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Chemo & Drug Assessment > Cancer Chemotherapy > Flashcards

Cancer Chemotherapy Flashcards

1
Q

which stage of cancer has quick doubling times, high growth fraction

A

early stage cancer

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2
Q

late phase cancer has

A

long doubling times, low growth fraction

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3
Q

describe the cell cycle

A
  • Mitosis
    • G0 resting stage comes off mitosis before G1
  • G1
    • enzyme production
    • growth and metabolism
  • S phase (synthesis)
    • DNA replication
  • G2
    • growth and preparation fo cell division
    • RNA synthesis spindle forms
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4
Q

the growth fraction is

A

the percent of cells not in G0

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5
Q

what do cell cycle specific anti-cancer agents need to take into consideration

A
  • doubling time and target therapy course and scheduling
  • growth fraction
  • type of cancner and stage
  • resistance
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6
Q

what are 3 objectives of cancer chemotherapy

A
  • curative
    • induce complete remission
  • palliative
    • allieviate symptoms
  • adjunct
    • improve chances for cure or prevent growth of new cancerous tissue
    • e.g. chemo after breast resection
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7
Q

what are the goals of therapy (5 things)

A
  • removal or destruction of cancerous cells while minimizing toxic effects
  • minimize resistance by use of more than one drug at a time maximizing kill
  • developign a dosage regimen that is often based as much upon pt tolerability as tumor response to therapy
  • administer locally to produce high concentration in limited area
  • used in combination with surgery or radiotherapy
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8
Q

what are some characteristics of cancer cells

A
  • divide rapidly, uncontrolled growth
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9
Q

a carcinoma is

A
  • solid tissue
  • epithelial cells
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10
Q

sarcoma

A

cancer of connective or mesenchymal tissue

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11
Q

leukemia/lymphoma is

A
  • cancer of hematopoetic system
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12
Q

when you have rapidly dividing cells you should use

A

antineoplastic agents

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13
Q

slow growing cells

A

cell cycle specific agents

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14
Q

what are issues with cancer drugs

A
  • very toxic
  • kill both cancerous and rapidly dividing non-cancerous cells
  • better at killing cells that are progressing through cell cycle than at resting phase
    *
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15
Q

what are rapidly dividing cells in the body often impacted by chemo

A
  • hair follicles
  • bone marrow
  • intestinal epitheilium
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16
Q

what are some things to consider in drug selection (5)

A
  1. use drugs that show activity or efficacy against the type of cancer being treated
    • should not be x-resistant
  2. there should be minimal or no overlapping toxicity between drugs
    • decrease AEs
    • side effects not centered around same organ
  3. dosing shechule should be optimal and at consistent times
    • use doubling time to plan dosing
    • allow time for recovery of sensitive cells (bone marrow) b/t treatments
  4. should use drug compbinations with synergistic effects
    • optimizing therapeutic benefit
    • decrease risk and severity of AEs
  5. use drugs with different mechanism of action or that effect tumor at different stages of cell cycle
    • more kill each cycle
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17
Q

cytotoxic drugs include these classes (8)

A
  1. alkylating agents
  2. microtubule inhibitors
  3. enzyme inhibitors
  4. antimetabolites
  5. protein kinase inhibitors
  6. monoclonal antibodies
  7. hormonal therapy
  8. immunomodulators
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18
Q

damage or disrupt DNA synthesis

A

alkylating agents

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19
Q

what is the mechanism of action of alkylating agents

A
  • cross link or form covalent bonds between amino acids
  • prevent separation of the strands of DNA during cell division
  • prevent DNA synthesis
20
Q

what are some commonly used alkylating agents and examples in each category

A
  • Nitrogen mustards
    • cyclophosphamide
  • Non-nitrogen mustards
    • alkyl-alkane sulfonate
      • Busulfan
    • Notrosourea
      • Carmustine
    • Misc alkylating agents
      • thiotepa, temozolomide
  • platinum coordination complexes
    • cisplating, carboplatin
  • antibiotics
    • bleomycin
      • mytomycin C
    • Actinomycin
    • Anthracycline
      • daunurubicin
21
Q

