
anal, breast, bladder, esophageal, head and neck, gastic rectal, osteogenic, soft tissue sarcomas
What diseases would you treat with adjuvant chemo?
breast, colorectal, gastric, non-small cell lung cancer, melanoma
How do conventional cytotoxics work?
drug kills tumor cells by forcing the cell into apoptosis via cellular damage. This will also affect regular cells.
Patients given conventional cytotoxics are treated with the ______ dose while those given targeted therapy are treated with the ______ dose.
- maximally tolerated dose (MTD)
- person’s optimal biologic dose for inhibition (OBD)
Targeted therapy drugs work by causing ______ in cells while conventional therapy drugs work by causing ______ in cells.
- death or growth arrest (in cells containing the defect)
- apoptosis (in tumor cells but will also affect regular cells)
In conventional cytotoxics drugs are chosen based on _____ while in targeted therapies drugs are chosen based on_____.
- tumor site (not specific defect)
- the particular defects that cause a patients cancer.
Do cytotoxic agents target specific pathways?
yes, they just target them in all cells unlike targeted therapies which attempt to target specific pathways in damaged cells only.
What is the basis for combining drugs in treating cancer?
clinically tolerable doses of drugs usually aren’t strong enough to kill cancer. If individual drugs are at least partly effective in the patient then they should be combined.
Why is it dangerous to reduce the dosage or completely remove a drug from the regimen?
can allow a resistant cell line to proliferate.
Why is inconsistency bad in giving cancer drugs?
patients can build up a resistance if given too much time in treatment free interval.
For targeted pathways you should combine drugs that target ___ steps in the same pathways
different. Or combine drugs that target separate (but involved) apoptotic mechanisms
Explain how cancer cells have a strong selective pressure to adapt.
They are trying to avoid drugs. can have mutations that affect the cellular target or which enhance the repair mechanism to prevent apoptosis. Can create tumor stem cells which resist the drug repopulate tumor with resistant cells.
