Anticancer Pharmacology Flashcards

1
Q

Cancer

A

Uncontrolled proliferation and spread of abnormal cells by invading tissues, lymph nodes, and organs

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2
Q

Metastasis

A

Causes cancers at other sites in the body by spreading. Locations such as the lymph nodes, bone, liver, brain, lungs, etc.

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3
Q

What are the two types of cancer?

A
  1. Solid cancer - tumor
  2. Hematological cancer - blood cancer
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4
Q

Give 1 occupational cause example and what part of the body it affects

A

Asbestos; lung

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5
Q

What does ultraviolet radiation cause?

A

Melanoma (skin cancer)

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6
Q

Which body part does alcohol affect?

A

Liver

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7
Q

Which body part does tobacco affect?

A

Lung

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8
Q

Which body part is affected by dietary choices?

A

Colon; high saturated fat and red meat can negatively impact the colon

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9
Q

Which does ionizing radiation (uranium deposits) cause?

A

Leukemia

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10
Q

Give 1 example of a virus and which body part it affects

A

HPV (human papillomavirus); Cervix

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11
Q

Give 1 example of how genetics play a role in causing cancer

A

The presence of both the BRCA1 and BRCA2 gene significantly increases the chances of breast cancer

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12
Q

Give 1 example an alkylating agent and 2 parts of the body that it can cause cancer in

A

Melphalan; blood (leukemia) and bladder

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13
Q

What is the purpose of diagnosis and staging?

A

Diagnosis: Tissue biopsy and pathological assessment.
We cannot diagnose cancer unless the cells are viewed under a microscope

Staging: Determines how widespread cancer is

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14
Q

How do you classify how widespread the cancer is?

A

TNM staging of solid tumours:

T = size of primary tumour

N = absence/presence and extent of regional lymph node metastasis (if present, then it may have gone past the local zone)

M = absence/presence of distant metastasis (if present, then there is evidence it has spread to other organs/tissues - stage IV cancer)

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15
Q

MOA of chemotherapy

A

Damages and interferes with DNA synthesis, causing cancer cell death

It can be phase specific (G1, S, G2, M) or non-phase specific

With this treatment, most cytotoxic cells (immune cells) are undergoing rapid division

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16
Q

What is the purpose of combination chemotherapy and what are the 4 factors an agent needs?

A

Since cancer cells are genetically unstable and have tumour masses of heterogeneous cells, this type of chemo has a broader coverage against resistant cells and can get rid of different cell lines

  1. Demonstrable single-agent activity
  2. Different MOA
  3. Devoid of overlapping toxicities
  4. Optimal dose and schedule
17
Q

Why does chemotherapy fail?

A

Drug resistance:
1. Increases with increased tumour size
2. Can be acquired or inherited
3. Can become multidrug resistance

(note: the cells can grow resistance through evolution)

18
Q

4 mechanisms of drug resistance

A
  1. Improves proficiency in DNA repair
  2. Inactivates cancer drug by: decreasing cellular uptake of the drug and increasing efflux of the drug
  3. Change in biochemical pathways
  4. Change target enzymes
19
Q

MOA and an example of alkylating agents

A

Bind DNA by creating covalent bonds → cross-link DNA → prevent unwinding of DNA molecule → less protein synthesis

Cyclophosphamide, melphalan

20
Q

MOA and an example of Epipodophyllotoxins

A

Inhibit topoisomerase II (responsible for DNA breaks) → inhibit DNA synthesis

Etoposide

21
Q

MOA and an example of Taxanes

A

Promote assembly and stabilization of microtubules → inhibit cell replication

May inhibit angiogenesis (blood vessel formation that cancer can use to spread throughout the body)

Docetaxel

22
Q

MOA and an example of Antimetabolites

A

Resemble naturally occurring nuclear structural components (eg. nucleotide bases) → incorporate into DNA/RNA → inhibit function/synthesis

5-Fluorouracil (5-FU)

23
Q

MOA and an example of Anti-tumor Antibiotics

A

Insert b/w DNA base pairs → uncoil DNA helix→ inhibit DNA/RNA synthesis. May also inhibit polymerase

Doxorubicin

24
Q

MOA and an example of Alkylating Agent + Anti-tumour Antibiotic

A

Undergoes spontaneous decomposition → reactive methylcarbonium ions → alkylate DNA → interstrand cross links → inhibit mitosis

Streptozocin

25
Q

MOA and an example of Camptothecins

A

Bind topoisomerase I (responsible for reversible, single-strand DNA breaks during DNA replication) → prevent religation of DNA strand → cell death

Irinotecan

26
Q

MOA and an example of Vinca Alkaloids

A

Prevent polymerization of tubulin to form microtubules + depolymerizes formed tubules → inhibit mitosis

Vincristine

27
Q

MOA of Immunotherapy

A

Immune Checkpoint Inhibitors - Take ‘brakes’ off immune system → helps it to recognize & attack cancer cells

28
Q

An example of Targeted Therapy

A

Monocolonal Antibodies target a receptor

Ex. Trastuzumab (Herceptin): Anti-HER2

29
Q

An example of Endocrine Therapy

A

Aromatase Inhibitors: Letrozole

30
Q

10 common side effects of treatment

A
  1. Febrile neutropenia (fewer neutrophils → fever)
  2. Anemia (few red blood cells)
  3. Thrombocytopenia (few #platelets = increase risk of bleeding)
  4. Mucositis/stomatitis (kill mucus/stomach cells → sores)
  5. Nausea & vomiting
  6. Diarrhea/constipation
  7. Weight loss
  8. Fatigue
  9. Alopecia
  10. Infertility
31
Q

4 examples of screening tests

A
  1. Colorectal - Colonoscopy
  2. Breast - Mammography
  3. Cervix - Pap Smear
  4. Skin - Dermatology Screening