which chemotherapeutic agents are cell cycle specific

A
  • Microtubule inhibitors (G2/M)
  • bleomycin antibiotics (G2)
  • enzyme inhibitors (G2)
  • antimetabolites (S)
22
Q

what class of chemotherapeutic agent: cyclophosphamide and busulfan

A

alkylating agents

23
Q

class of chemo agent: carmustine, lomustrine

A

nitrosoureas

24
Q

class of chemo agent: taxanes & vinca alkaloids

A

microtubule inhibitors

25
Q

platinum coordination complexes egs

A

cisplating, carboplatin

26
Q

antibiotics

A
  • bleomycin
    • mitomycin C
  • actinomycin
  • anthracycline
    • doxorubicin
    • daunorubicin
27
Q

enzyme inhibitors

A
  • topoisomerase I Inhibitors
    • irinotecan
    • toptecan
  • Topoisomerase II inhibitors
    • Epipodophyllotoxins
      • etoposide
      • teniposide
    • Antibiotics
      • daunorubicin, doxorubicin
28
Q

antimetabolites include

A
  • antifolates
    • methotrexate
  • purine antagonists
    • mercaptopurine, thioguanine
  • purine analogues
    • 6-mercaptopurine
  • pyrimidine analogs
    • flurouracil, gemcitabine
29
Q

imitinib, everolimus, temsirolimus are examples of this type of chemo agent

A

protein kinase inhibitors

30
Q

some monoclonals for cancer include

A

bevacizumab, herceptin,

31
Q

hormonal cancer therapy includes

A
  • antiestrogens
    • tamoxifen
  • antiandrogens
    • flutamide
  • gonadotrophin releasing hormone analogue
    • buserelin
32
Q

immunomodulators used to treat cancer include

A

alpha interferon

rituximab

interleukin 2

33
Q

what is the mechanism of action of antimetabolites

A
  • mimic structures or normal metabolic constituents
  • inhibit enzymes necessry for folic acid regeneration and purine/pyrimidine activation
34
Q

how do cytotoxic antibodies work

A
  • damage or disrupt intercalation b/t bases in DNA causing
    • poisoning of topoisomerases
    • generating free radicals which inhibit enzymes
    • distrupting plant membranes
35
Q

how do vinca alkaloids work

A
  • bind tubulin and block polymerization during M stage of the cell cycle
36
Q

what is an example of a vinca alkaloid

A

vincristine, vinblastine

37
Q

what is the mech of action of taxanes

A
  • e.g. paclitaxel
  • binds tubulin, prevents depolarization at end of mytosis
38
Q

epipodophyllotoxins are _______ __________ and work via this mech action

A
  • plant alkaolids
  • inhibit topoisomerase II enzyme activity
39
Q

topotecan or irinotecan are examples of this class of chemo agents and have this mech of action

A
  • topoisomerase I inhibitors
  • inhibit topoisomerase 1 causing single strand DNA breaks resulting in cell death
40
Q

everolimus and temisirolimus are examples of this class and have this Mech action

A
  • protein kinase inhibitors
  • prevent phosphorylation by blocking protein kinase action
41
Q

what is the mechanism of action of immunomodulators

A
  • harness immune response to destroy tumors by
    • lymphocyctes
    • cytokines
    • proteins and antibodies
    • natural killer cells, t cells
42
Q

what are conjugated antibodies and naked mabs

A
  • conjugated: mab attached to a chemotherapeutic agent or radio therapeutic agent
  • naked: targets antigen on cancer cell
43
Q

what are two types of protein kinase inhibitors

A

tyrosine and serine kinases

44
Q

describe how protein kinase inhibitors can be used in Her2 or EGFR cancers

A
  • Her2 = human epidermal growth factor receptor
  • EGFR = epidermal growth factor receptor
  • in some cancers Her2 and EGFR are continuously activated causing cell multiplication and growth
  • protein kinase inhibitors block the protein kinase action and decrease cancers cause by overactive kinases
45
Q

reversibly cuts one strand of DNA, reducing stress from coiling

A

topoisomerase I

46
Q

cuts both strands of dNA

A

topoisomerase II

Chemo & Drug Assessment (10 decks)

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