Cancer Screening/Therapy Flashcards
What makes an ideal tumor marker?
Usefulness of Tumor Marker Kinetics?
Kinetics best used in monitoring for recurrence
Why are serum tumor markers measured?
Heterodimeric Glycoprotein
▪ a-chain virtually identical in LH, FSH, TSH
▪ b-chain different and responsible for unique functions
Use of this Tumour Marker?
Human Chorionic Gonadotrophin (hCG)
Use:
- Early detection/monitoring of pregnancy
- Detection/monitoring of hCG-producing germ cell tumors (ovarian, placental, testicular origin)
______________________ is a neoplastic process arising from trophoblastic cells which can lead to _______________________ a RARE malignant form associated with incomplete removal of the chorion during molar pregnancy, abortion, ectopic, normal pregnancy
How is this condition detected/monitored?
Indications for chemotherapy?
Gestational trophoblastic disease (GTD) is a neoplastic process arising from trophoblastic cells which can lead to Choriocarcinoma a RARE malignant form associated with incomplete removal of the chorion during molar pregnancy, abortion, ectopic, normal pregnancy
Human Chorionic Gonadotrophin (hCG) Monitored
Glycoprotein produced during embryonic development which performs functions of albumin in fetal circulation?
When do concentrations fall to adult levels?
What is this marker elevated in?
Cell surface glycoprotein that plays a role in cell adhesion?
Use of this Tumour Marker?
Antigenic glycoprotein markers on cell surface secreted by tumor cells?
Use of CA 125?
Serine protease expressed by epithelial cells in the prostate gland.
Function?
What causes elevation of this marker?
Staging/Prognosis of Prostate Cancer?
Detection of Multiple Myeloma?
Dimeric glycoprotein made in follicular cells of the thyroid glands and deposited into the colloid. Use of this tumour marker?
Thyroglobulin (Tg)
Presence in circulation in very SMALL AMOUNTS => Marker for active thyroid issue.
Tumor marker used for detection of Medullary Thyroid Cancer?
Chemotherapeutic that functions by cross-linking DNA Strands?
Alkylating Agents
Chemotherapeutic that functions by adducting DNA => Strand breaks?
Platinums
Chemotherapeutic that functions by interfering with mitosis?
Microtubule Inhibitors
Chemotherapeutic that functions by stopping DNA replication and RNA Transcription?
Topoisomerase Inhibitors
Chemotherapeutic that functions by inhibiting DNA Synthesis?
Antibiotics
Chemotherapeutic that functions by interfering with RNA/DNA Synthesis?
Antimetabolites
EGFR Targeted therapies?
Cell Cycle
- __________: cell prepares for DNA synthesis
- __________: cell generates complete copy of genetic material
- __________: cell prepares for mitosis
- __________: replicated DNA is condensed and segregated into chromosomes
- __________: resting state
Alkylating Agents
- Examples
- Cell Cycle Specificity
- MOA
Platinum Analogues
- MOA
- Indications
Anti-Metabolites
- Examples
- Cell Cycle Specificity
- MOA
- Indications
- Side Effects
Topoisomerase Inhibitors
- Examples
- Cell Cycle Specificity
- MOA
- Indication
Anti-Tumor Antibiotics
- Example
- MOA
- Side Effects
- Indication
Therapeutics Affecting Microtubules
- Examples
- MOA
- Side Effects
- Indications
Small Molecule Kinase Inhibitors
- Examples
- MOA
- Indication
Hormonal Therapies for Breast Cancer
Estrogen Receptor antagonist (Tamoxifen)
Aromatase inhibitors (Anastrozole, Letrosole): Block conversion of androgens to estrogens in peripheral fat
Hormonal Therapies for Prostate Cancer
Androgen receptor antagonists: Bicalutamide, Flutamide
Gonadorelin analogs => pituitary suppression of androgen secretion: Buserelin, Goserelin
Asparaginase MOA as a Chemotherapeutic?
Types of Biotherapeutics?
Group IIa- Interphering with a molecule or protein
group IIb- Delivering other compounds/proteins
mAb that binds to and neutralizes TNF-alpha. Used to treat Chron’s Disease and RA
Infliximab
Recombinant IL-1 receptor antagonist used to treat moderate/severe RA?
Anakinra
Binds to integrins blocking VCAM-1 Interaction used to treat MS?
Natalizumab
Chimeric mAb against CD20 that depletes B-Cell populations and is used to treat Non-Hodgkins Lymphoma and RA?
Rituximab
mAb against HER-2 cell surface receptor, used to treat HER2 Positive breast cancer?
Transtizumab (Herceptin)
Checkpoint inhibitor that binds PD-1 receptor restoring T-Cell function, enabling activated T-cells to kill tumor cells?
Pembrolizumab
Humanized HER-2 Antibody conjugated to a DNA topoisomerase I inhibitor, used to treat HER2 Positive breast cancer.
Trastuzumab Deruxtecan
Combines extracellular recognition w/ intracellular delivery of drugs. Deliver a high dose of chemotherapy to cells ONLY expressing HER-2.
Dimeric fusion protein between soluble TNF-alpha receptor and Fc portion of IgG1 used to Moderate/severe RA + Severe Polyarticular Juvenile RA
Etanercept
Early Diagnosis vs. Screening for Cancer?
How to Asses the Value of a Diagnostic test?
- Sensitivity
- Speciicity
- Positive Predictive Value
- Negative predictive value
Sensitivity: True Positive/ (True Positive + False Negative)
Specificity: True Negative/ (True negative + False Positive)
Statistical properties of successful screening?
- Sensitivity
- Specificity
- Positive Predictive value
Biases of Screening tests?
Principles of Screening for a Disease (10)
Conventional vs. Serrated vs. Microsatellite Instability Pathway Mutations?
Screening for Colorectal Cancer?
FIT (Fecal Immunochemical Test):
- Delivered to home
- Ages 55-74 Targeted
- Negative (95%)- Repeat in 2 years
- Positive (5%)- Refer for colonoscopy
Screening for Cervical Cancer?
MOST SUCCESSFUL SCREENING TEST
HPV Vaccination recommendations?
