Biological Basis of Cancer Therapy Flashcards
What are the five most common cancers worldwide?
Lung Breast Bowel Prostate Stomach
What are the four main anti-cancer modalities?
Radiotherapy
Chemotherapy
Surgery
Immunotherapy
List the different types of cytotoxic chemotherapy.
Alkylating agents Pseudoalkylating agents Antimetabolites Anthracyclines Vinca alkaloids and taxanes Topoisomerase inhibitors
What are the main types of targeted therapy for cancer?
Monoclonal antibodies
Small molecule inhibitors
hat is the term used to describe chemotherapy that is given:
a. Following surgery
b. Before surgery
Adjuvant
Neoadjuvant
How do alkylating agents work?
They add an alkyl group to the guanine residues in DNA
This causes cross-linking of the DNA strands and prevents DNA from uncoiling at replication
This then triggers apoptosis (via a DNA checkpoint pathway)
It encourages mis-pairing
Name four alkylating agents.
Chlorambucil
Cyclophosphamide
Dacarbazine
Temozolomide
How do pseudoalkylating agents work?
They have the same mechanism as alkylating agents but use platinum instead of alkyl groups
Name three pseudoalkylating agents.
Carboplatin
Cisplatin
Oxaliplatin
What are some side effects of alkylating and pseudoalkylating agents?
Alopecia (except carboplatin) Nephrotoxicity Neurotoxicity Ototoxicity (platins) Nausea, Vomiting, Diarrhoea, Immunosuppression, Tiredness
How do anti-metabolites work?
They masquerade as purine or pyrimidines leading to inhibition of DNA replication and transcription
They can also be folate antagonists (dihydrofolate reductase inhibitors)
This blocks DNA replication and transcription
Give six examples of anti-metabolites.
Methotrexate Capecitabine Gemcitabine 5-fluorouracil 6-mercaptopurine Fludarabine
State some side effects of anti-metabolites.
Alopecia (not 5-fluorouracil or capecitabine)
Bone marrow suppression
Increased risk of neutropenic sepsis
Nausea, Vomiting, Mucositis, Diarrhoea, Fatigue
Palmar-plantar erythrodysesthesia (PPE)
How do anthracyclines work?
They intercalate into DNA or RNA sequences and inhibit transcription and replication
It also blocks DNA repair
They create DNA damaging and cell membrane damaging oxygen free radicals
Give two examples of anthracyclines.
Doxorubicin
Epirubicin
State some side effects of anthracyclines.
Cardiac toxicity (probably due to the free radicals) Alopecia Neutropenia Nausea, Vomiting, Fatigue Red urine (doxorubicin –‘the red devil’)