Cancer Flashcards
Compare proto-oncogene vs oncogene
A proto-oncogene is an inactive oncogene. Oncogenes cause cancers by stimulating growth factors (oncogenes are in cancer cells, not normal cells)
Aside from cancer cells, which cells in the body rapidly proliferate, therefore leading to some side effects?
Skin, hair, blood / bone marrow (myeloid cells), GIT lining
Name an alkylating agent
Cyclophosphamide
Are alkylating agents cytotoxic?
Yes
Explain the MOA of alkylating agents.
Once activated in the liver, they cause covalent cross linking of DNA. Apoptosis is induced due to the damaged DNA
Unique ADR of alkylating agents?
Can cause cancer due to DNA damage
Name an anti-metabolite
Methotrexate, 5-fluoro-uracil
Methotrexate MOA?
Inhibits DHFR, preventing the production of purines for DNA production
Side effects and their management for methotrexate?
Other than the usual cytotoxic ADRs, methotrexate causes pulmonary and liver toxicity.
Can co-administer with folate to manage this
What class of drugs does doxorubicin belong to
Cytotoxic antibiotics
Explain the MOA of doxorubicin
It is a topoisomerase II inhibitor. Too toxic to be used as an antibiotic.
Inhibiting topoisomerase II = prevents DNA replication
ADR unique to doxorubicin?
Cardio toxicity
Name a drug belonging to the cytotoxic class of tubulin binding drugs
Vincristine
Vincristine MOA?
Inhibits microtubule formation. It is cell-cycle specific as it prevents cell division during metaphase
Unique ADRs of vincristine
Numbness and tingling due to microtubule’s role in nerve function
Are hormone antagonists cytotoxic
No
Name a hormone antagonist + explain its’ MOA
Tamoxifen - an estrogen antagonist used in estrogen dependent cancers. It competes for binding with estrogen. Inhibits the transcription of estrogen-dependent genes and decreases the expression of growth factors
ADRs of tamoxifen
Similar to menopause (flushes, etc)
Can increase uterine cancer risk and blood clot risk
What class does anastrazole belong to
Aromatase inhibitors
Explain the role of aromatase
It converts androgens into estrogen
Name a protein kinase inhibitor
Imatinib
Explain the MOA of imatinib
Inhibits protein kinases involved in growth factor signalling
Which drug binds to the human epidermal growth factor 2 and promotes internalisation of the receptor?
Trastuzumab
Explain use of bevacizumab
It is an anti-VEGF antibody. Inhibits vessel growth to block blood supply to the tumour.
Careful when using in combination, as it could prevent other drugs from reaching the tumour by limiting the blood supply
What is VEGF
Vascular endothelial growth factor.
Tumours secrete VEGF to stimulate angiogenesis
Treatment for neutropenia?
Colony stimulating factors such as filgrastim
Explain use of the CSF filgrastim
Stimulates the bone marrow to increase proliferation of immune cells - specifically the proteins that increase neutrophil production
