Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

3028PHM > Cancer 2.0 > Flashcards

Cancer 2.0 Flashcards

1
Q

Explain the cell cycle and involved drug classes

A

Go= resting phase (dormant, hidden cancer cells)

Growth factors between G1 and G0

Temsirolimus works on G1

Checkpoint 1 between G1 and S

DNA synthesis inhibitors work on S phase

G2 = bleomycin, etoposide, and teniposide

Checkpoint 2 between G2 and M

M= mitotic inhibitors

Nonspecific= all DNA alkylating and most DNA intercalating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Explain tumour hypoxia

A

Limits chemo ability
Further from capillary = less oxygen
Less vasculature to get chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Explain clonal selection

A

Increased resistance from second round of chemo, increases w/ more rounds.
Commensalism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Explain tumour initiation and metastasis

A
  1. Initiation of growth of tumour
  2. metastasis initiation = invasion, angiogenesis
  3. metastasis progression = remodelling, immune evasion
    Leads to metastasis virulence= organ specific function

Simply, blood vessel breaks and primary tumour spreads. No pattern in brain. Bone pattern= prostate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Explain tumour staging

A

TNM method to provide informed plan

T= size of primary tumour (0-3)
N= extent of lymph node spread (0-3)
M= distant metastasis (organ specific)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Principles of chemotherapy

A

Treat blood cancers that cannot be surgically removed
Combined w/ surgery or radiation to treat solid tumours
Palliative therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Limitations of chemo

A

Drug resistance:
- abnormal gene mutations/expression
- proapoptotic expression changes

Multidrug-resistance protein (MRP) and P-glycogprotein (Pgp)

Drug toxicity:
- myelosuppression (RBC, WBC)
- N/V
- Alopecia
- Tumour lysis syndrome
- Secondary cancers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Methotrexate class and MOA

A

DNA synthesis inhibitor / folate antagonist

Inhibit dihydrofolate reductase (DHFR) to prevent conversion of dihydrofolate to tetrahydrofolate. Stop DNA synthesis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pemetrexed class and MOA

A

DNA synthesis inhibitor / folate antagonist

Inhibit DHFR, TS, and GARFT to prevent conversion of dihydrofolate to tetrahydrofolate. Stop DNA synthesis. Tetra=DNA synthesis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Methotrexate PK

A

Oral or intrathecal
Does not penetrate CNS, intrathecal only
Renal excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

DNA synthesis inhibitor indications

A

Methotrexate- trophoblastic (repro), blood, and solid.
Pemetrexed- solid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

DNA synthesis inhibitor ADR

A
  • Myelosuppression (RBC and WBC- bone marrow suppression, anaemia, fatigue, low O2, immunocompromise, febrile neutropenia)
  • GI toxicity - N/V
  • Stomatitis
  • Hepatotoxicity
  • Renal toxicity

Toxicitiy can be reduced w/ folinic acid supplements. Leucovorin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Mercaptopurine class and MOA

A

Purine analogue (A and G)

Inhibit purine biosynthesis to interfere w/ DNA synthesis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Thioguanine class and MOA

A

Purine Analogue (A and G)

Inhibit purine biosynthesis to interfere w/ DNA synthesis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Purine analogue ADRs

A

Dose-limiting myelosuppression w/ thioguanine. Mild w/ mercaptopurine.

Hepatotoxicity w/ mercaptopurine.

2nd cancers from both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Allopurinol in purine analogues

A

Mercaptopurine dose must be reduced in allopurinol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Purine analogue indications

A

Blood cancers
Cladribine for hairy cell leukaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Fludarabine class and MOA

A

Purine analogue

DNA chain termination. Incorporates itself into developing DNA to disrupt DNA synthesis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Cladribine class and MOA

A

Purine analogue

DNA chain termination. Incorporates itself into developing DNA to disrupt DNA synthesis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Cytarabine class and MOA

A

Pyrimidine antagonist (CTU)

Cytarabine active metabolites (di and triphosphates) block DNA synthesis. Inhibit DNA polymerase. Incorporate drug into growing chain to cause DNA chain termination.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Fluorouracil class and MOA

A

Pyrimidine antagonist (prodrug)

Converted to 5dUMP and 5dUTP. 5dUMP inhibits TS to stop thymidine synthesis.
5dUTP incorporated into RNA by RNApolymerase.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Gemcitabine class and MOA

A

Pyrimidine antagonist

Converted from mono to di and triphosphate (RNA integrity). Inhibits DNA synthesis during S phase.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Explain use of leucovorin w/ fluorouracil

A

Synergy.
Counter effects.
Synergy at receptor to bind more effectively.
Synergy w/ DUMP of fluorouracil.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Pyrimidine antagonist indications

A

Cytrabine IV or SC combined w/ daunorubicin

Fluorouracil IV for solid tumours. Topical for actinic keratosis.

