Cancer Flashcards
What does a complete blood count tell us?
This tell us the number of different cells in the blood
abnormality may indicate cancer such as high number of RBC
What are the other lab test can be conducted for cancer?
Blood protein staining- test for antibodies
Tumor marker test
Circulating tumor cell tests
What does hematocrit mean?
it is the volume proportion of blood that consists of RBC
WHat does reticulocyte mean?
immature RBC
What does blood protein staining aid in the diagnosis of?
Lymphoma, leukemia, multiple myeloma
What does blood protein staining test?
Test for abnormalities in albumin, transferrin, globulin, antitrypsin
What are some tumor markers that we test for?
CA-125= ovary cancer
ER= Breast cancer
What does a high value of CA-125 indicate?
> 46U/ml
ovarian cancer
True or False: Some tumor markers are not only used to diagnose but to be specifically treated
TRUE EX. CA-125 and ER
What is the 70-Gene signature?
test genes to predict the metastasis and recurrence of breast cancer. GOOD FOR EARLY STAGE
What are the three cancers that often use CTC tests?
breast, prostate, colorectal
What imaging is used in a breast mammogram?
low does xrays
True or False abnormal areas in breast tissues seen in a mammogram confirms cancer
FALSE
only biopsy confirms
What is the defining feature of a PET scan?
uses a radiactive drug tracer
Why does using a radioactive tracer work in cancer scans?
Tumors require a ton of energy to grow so a sugar derivative that’s radioactive will be highly localized in tumor areas
True or False The brain will not show up on a PET scan
FALSE- brain will show up as it uses a ton of sugar energy
What is the main way to diagnose cancer?
BIOPSY
What else can a biopsy tell us?
Give us the grade of cancer and targets for therapy
What is the 2 purposes of surgical removal of cancer?
Remover entire tumor
debulk= lower symptoms, better survive
When can we use laser surgery?
tumours on the surface
Explain how you would use a 3D conformal radiation therapy.
Get a 3D image through a CT scan, and beam the tumor with photons
What is INtensity-modulated radiotherapy?
big beam is split into beamlets to get more precise treatment
What are some internal radiation therapies?
brachytherapy= sealed container is placed in tumor
radioisotope therapy= ex thyroid
radioembolization= radioactive beads on vasculature to lower blood supply to tumor
What is the difference between adjuvant chemo vs neoadjuvant chemo?
Adjuvant= used after primary treatments such as surgery to prevent or lower recurrence
Neoadjuvant= given before to reduce size to make surgery easier
What is the main method of action that alkylating agents do?
damage DNA
What is the method of action of nitrogen mustards?
turns into a reactive aziridinium intermediate and reacts with 2 guanines and interrupts DNA
What are the general structure of nitrogen mustards
nitrogen with two alkyl chains with chlorines at the end
What is the general structure of nitrosourea?
similar to nitrogen mustards but has amide with a N=O on one of the N’s
What are the nitrogen mustards drugs?
Melphan
Chlorambucil
estramustine
ifosfamide
What are the nitrosourea drugs?
Carmustine
lomustine
nimustine
streptozocin
What is the MOA of Nitrosourea?
chloroethylene ion binds to guanine
WHat is different about Streptozocin?
doesnt have chloroethylene. Has a hydroxylated methyl that does the same job
WHat are the platinum agents?
Cisplatin
Carboplatin EASY
What is the MOA of platinum agents
cell cycle non specific DNA damagers
What does busulfan do?
Binds to N7 guanine
What does busulfan do?
Binds to N7 guanine
What does busulfan do?
Binds to N7 guanine and interrupts DNA
What does procarbazine do?
methylates guanine at O6 and stops synthesis
Antimetabolites MOA?
prevent biosynthesis
Antimetabolites drugs?
FU= uracil
Capecitabine=
Gemcitabine= cysteine
Azacitidine=
Cytarabine=cystein
What is Cytarabine MOA
prevent cytidylic conversion= miscoding of DNA during S phase
What are the antimitotics drugs?
Taxanes
Paclitaxel
docetaxel *****
What is the method of action for antimitotics?
bind to free tubulin and form tubules and disrupt normal microtubule arrangement and prevents disassembly of microtubules
What is the MOA of vinca alkaloids?
prevent microtubules from forming
What are the drugs for vinca alkaloids?
vinblastine, vincristine, vindesine
What are the antitumor antibiotic drugs?
rubicin
daunorubicin, doxorubicin, epirubicin, idarubicin
WHat is the MOA for antitumor antibiotics
intercalate in DNA causing cleavage of strands
What is a PARP inhibitor MOA?
inhibit poly ADP-ribose polymerase= stop DNA repair= cell death
What are the PARP inhibitors?
parib
olaparib, rucaparib
True or False: PARP hurts normal cells as well
FALSE normal cells have other DNA repair enzymes
cancer generally has only PARP
What is the mechanism of action of tyrosine Kinase inhibitors?
TK is usually more expressed such as in EGFR and VEGFR
How does Imatinib work?
inhibits BCR-ABLE TK= stop growth and kill
How does Gefitinib work/
Inhibit EGFR= stop growth and kill
What is the MOA for Trastuzumab?
targets Her2 Subdomain 4
What is the MOA for pertuzumab?
targets subdomain2 of Her2 Blocks homodimerize of Her 2-2 or Her 2-3
What is the benefit of using both pertuzumab and trastuzumab and docetaxel?
Fully block Her2 and stops mitosis
What is the mechanism of action of T-DM1?
Has trastuzumab and emtansine
target breast cancer then emtansine is cytotoxic
What is the mechanism of action of bortezomib?
induces apoptosis
What is the mechanism of bevacizumab?
antiangiogenesis of VEGF= starve cancer cells
What does Sunitinib do?
Targets Tyrosine Kinase, VEGFR, and stops angiogenesis as well
What is PD-1?
Protein for cell death on the surface of t cells that will bind to PD-L1 to NOT kill cell
What occurs when using a PD-1 or PD-l1 inhibitor?
If you use a PD-1 or PD-l1 inhibitor blocks this safety mechanism and allows the cell to be killed
True or False: using both Pd-1 and PD-L1 inhibitors gives more of an effect
FALSE- need to block only one
What are some PD-1 inhibitors?
pembrolizumab
nivolumab
cemiplimab
What are some PD-L1 inhibitors?
Atezolizumab
avelumab
durvalumab
What is the mechanism of action for tamoxifen?
block ER and inhibit breast cancer Hormonal therapy
What can tamoxifen increase the chance of?
uterine cancer
