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Yr 2 EOYS > Cancer EOYS2 > Flashcards

Cancer EOYS2 Flashcards

1
Q

What are the different types of biopsy? [6]

A
  1. Transcutaneous
  2. Endoscopic Biopsy
  3. Laparoscopic Biopsy
  4. Image-directed (with fine-needle aspiration or
    cutting needle)
    –Ultrasonography
    –Computerized tomography
    –Magnetic resonance imaging
  5. Open incisional ( portion of the tumor)
  6. Open excisional (all tumor mass removed)
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2
Q

What are the 5 types of surgical treatment? [5]

A
  1. Local resection
  2. Radical resection with en-bloc resection of
    lymph nodes
  3. Supra-radical resections = LN+Organs
  4. Surgery for metastasis/recurrence
  5. Surgical management of complications
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3
Q

Name a classification type for bowel cancer [1]

A

Dukes Classification

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4
Q

Curative Resection

The complete removal of tumour is termed []

A

The complete removal of tumour is termed R0

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5
Q

When is radical surgery utilised as treatment? [1]

What tissue is removed? [2]

A

When area/organ-confined & it is likely that all of the tumour can be removed with clear margins.

Lymph Nodes which drain the affected area are sometimes removed along with the primary tumour

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6
Q

What are the 3 categories of surgery? [3]

A

1. Open Surgery
2. Minimally Invasive Surgery (MIS)
 Hand Assisted (MIS)
 Laparoscopic Surgery
 Robot Assisted Surgery
 Surgery thru natural orifice (NOTES)
3. Image Guided Surgery

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7
Q

What are the 4 types of minimally invasive surgery? [4]

A

2. Minimally Invasive Surgery (MIS)
 Hand Assisted (MIS)
 Laparoscopic Surgery
 Robot Assisted Surgery
 Surgery thru natural orifice (NOTES)

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8
Q

What is this type of surgery?

 Hand Assisted (MIS)
 Laparoscopic Surgery
 Robot Assisted Surgery
 Surgery thru natural orifice (NOTES)

A

What is this type of surgery?

 Hand Assisted (MIS)
 Laparoscopic Surgery
 Robot Assisted Surgery
 Surgery thru natural orifice (NOTES)

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9
Q

Define palliative surgery [1]

Name some examples

A

‘surgery performed for relief of symptoms caused by advanced cancer not amenable for cure’

  1. Adequate control of pain
  2. Relief gastrointestinal and biliary obstruction
  3. Stop haemorrhage
  4. Supplement poor nutrition
  5. Airway obstruction
  6. Renal failure
  7. Rectal or urinary incontinence
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10
Q

Which types of urological cancer are now treted robotically? [4]

A
  • Prostate cancer – robotic prostatectomy
  • Bladder cancer – robotic cystectomy with
    urinary diversion
  • Renal cancer – robotic partial nephrectomy
  • Testis cancer - robotic retroperitoneal lymph
    node dissection
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11
Q

Why may curative resection not be successful? [3]

A

– Invasion of a vital, unresectable structure (e.g. SMA)
– Undetectable micrometastasis in distal organ
– Distal metastasis which cannot be safely removed

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12
Q

Name 7 types of AEs that arise from anaesthesia for surgery? [7]

A

1. Local trauma– teeth, throat from intubation
2. Drug related – reaction/allergy
3. Aspiration of oesophageal/gastric contents
4. Anaesthetic line complication
– Arterial line
– bleeding
– Central venous line complication
– Epidural catheter complication
5. Lung injury from high pressure ventilation
6. Iontropes
7. Electrolyte imbalance

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13
Q

Name two potential future cancer surgery treatments

A
  • Pre-emptive surgery in at risk populations (e.g. BRCA)
  • Tissue and function-preserving improvements
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14
Q

Future potential cancer treatments

What are 4 types of tissue and function-preserving improvements surgery that may be possible in the future? [4]

A
  1. Ablative, minimally-invasive, image guided surgery
  2. Tissue-engineered, implantable “spare parts”
  3. Implantable monitors
  4. Treatment sensitizers
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15
Q

Name three cancers that often diagnosed late [3]

A

Ovarian

Pancreatic

Myeloma

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16
Q

The majority of humanised monoclonal antibodies use which Ig as a backbone?

IgA
IgD
IgE
IgG
IgM

A

IgG

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17
Q

Which of the following is targeted by Pembrolizumab

PD-1
CTLA-4
PD1-Ligand
LAG-3
PD2-Ligand

A

PD-1

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18
Q

Which cascade is perhaps the most important oncogenic driver of human cancers?

PI3 Kinase
MAP Kinase
KRAS
AKT

A

Which cascade is perhaps the most important oncogenic driver of human cancers?