Gemcitabine for pancreatic carcinoma w/ cisplatin for inoperable solids.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Pyrimidine antagonist ADRs
N/V usually mild Myelosuppression GIT and oral ulcers Fluorouracil bolus injection (IV push) = myelosuppression Mucosal damage = continuous IV High doses= liver, heart, and organ damage Rapid tumour lysis syndrome
26
Cyclophosphamide class and MOA
DNA alkylating drug Converted to phosporamide mustard. Cross-link DNA strands by forming covalent bonds between alkyl groups and guanine bases. DNA synthesis disrupted. Partly converted to acrolein.
27
DNA alkylating drug ADRs
Alopecia N/V - severe w/ IV Myelosuppression - dose-limiting Tumour lysis syndrome Hemorrhagic cystitis (caused from acrolein, depletes thiol groups. Protect by mesna to replenish thiol groups).
28
Platinum compound drug example and MOA
Cisplatin and carboplatin. Cross-link DNA by forming intra and interstrand covalent bonds w/ DNA bases. DNA synthesis disrupted.
29
Platinum compounds indications and ADR
IV- testicular, ovarian, cervical, bladder, melanoma. ADR= significant N/V and nephrotoxicity. Mild myelosuppression.
30
Mitomycin C class and MOA
DNA alkylating drug Alkylates DNA to break strand and inhibit DNA synthesis.
31
Mitomycin C indication and PK
Parenteral = activated by hepatic reduction Indicated for salvage therapy for breast cancer in combination w/ vincristine.
32
DNA intercalating drugs/anthracyclines example and MOA
Daunorubicin, doxorubicin, and dactinomycin. 1. Intercalate DNA. 2. Inhibit topoisomerase. 3. Produce free radicals
33
Bleomycin class and MOA
DNA intercalating drug Intercalate DNA and produce free radicals. G2 cell cycle specific.
34
DNA intercalating drugs / anthracyclines PK
IV= rapidly distributed to all tissues except CNS Long half-lives. Bind to tissues. Large Vd. Liver metabolised.
35
DNA intercalating drug / anthracyclines ADR
Myelosuppression and cardiac damage (dose limiting) NV dose related Alopecia Mucosal ulcerations Tumor lysis syndrome IV infusion can lead to severe localised tissue ulceration and necrosis (shai's example)
36
Advantages of PEG liposomal doxorubicin
Pegylated liposomal coating allows drug to evade detection and destruction by immune system. Increase blood circulation time. Remain stable in blood. increase delivery to tumour. Less systemic side effects. Drug stays encapsulated within liposome during circulation. Coat and stability = better delivery, safer. Less cardiovascular events and less toxicity.
37
Bleomycin / DNA intercalating drug ADR
Very little myelosuppression Often combined w/ myelosuppressive drugs Pulmonary and mucocutaneous reactions (no aminohydrolase in skin) Pneumonitis that progresses to interstitial fibrosis (lose elastic), hypoxia, and death. Mild stomatitis, skin hyperpigmentation, erythema, and edema.
38
Why do you see hyperpigmentation w/ bleomycin use
Aminohydralase inactivates drug. Not a high conc in skin or lungs Drug build up = toxicity
39
Vinca alkaloids / mitotic inhibitor examples and MOA
Vincristine and vinblastine Inhibit mitosis by blocking microtubule assembly. = Continued disassembly.
40
Vinca alkaloid / mitotic inhibitor PK
IV administration only, intrathecal will kill. Does not enter CNS. Biliary excretion, extensive metabolism.
41
Vinca alkaloids indications
Blood. Solid= small-cell lung cancer and neuroblastoma
42
Vincristine and vinblastine ADR
Dose-limiting neurotoxicity (peripheral neuropathy) Suppress deep tendon reflexes. Parasthesia. Cranial nerve damage= hoarse, facial palsies, jaw pain. Autonomic neuropathies= orthostatic hypotension, abdominal pain, and constipation. Vinblastine= dose-limiting myelosuppression. Little neurotoxicity.
43
Taxanes / mitotic inhibitor drug examples and MOA
Paclitaxel and docetaxel Inhibit mitosis by blocking microtubule disassembly. = Continued assembly.
44
Taxane PK and indications
Given IV. Eliminated via metabolism and biliary excretion. Paclitaxel indicated for metastatic ovarian/breast cancer in combination w/ cisplatin or if unresponsive to first-line therapy. Docetaxel indicated for castrate-resistant prostate cancer.
45
Taxanes ADR
Dose-limiting myelosuppression. Alopecia. Neurotoxicity. Hypersensitivity reactions at site of infusion.
46
Explain nAB paclitaxel
Albumin-bound paclitaxel = better delivery and less toxicity
47
Etoposide class and MOA
Topoisomerase inhibitor / podophyllotoxin Cause double stranded DNA breaks by inhibiting topoisomerase 2.
48
