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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
Explain the role of the PD1 checkpoint [2]
**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
Explain the influence of cancer cells on PD1 checkpoint
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
Which drugs bind to PD-L1? [3]
**Atezolizumab** Durvalumab Avelumab
28
Which drugs bind to PD-1? [2]
**Pembrolizumab** Nivolumab
29
Explain the role of CTLA-4 [1] What happens if CTLA-4 is inhibited? [1]
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
Name two drugs that inhibit CTLA-4
Ipilimubab Tremelimubab
31
What is the difference between chimeric and humanised monoclonal antibodies? [2]
**- chimeric**: Monoclonal antibody with a large stretch of non-human proteins **- humanized**: Monoclonal antibody coupled with a human Ig backbone
32
What are the three ways that monoclonal antibodies are broadly used? [3]
**Complement mediated lysis**: unconjugated **Immunotoxins:** Coupled to toxin **Radioimmunoconjugates**: Coupled to radioisotopes
33
Give an example that is a chimeric monoclonal antibody used for treating B-Lymphomas [1] What is the target? [2]
**Rituximab**: targets **CD20 on malignant B-cells** and **CD3 on normal T cells** Together enhance **cytotoxicity**
34
What are Chimeric antigen receptors? [1]
**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
Give an example of CAR-T drug for targetting large B-cell lymphoma? [1] What is the drug target? [1]
**Tisagenlecleucel (Kymriah)** CAR-T Cell targeting **CD19**
36
What is the point of using immunotherapy biomarkers? [1] Name 3 key biomarkers for immunotherapy
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
Name 5 future immunotherapy treatments
**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
Explain the mechanism of how chimeric antigen receptor treatment occurs [3]
**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
The majority of humanised monoclonal antibodies use which Ig as a backbone? IgA IgD IgE IgG IgM
**IgG**
40
Which of the following is targeted by Pembrolizumab PD-1 CTLA-4 PD1-Ligand LAG-3 PD2-Ligand
**PD-1**
41
Which cascade is perhaps the most important oncogenic driver of human cancers? PI3 Kinase MAP Kinase KRAS AKT
Which cascade is perhaps the most important oncogenic driver of human cancers? PI3 Kinase **MAP Kinase** KRAS AKT
42
Which of the following is targeted by Rituximab CD10 CD12 CD15 CD19 CD20
Which of the following is targeted by Rituximab CD10 CD12 CD15 CD19 **CD20**
43
Which of the following is targeted by Atezolizumab PD-1 CTLA-4 PD1-Ligand LAG-3 PD2-Ligand
Which of the following is targeted by Atezolizumab PD-1 CTLA-4 **PD1-Ligand** LAG-3 PD2-Ligand
44
Which of the following is an example of a CAR-T drug? Tisagenlecleucel (Kymriah) Atezolizumab Rituximab Ipililumbab Nivolumab
Which of the following is an example of a CAR-T drug? **Tisagenlecleucel (Kymriah)**
45
Which of the following binds uses this as its mechanism of action Tisagenlecleucel (Kymriah) Atezolizumab Rituximab Ipililumbab Nivolumab
Which of the following binds to CD19 in its mechansim of action? **Tisagenlecleucel (Kymriah)**
46
Which of the following binds to CTLA4? Tisagenlecleucel (Kymriah) Atezolizumab Rituximab Ipililumbab Nivolumab
Which of the following binds to CTLA4? Tisagenlecleucel (Kymriah) Atezolizumab Rituximab **Ipililumbab** Nivolumab
47
Which drug prevents the HER2/HER3 dimer from forming? Trastuzumab Pertuzumab Cetuximab Kadcycla
Which drug prevents the HER2/HER3 dimer from forming? Trastuzumab **Pertuzumab** Cetuximab Kadcycla
48
Herceptin is also known as Trastuzumab Pertuzumab Cetuximab Kadcycla
Herceptin is also known as **Trastuzumab** Pertuzumab Cetuximab Kadcycla
49
Which drug stops HER2 binding to another HER2 Trastuzumab Pertuzumab Cetuximab Kadcycla
Which drug stops HER2 binding to another HER2 **Trastuzumab** Pertuzumab Cetuximab Kadcycla
50
Tarceva (Erlotinib) targets which of the following HER2 HER2/HER3 EGFR VEGF
Tarceva (Erlotinib) targets which of the following HER2 HER2/HER3 **EGFR** VEGF
51
Which drug has a side effect of a rash? Trastuzumab Pertuzumab Cetuximab Kadcycla
Which drug has a side effect of a rash? **Trastuzumab** Pertuzumab Cetuximab Kadcycla
52
Which drug causesa decline in left ventricular function AND congestive heart failure Trastuzumab Pertuzumab Cetuximab Kadcycla
Which drug causesa decline in left ventricular function AND congestive heart failure **Trastuzumab** Pertuzumab Cetuximab Kadcycla
53
Which drug blocks ATP binding to tyrosine kinase receptor Trastuzumab Pertuzumab Osimertinib Erlotinib Kadcycla
Which drug blocks ATP binding to tyrosine kinase receptor Trastuzumab Pertuzumab Osimertinib **Erlotinib** Kadcycla
54
Which of the following drug binds to B Trastuzumab Pertuzumab Osimertinib Erlotinib Kadcycla
Which of the following drug binds to B **Trastuzumab** Pertuzumab Osimertinib Erlotinib Kadcycla
55
Which of the following drug binds to C Trastuzumab Pertuzumab Osimertinib Erlotinib Kadcycla
**Pertuzumab**
56
Which drug acts according to this image as a first line drug used for non-small cell lung cancer Trastuzumab Pertuzumab Osimertinib Erlotinib Kadcycla
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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