PI3 Kinase
MAP Kinase
KRAS
AKT

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19
Q

Which of the following is targeted by Rituximab

CD10
CD12
CD15
CD19
CD20

A

Which of the following is targeted by Rituximab

CD10
CD12
CD15
CD19
CD20

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20
Q

Which of the following is targeted by Atezolizumab

PD-1
CTLA-4
PD1-Ligand
LAG-3
PD2-Ligand

A

Which of the following is targeted by Atezolizumab

PD-1
CTLA-4
PD1-Ligand
LAG-3
PD2-Ligand

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21
Q

Which of the following is an example of a CAR-T drug?

Tisagenlecleucel (Kymriah)
Atezolizumab
Ipililumbab
Nivolumab

A

Which of the following is an example of a CAR-T drug?

Tisagenlecleucel (Kymriah)

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22
Q

Which of the following binds to CD20 in its mechansim of action?

Tisagenlecleucel (Kymriah)
Atezolizumab
Rituximab
Ipililumbab
Nivolumab

A

Which of the following binds to CD20 in its mechansim of action?

Rituximab

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23
Q

Which of the following binds to CTLA4?

Tisagenlecleucel (Kymriah)
Atezolizumab
Rituximab
Ipililumbab
Nivolumab

A

Which of the following binds to CTLA4?

Tisagenlecleucel (Kymriah)
Atezolizumab
Rituximab
Ipililumbab
Nivolumab

24
Q

Describe what checkpoint inhibition is [1]

State two key molecules influential in checkpoint inhibition [2]

A

Checkpoint inhibitors: take the brakes off the immune system; checkpoints inhibits the stop sign that a cancer cell usually presents to immune cells

Checkpoints (caused by)
PD1 Programmed Death Receptor 1
CTLA-4 Cytotoxic T-Lymphocyte Associated protein 4

25
Q

Explain the role of the PD1 checkpoint [2]

A

PD1 regulates T cell activation through binding with the ligands programmed death-ligand 1 (PDL1) and programmed cell death 1 ligand 2 (PDL2)

Under physiological conditions this inhibits T cell proliferation and survival: helps prevent the immune system from attacking itself

Cancer cells can hijack this pathway to escape immune detection

26
Q

Explain the influence of cancer cells on PD1 checkpoint

A

Cancer cell can turn off the PD-1 pathway:
.
If PDL1 or PDL2 are expressed within the tumour microenvironment (TME), the ligands can bind to PD1, terminating TCR signalling and reducing the activation of T cells.

27
Q

Which drugs bind to PD-L1? [3]

A

Atezolizumab
Durvalumab
Avelumab

28
Q

Which drugs bind to PD-1? [2]

A

Pembrolizumab
Nivolumab

29
Q

Explain the role of CTLA-4 [1]

What happens if CTLA-4 is inhibited? [1]

A

CTLA-4 suppressed T cell activation and inhibits cell function; plays a role in T-cell priming

Inhibiting CTLA-4 ”takes the breaks off” the immune system

30
Q

Name two drugs that inhibit CTLA-4

A

Ipilimubab
Tremelimubab

31
Q

What is the difference between chimeric and humanised monoclonal antibodies? [2]

A

- chimeric: Monoclonal antibody with a large stretch of non-human proteins
- humanized: Monoclonal antibody coupled with a human Ig backbone

32
Q

What are the three ways that monoclonal antibodies are broadly used? [3]

A

Complement mediated lysis: unconjugated
Immunotoxins: Coupled to toxin
Radioimmunoconjugates: Coupled to radioisotopes

33
Q

Give an example that is a chimeric monoclonal antibody used for treating B-Lymphomas [1]

What is the target? [2]

A

Rituximab: targets CD20 on malignant B-cells and CD3 on normal T cells

Together enhance cytotoxicity

34
Q

What are Chimeric antigen receptors? [1]

A

Chimeric antigen receptors (CARs): are recombinant receptors for antigens which redirect the specificity and function of T lymphocytes and/or other immune cells in a single molecule.

(Chimeric antigen receptors: on the surface we have the antibody components so the T cells are recognised by the antigen on the tumour cells, and 2nd and 3rd generation CARs have additional costimulatory molecules to enhance the immune response)

35
Q

Give an example of CAR-T drug for targetting large B-cell lymphoma? [1]

What is the drug target? [1]

A

Tisagenlecleucel (Kymriah)

CAR-T Cell targeting CD19

36
Q

What is the point of using immunotherapy biomarkers? [1]

Name 3 key biomarkers for immunotherapy

A

All cancer treatment comes with AES. If can ID patients who will likely have least AEs then best cost / benefit: using biomarkers can try and ID.

General immune status (how many T cells are in the tumour)
Absence of checkpoints
Tumour insensitivty to immune effectors

(listen over quickly)

37
Q

Name 5 future immunotherapy treatments

A

Microbiome: faecal microbiota transplant treated checkpoint inhibition

ECM: cancerous cells can manipulate the immune system so they can change what type of collagen is in the matrix (and make it an easier place for them to live). Can change the type of collagen or structure in our immune system to combat the cancer

Adaptive T cell therapy: Priming - generation a new immune response; Boosting of immune memory

Adpotive cell transfer:

Dendritic Cell Vaccination

38
Q

Explain the mechanism of how chimeric antigen receptor treatment occurs [3]

A

Take T cells

Retrovirally transfect them to be able to express the chimeric antigen whereby you have the antibody on the surface linked into the molecule that activates the T cell

(T cells are removed from a cancer patient and modified so they express receptor specific to the patient’s cancer, then are reintroduced to patient)

T cell then recognises the tumour cell and that activated tumour cell kills off these cells

39
Q

The majority of humanised monoclonal antibodies use which Ig as a backbone?

