cancer chemotherapy

Question 1

benign vs malignant

Answer 1

malignant capable of invading surrounding tissue

benign confined to its original location

Question 2

causes of cancer

Answer 2

1) environmental exposure eg UV light, radiation
2) verse’s
3) oncogenes
4) tumour suppressor genes

Question 3

treatmetns

Answer 3

surgery
radiotherapy
cehmotheraory

Question 4

chemotherapy

Answer 4

once cancer metasies chemo required for effective cancer managment

Question 5

what do cancer drugs vary by

Answer 5

• chemical composition
• route of administration
• type of cancer targeted
• side effects

Question 6

chemotherapy approaches

Answer 6

primary induction chemo
neoadjuvant chemo
adjuvant chemo

Question 7

primary induction chemo

Answer 7

administed in its with advance cancer

no alternative tx

Question 8

neoadjuvant chemo

Answer 8

its with localised therapies where alternatives are not as effective

Question 9

adjuvant chemo

Answer 9

as an adjuvant to local therapy

effective in prolonging both disease free and overall surviial

Question 10

therapeutic index

Answer 10

Therapeutic index is the lethal dose of a drug for 50% of the population (LD50) divided by the minimum effective dose for 50% of the population (ED50)

want a large therapeutic index

Question 11

what is needed for total cell kill

Answer 11

early diagnosis and tx
combination chemo
intermittent regimens
adjuvant and neoajuwant

Question 12

what do chemotherapeutic agents

Answer 12

kill a constant proportion of tumour cell population, rather than a constant number of cells after each dose

Question 13

solid vs disseminated cancer

Answer 13

solid cancer
- have a low growth fractions thus respond poorly to chemo and need surgical removal
disseminated
high growth fraction and respond well to chemo

Question 14

cell cycle specific drugs

Answer 14

exhert action on cells traversing the cell cycle

Question 15

CCNS cells

Answer 15

can sterilise tumour cells whether cycling or resting in G0

Question 16

CCNS vs CCS

Answer 16

non specific able to block more cells as they are non specific

Question 17

what can alkylating agents o

Answer 17

CCNS

• transfer alkyl groups to nucleophilic sites on DNA bases (form highly reactive carbonium ion)
• cross linkage, abnormal base pairing, DNA strand breakage

Question 18

what can alkylating agents lead to

Answer 18

can alter healthy cells as interferes with cell cycle
lead to toxicity of other cells themselves
increase risk of second maliganies

Question 19

what is often given with alkylating agents

Answer 19

antiemetics

Question 20

alkylating drugs - examples

Answer 20

buluslfan
- control tumour burten
lomustine - BBB,
decarbaizine

Question 21

resistant to agents - what to do

Answer 21

• increase activity of DNA repair enzyme
• increase metabolic inactivation of the drug
• decrease influx of the drug

Question 22

platinum analogues CCNS

Answer 22

thought to exhort cytotoxic effect similar to alkylating agents
- form platinum complexed 
intrastrand and inter strand cross link
DNA damge
inhibits cell proliferation

Question 23

cisplatin

Answer 23

highly bound to plasma protein
poor for BBB
extensively cleared by kidney and excrete slow

adverse effects
emesis
nephrotoxicity
p

Question 24

antimetabolites and type

Answer 24

CCs
acts on intermediary metabolism of proliferating cells
interferes with DNA/RNA growth by substituting for the normal building blocks of RNA/DAN

eg folate anatagonist - methotrexate

Question 25

examples of antimetaboltes

Answer 25

folates
purine
prymidine

…. antagonists

Question 26

folic acid antagonist

Answer 26

methotrexate
- interferes with formation od DNA RNA and cellular proteins
prolongs inhibitor effect as her to metabolise

immunosuppressive, cytotoxic and anti inflammatory

Question 27

purine anatagnost

Answer 27

6 mercaptopurine
must be metabolised into active form
alters synthesis of DNA/rNA

nausea
vomiting
pain abdomanal

Question 28

pyrimidine anatagnoist

Answer 28

flurouracil
requires activation to interfere with DNA synthesis
short half life

nausea, vomiting, headache, mood disorder

Question 29

vinca alkaloids and what type of drug are they

Answer 29

CCS
inhibits tunilin proliferation
microtubules not assembles
cell death from mitosis arrest

eg vincacrystine

Question 30

vincristine main dose limiting toxicity

Answer 30

neurotoxicity

Question 31

taxanes and type of drug

Answer 31

CCS
Enhance tubular polymerisation
inhibition of mitosis and cell division

eg palcitaxel

Question 32

paclitaxel

Answer 32

used in slid tumours

dose reduction required in pts with liver diseases to prevent accumulation

Question 33

antitumoru antiiotics

Answer 33

abnormality in the cell proliferation

- block synthesis, DNA strand scission, interfere with cell repliation

Question 34

doxorubicin

Answer 34

generates free radicals leading to cardiotoxiciyt

Question 35

hormones and anatagonists

Answer 35

glucocorticoids -
estrogens - antagonists of androgens
estrogens antagonists - ER modulators

Question 36

what is given to its with bone metastats

Answer 36

bisphosphonates
slow down rate of growth of bone crystal
reduce morbidity by reducing skeletal vents

Question 37

when does metastasis in skeleton occur

Answer 37

in its with multiple myeloma and metastatic breast prostate, thyroid cancer

Question 38

drug combination

Answer 38

provide maximal cell kill within a range of toxicity tolereted by the host for each drug without dose comprmose

Question 39

drug resistance

Answer 39

• some tumours exhibit primary resistance

- acquire resistance develops in response to exposure to a given anticancer agent