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MSRA oncology > cancer therapy > Flashcards

cancer therapy Flashcards

1
Q

what are examples of alkylating agents?

A

cyclophosphamide
chlorambucil
busulfan

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2
Q

what is the mechanism of action of cyclophosphamide?

A

alkylating agent - causes cross-linking in DNA

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3
Q

what are adverse effects of cyclophosphamide?

A

haemorrhagic cystitis- give mesna
hair loss
meylosuppression
TCC- transitional cell carcinoma

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4
Q

what are examples of cytotoxic antibiotics?

A

bleomycin
anthracyclines eg doxorubicin
actinomycin D/dactinomycin

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5
Q

what is the mechanism of action of bleomycin?

A

degrades pre-formed DNA

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6
Q

what are the adverse effects of bleomycin?

A

lung fibrosis

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7
Q

what is the mechanism of action of anthracyclines eg doxorubicin?

A

stabilises DNA- topoisomerase II complex inhibits DNA + RNA synthesis

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8
Q

what are adverse effects of anthracyclines eg doxorubicin?

A

cardiomyopathy

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9
Q

what is mechanism of action of dactinomycin?

A

antineoplastic antibiotic

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10
Q

what are adverse effects of dactinomycin?

A

myelosuppression
GI toxicity

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11
Q

what are antimetabolites?

A

methotrexate
5-FU fluorouracil
6-mercaptopurine
cytarabine

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12
Q

what is the mechanism of action of methotrexate?

A

inhibits dihydrofolate reductase + thymidylate synthesis

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13
Q

what are adverse effects of methotrexate?

A

myelosuppression
mucositis
liver fibrosis
lung fibrosis

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14
Q

what is the mechanism of action of 5-FU?

A

pyrimidine analogue inducing cell cycle arrest + apoptosis by blocking thymidylate synthase (works during S phase)

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15
Q

what are adverse effects of 5-FU?

A

myelosuppression
mucositis
dermatitis

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16
Q

what is the mechanism of action of 6-mercaptopurine?

A

purine analogue that is activated by HGPRTase
decreasing purine synthesis

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17
Q

what are adverse effects of 6-mercaptopurine?

A

myelosuppression

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18
Q

what is the mechanism of action of cytarabine?

A

pyrimidine antagonist
interferes with DNA synthesis at S phase of cell cycle + inhibits DNA polymerase

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19
Q

what are adverse effects of cytarabine?

A

myelosuppression
ataxia

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20
Q

which cytotoxic agents act on microtubules?

A

vincristine
vinblastine
docetaxel

21
Q

what is the mechanism of action of vincristine/vinblastine?

A

inhibits formation of microtubules

22
Q

what is the mechanism of action of docetaxel?

A

prevents microtubule depolymerisation + disassembly
decreasing free tubulin

23
Q

what are adverse effects of vincristine?

A

peripheral neuropathy- reversible (urinary hesitancy can result from bladder atony)
paralytic ileus

24
Q

what are adverse effects of vinblastine?

A

myelosuppression

25
Q

what are topoisomerase inhibitors?

A

irinotecan

26
Q

what is the mechanism of action of irinotecan?

A

inhibits topoisomerase I which prevents relaxation of supercoiled DNA

27
Q

what are adverse effects of irinotecan?

A

myelosuppression

28
Q

what is the mechanism of action of cisplatin?

A

causes cross-linking in DNA

29
Q

what are adverse effects of cisplatin?

A

ototoxicity
peripheral neuropathy
hypomagnesaemia
n+v
nephrotoxic

30
Q

what is the mechanism of action of hydroxyurea (hydroxycarbamide)?

A

inhibits ribonucleotide reductase which decreases DNA synthesis

31
Q

what are adverse effects of hydroxyurea?

A

myelosuppression

32
Q

what are examples of taxanes?

A

paclitaxel

33
Q

what are adverse effects of paclitaxel?

A

hypersensitivity

34
Q

what are immune modulators?

A

thalidomide
lenalidomide

35
Q

what are tyrosine kinase inhibitors?

A

erlotinib- lung ca
imatinib- CML

36
Q

what are endocrine modulators?

A

tamoxifen
anastrazole

37
Q

what is trastuzumab and which cancer is it given in?

A

anti-Her2
breast ca

38
Q

what is bevacizumab and which cancer is it given in?

A

anti-VEGF
RCC, CRC, lung

39
Q

what is cetuximab and which cancer is it given in?

A

anti-EGFR
CRC

40
Q

what is rituximab and which cancer is it given in?

A

anti-CD20
NHL

41
Q

what are common side effects of chemotherapies?

A

n+v- prophylactic granisetron + dex
alopecia
neutropenia- 10-14d after chemo
extravasation of chemo agent
- presents w pain, burning + bruising at infusion site
- stop infusion, give steroids, apply cold pack
- liaise early w plastics

42
Q

what is radial radiotherapy?

A

treatment w curative intent
40-70gy (gray- radiation dose)
given in 15-30 daily fractions

43
Q

what is palliative radiotherapy?

A

for symptom relief- bone pain, haemoptysis, cough, dyspnoea, bleeding
8-30Gy
1-10 fractions

44
Q

what are early reactions to radiotherapy?

A

tiredness
skin reactions- erythema -> ulceration
mucositis
n+v- occur w stomach, liver or brain rx
diarrhoea- w pelvic or abdo rx
cystitis
myelosuppression

45
Q

what are late reactions to radiotherapy? (months or years)

A

brachial plexopathy- follows axillary radiotherapy- numb, weak, painful arm
lymphoedema
pneumonitis - dry cough +/- dyspnoea, rx w pred
xerostomia- oral dryness
benign strictures
fistulae
reduced fertility
panhypopituitarism

46
Q

what is neoadjuvant chemotherapy?

A

receives chemo prior to primary treatment
shrink tumour to reduce need for major surgery
control early micrometastases

47
Q

what is adjuvant chemotherapy?

A

chemo given after primary treatment to reduce chance of relapse eg breast and GI ca

48
Q

what is palliative chemo?

A

provide relief from symptoms
prolong survival

MSRA oncology (4 decks)

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