IgA
IgD
IgE
IgG
IgM

A

IgG

40
Q

Which of the following is targeted by Pembrolizumab

PD-1
CTLA-4
PD1-Ligand
LAG-3
PD2-Ligand

A

PD-1

41
Q

Which cascade is perhaps the most important oncogenic driver of human cancers?

PI3 Kinase
MAP Kinase
KRAS
AKT

A

Which cascade is perhaps the most important oncogenic driver of human cancers?

PI3 Kinase
MAP Kinase
KRAS
AKT

42
Q

Which of the following is targeted by Rituximab

CD10
CD12
CD15
CD19
CD20

A

Which of the following is targeted by Rituximab

CD10
CD12
CD15
CD19
CD20

43
Q

Which of the following is targeted by Atezolizumab

PD-1
CTLA-4
PD1-Ligand
LAG-3
PD2-Ligand

A

Which of the following is targeted by Atezolizumab

PD-1
CTLA-4
PD1-Ligand
LAG-3
PD2-Ligand

44
Q

Which of the following is an example of a CAR-T drug?

Tisagenlecleucel (Kymriah)
Atezolizumab
Rituximab
Ipililumbab
Nivolumab

A

Which of the following is an example of a CAR-T drug?

Tisagenlecleucel (Kymriah)

45
Q

Which of the following binds uses this as its mechanism of action

Tisagenlecleucel (Kymriah)
Atezolizumab
Rituximab
Ipililumbab
Nivolumab

A

Which of the following binds to CD19 in its mechansim of action?

Tisagenlecleucel (Kymriah)

46
Q

Which of the following binds to CTLA4?

Tisagenlecleucel (Kymriah)
Atezolizumab
Rituximab
Ipililumbab
Nivolumab

A

Which of the following binds to CTLA4?

Tisagenlecleucel (Kymriah)
Atezolizumab
Rituximab
Ipililumbab
Nivolumab

47
Q

Which drug prevents the HER2/HER3 dimer from forming?

Trastuzumab
Pertuzumab
Cetuximab
Kadcycla

A

Which drug prevents the HER2/HER3 dimer from forming?

Trastuzumab
Pertuzumab
Cetuximab
Kadcycla

48
Q

Herceptin is also known as

Trastuzumab
Pertuzumab
Cetuximab
Kadcycla

A

Herceptin is also known as

Trastuzumab
Pertuzumab
Cetuximab
Kadcycla

49
Q

Which drug stops HER2 binding to another HER2

Trastuzumab
Pertuzumab
Cetuximab
Kadcycla

A

Which drug stops HER2 binding to another HER2

Trastuzumab
Pertuzumab
Cetuximab
Kadcycla

50
Q

Tarceva
(Erlotinib) targets which of the following

HER2
HER2/HER3
EGFR
VEGF

A

Tarceva
(Erlotinib) targets which of the following

HER2
HER2/HER3
EGFR
VEGF

51
Q

Which drug has a side effect of a rash?

Trastuzumab
Pertuzumab
Cetuximab
Kadcycla

A

Which drug has a side effect of a rash?

Trastuzumab
Pertuzumab
Cetuximab
Kadcycla

52
Q

Which drug causesa decline in left ventricular function AND congestive heart failure

Trastuzumab
Pertuzumab
Cetuximab
Kadcycla

A

Which drug causesa decline in left ventricular function AND congestive heart failure

Trastuzumab
Pertuzumab
Cetuximab
Kadcycla

53
Q

Which drug blocks ATP binding to tyrosine kinase receptor

Trastuzumab
Pertuzumab
Osimertinib
Erlotinib
Kadcycla

A

Which drug blocks ATP binding to tyrosine kinase receptor

Trastuzumab
Pertuzumab
Osimertinib
Erlotinib
Kadcycla

54
Q

Which of the following drug binds to B

Trastuzumab
Pertuzumab
Osimertinib
Erlotinib
Kadcycla

A

Which of the following drug binds to B

Trastuzumab
Pertuzumab
Osimertinib
Erlotinib
Kadcycla

55
Q

Which of the following drug binds to C

Trastuzumab
Pertuzumab
Osimertinib
Erlotinib
Kadcycla

A

Pertuzumab

56
Q

Which drug acts according to this image as a first line drug used for non-small cell lung cancer

Trastuzumab
Pertuzumab
Osimertinib
Erlotinib
Kadcycla

A

Which drug acts according to this image as a first line drug used for non-small cell lung cancer

Trastuzumab
Pertuzumab
Osimertinib
Erlotinib
Kadcycla

Yr 2 EOYS (58 decks)

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