Anti-Tumor agents Flashcards
EX of alkylating agent
Cyclophosphamide
Cells with ____ are resistant to cyclophosphamide
High ALDH
*** hematopoietic and intestinal cells have high levels so this drug has low toxicity compare to other alkylating agents
Resistance to alkylating agents (3)
- High levels of GSH
- removal of alkyl group
- cross link repair
Toxicity of alkylating agents (5)
- hematopoietic
- GI
- Gonadal
- Alopecia
- Carcinogenesis
Cisplatin and analogues
Crosslink DNA
Pt compounds resistance (5)
- Reduced accumulation
- inactivation
- increased DNA repar
- Increased tolerance for DNA damage
Cisplatin toxixity
nephrotoxivity
carboplatin toxicity
myelosupression
platelet toxicity
oxaliplatin toxicity
sensory neuropathy
2 EX of antimetabolites
- Methotrexate
2. 5- fluorouracil
Methotrexate is a ___, ___ inhibitor of ___
reversible, competitive
dihydro folate reductase (DHFR)
MTX is metabolized to
polyglutamated MTX
MTX resistance (3)
- decreased capacity to make polyglutamated MTX
- Increased expression of DHFR
- Mutant DHFR
DHFR is required for _____ synthesis
purine
5_flurouracil is a ___ analog
pyrimadine
5-FU resistance (2)
- alterations in target enzyme (TS, causes dTTP depletion)
- Increased levels of TS
5-FU toxicity
- hematological
- GI
- alopecia
- derm problems
Topoisomerase inhibitors are derived from
natural products
Topoisomerase inhibitors inhibit
DNA relegation to leave DNA breakes
camptothecins
Topo I and II inhibitors
Anthracyclines
Topo II inhibitors (doxorubicin)
Topoisomerase inhibitors resistance (2)
- increased drug efflux
- mutations in toposiomerases
Topo drugs toxicity
- myelosupression
- secondary malignancies
anthracyclins toxicity
cardiotoxicity
2 antimicrotubule agents
- Vinca alkaloids
2. Taxanes
Vinca alkaloids ____ microtubules
stabilize
Taxanes ___ microtubules
de stabilize
Vinca alkaloids resistance (2)
- increased drug efflux
- mutations is tubulin that alter binding
Vinka alkaloids toxicity (2)
- NEUROTOXICITY
- myelosuppression
Taxanes resistance (3)
- drug efflux
- mutations in tubulin
- inhibition of apoptosis
Taxanes toxicity (3)
- myelosuppresion
- peripheral neuropathy
- alopecia
Tamoxifen
ER inhibitor
antiandrogens (2 examples) and action
- bicalutamide, flutamide
bind to AR and inhibit function as tf
Steroid receptor resistance
- activate recptor by other mechanisms
- mutations in receptor cause drug binding to activate rather than inactivate
mutations in receptor in response to flutamide
- activate rather than inhibit
Aromatase inhibitor (1 EX) and action
Letrozole
inhibit synthesis of estrogen from androgens
Gonadotropin-releasing hormone analogues
leuprolide
Inhibit testosterone production
Hormonal agents toxicities
- altered steroid function
Rituximab
Anti CD20 used to treat B cell tumors
- dependent on different stages
Trastuzumab/ Herceptin
Anti- Her2 breast cancer
Bevacizumab/ Avastin
anti-VEGF colon cancer
Antibody function against cancer (2)
- inhibit function of target
- cell mediated toxicity
Poster child for kinase inhibitors
Imatinib/Glebevec
Imatinib treats
CML and GIST
Bcr-ABL translocation
Resistance to imatinib
inhibitor insensitive BCR-ABL alleles (alter drug binding)