Camptothecin analogue / topoisomerase inhibitor examples and MOA
Topotecan and irinotecan. Cause single stranded DNA breaks by inhibiting topoisomerase 1.
49
Etoposide (T2) PK and indications
TDM important- oral bioavailability varies between patients, so check for over/underdosing. Unchanged in urine. Synergy w/ platinum compounds. Indicated for preoperative treatment for bone marrow transplant
50
Etoposide ADR
Well tolerated. Alopecia, mild N/V, dose-limiting myelosuppression. Low incidence of secondary nonlymphocytic leukemias.
51
Camptothecin analogue (topotecan and irineotecan) PK and indications
IV. Prodrugs. Indicated for colorectal cancer that has recurred or progressed following fluorouracil therapy.
52
Camptothecin analogue ADRs
Myelosuppression - dose-limiting - both. Irinotecan = diarrhoea Both = alopecia and mild N/V
53
Imatinib class and MOA
Protein kinase inhibitor Inhibit BCR-ABL tyrosine kinase that decreases transformation and proliferation. Increases apoptosis.
54
Erlotinib class and MOA
Protein kinase inhibitor Inhibit epidermal growth factor (EGFR), which decreases proliferation, metastasis, and angiogenesis. Increases apoptosis.
55
Abemaciclib class and MOA
Protein kinase inhibitor Inhibit CDK4 and 6. Prevents transition from G1 to S phase. Arrests cell in G1 phase to prevent DNA synthesis.
56
Encorafenib class and MOA
Protein kinase inhibitor Inhibit BRAF gene. Prevent activation of RAF/MEK/ERK signalling pathway to prevent tumour proliferation.
57
Venetoclax class and MOA
Monoclonal antibody. Inhibit BCL-2 and promote apoptosis.
58
Sunitinib class and MOA
Protein kinase inhibitor Inhibit VEGFR to decrease angiogenesis.
59
Rituximab class and MOA
Monoclonal antibody. Bind to CD20 antigen on surface of non-Hodgkins lymphoma cell to prevent cell cycle initiation.
60
Cetuximab class and MOA
Monoclonal antibody. Antobody to EGFR. Decrease proliferation, metastasis, and angiogenesis. increase apoptosis.
61
Bevacizumab class and MOA
Monoclonal antibody Antibody binds to VEGF that inhibits angiogenesis.
62
Trastuzumab class and MOA
Monoclonal antibody MAB binds to HER2/neu receptor which inhibits cell proliferation.
63
Ipilimumab class and MOA
MAB / immunomodulator Antibody binds to CTLA-4 and leads to T-cell activation.
64
Pembrolizumab and nivolumab class and MOA
MAB / immunomodulator MAB binds to PD1 receptor. Blocks interactions between ligands, PD1, PDL1 and 2. = Increase T cell activation.
65
Trastuzumab ADRs
Chills, fever, N/V, chest pain, and dyspnoea.
66
Ipilimumab (Yervoy) ADR
Immune-related - colitis - hepatitis - dermatitis - neuropathies
67
Pembrolizumab (Keytruda) ADR
Pneumonitis Colitis Hepatitis (and autoimmune) Hypophysitis If SE, stop drug forever.
68
Abemaciclib indication
HR+ve or HER2-ve metastatic breast cancer
69
Tamoxifen class, MOA, and use.
Oestrogen antagonist. Starve tumour of hormones. Prevent breast cancer. Combination w/ surgery to treat.
70
Aromatase inhibitors examples and MOA
Anastrozole and letrozole. - prevent oestrogen synthesis
71
Gonadotropin-releasing hormone agonist example and MOA
Leuprorelin Increase testosterone levels, increase DHT, then hypothalamus stops production of T. Bad SE at first because tumour size increases for 2-3weeks at start
72
Gonadotropin-releasing hormone receptor antagonist example and MOA
Degarelix Block GNRH on testes. Androgens release T from testes.
73
Corticosteroid MOA in cancer
switch off hypothalamus androgen production. Block ACTH.
74
5a-reductase inhibitor example and MOA
Finasteride Decrease DHT = stop tumour proliferation.
75
ADT side effects
Sexual - erectile dysfunction, libido loss, genital shrinkage Physical - weight gain, gynaecomastia, muscle atrophy Metabolic - osteoporosis, anaemia, hypertension, diabetes, heart disease, dyslipidemia Emotional Systemic - fatigue Tumour "flare" - GnRH agonist
76
Principles of radiotherapy
Direct= radiation->DNA damage-> cell death Indirect= radiation-> free radicals-> DNA damage-> cell death. (increase cytokine production)
77
External vs internal radiotherapy
External= x-ray, gamma, proton beams Internal= brachytherapy.
78
ADR of radiation
Psychological= depression Fatigue Skin= dermatitis. Cardio/pulm= CVD. Pneumonitis. GIT= dry mouth, esophagitis, diarrhea, N/V. Genitourinary= erectile dysfunction, dry vagina, infertile, cystitis, teratogenic. Radiation recall= skin necrosis, inflammatory response. Only problem if radiation+chemo.

3028PHM (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions