Anti-Tumor Agents

Question 1

Adjuvant Chemotherapy

Answer 1

After surgery or radiation to reduce local or systematic recurrence, effects hard to measure

Question 2

Neoadjuvant Chemotherapy

Answer 2

before surgery or radiation, spares healthy organs and kills micrometastases.

Question 3

Primary Chemotherapy

Answer 3

No radiation or surgery, used for late stage cancers as palliative measure but can be curative (ALL)

Question 4

Targeted vs. Conventional Therapy

Answer 4

Conventional is cytotoxic agent that interferes w/ fundamental biology and has slight preference for fast dividing cells.
Targeted are more precise, designated to interfere w/ specific defect that caused cancer

Question 5

Alkylating Agents

Answer 5

Mechanism: add adducts to DNA or cross-link DNA
Toxicity: injures fast dividing cells, alopecia, additional carcinogenesis
Resistance: inactivation of drug w/in cell (GSH), increase in DNA repair

Question 6

Cisplatin Analogues

Answer 6

Mech: cross-link/intercalates in DNA
Toxicity: fast dividing cells, nephrotoxicity
Resistance: reduced absorption or increased efflux, inactivation via GSH, increased DNA repair, increase in DNA damage tolerance

Question 7

Anti-Metabolites

Answer 7

Mech: pyrimidine analogue that stops DNA synthesis
Toxicity: fast dividing cells, alopecia, derm effects major concern
Resistance: increase production of target enzyme, mutation of target enzyme

Question 8

Topoisomerase Inhibitors

Answer 8

Mech: inhibit DNA re-ligation
Toxicity: cardiotoxicity, carcinogenesis
Resistance: increased efflux, mutation in target enzyme

Question 9

Anti-Microtubule Agents

Answer 9

Mech: stabilize (taxanes) or destabilize (vinca alkyloids) microtubule dynamics
Toxicity: Bone marrow suppression and neurotoxicity
Resistance: increased efflux, mutation in target enzyme

Question 10

Hormonal Agents

Answer 10

Mech: used to target specific driver mutations (tamoxifen)
Toxicity: little hormone effect
Resistance: Receptors activated by different mechanism (phosphorylation) or mutation that makes drug agonist

Question 11

Antibodies

Answer 11

Mech: bind target to inhibit function or bind w/ conjugated toxin
Toxicity: auto-immune possible (little)
Resistance: target no longer expressed

Question 12

Kinase Inhibitors

Answer 12

Mech: targeted to specific kinase mutations (Imatinib)
Toxicity: Very Little
Resistance: incrased efflux, mutation of drug binding (ATP site), secondary activation of kinase