cancer treatment Flashcards
systemic treatment of cancer
- therapies that treat entire body, targetting cancer cells that may have spread beyond the primary site
these include:
- chemotherapy
- hormonal therapy
- targeted treatment
- immunotherapy
principles of systemic treatment
control / eliminate cancer cells around the body:
- selectivity and toxicity - aims to target cancer cells while minimising damage to normal cells - this is hard
- combination therapy - many treatments used in combination to improve efficacy and reduce risk of resisatnce
- adjuvant and neoadjuvant therapy
types of chemotherapy
Curative: Aim to eliminate cancer completely
Adjuvant: Used after surgery or radiotherapy to eliminate remaining cancer cells
Neoadjuvant: Administered before surgery to shrink tumours
Palliative: Relieves symptoms when a cure isn’t possible
endocrine therapy
Involves blocking or lowering hormones that fuel certain cancers, such as breast and prostate cancers
Targeted therapy
Uses drugs or other substances to precisely identify and attack cancer cells, typically with less harm to normal cells
immunotherapy
Definition: Immunotherapy boosts or restores the body’s natural immune system to fight cancer
Mechanism: Enhances the immune system’s ability to recognize and destroy cancer cells
Types:
- Checkpoint Inhibitors: Block proteins that prevent immune cells from attacking cancer cells
- CAR-T Cell Therapy: Involves modifying a patient’s T cells to better target cancer cells
phase I clinical trials
focus - safety and dosage
- determine maximum tolerated dose
- identify effects
participants - small amount often with advanced cancer
phase II trials
focus - effectiveness and safety
- assess the initial therapeutic efficacy and further refine safety profile
- larger group of participants with specific types of cancer
- see how the drug works on specific cancer types
phase III trials
- comparative effectiveness
- compare new treatment with current standard of care and assess overall survival and pregression-free survival
- large group of partcicipants across multiple locations
chemotherapy how it works
- using cytotoxic drugs to kill dividing cells
- by interfering with dna synthesis or cell division
- effects both cancerous and normal cells
- especially those which divide quickly like hair follicles and bone marrow
common chemotherapy drugs
- Cyclophosphamide
- doxorubicin
- cisplatin
- paclitaxel
chemotherapy side effects
Due to its lack of specificity for cancer cells, chemotherapy causes side effects like nausea, hair loss, immunosuppression, and fatigue.
chemo mechanism of action
Chemotherapy drugs act on different phases of the cell cycle, with some targeting DNA replication, while others affect mitosis.
Hormonal Therapy
- used in cancers that are hormone-sensitive
- such as breast cancer and prostate cancer
- involves blocking natural hormones or interfering with hormone receptors to slow or stop cancer cell growth
Hormonal Therapy mechanism
In breast cancer, for example, estrogen can stimulate tumor growth. Drugs like tamoxifen block estrogen receptors, while aromatase inhibitors prevent the body from making estrogen.
hormone therapy side effects
Hormonal therapies can cause hot flashes, mood changes, and osteoporosis.
hormone therapy common drugs
- Tamoxifen, aromatase inhibitors (letrozole, anastrozole)
- gonadotropin-releasing hormone (GnRH) agonists (for prostate cancer).
targeted treatment
Targeted therapies are designed to specifically target cancer cell molecules or signaling pathways that are involved in tumor growth and survival. They are more selective than chemotherapy and often cause fewer side effects
- effects proteins or enzymes such as tyrosine kinase inhibitors + monoclonal antibodies
targetted therapy example drugs + side effects
Tyrosine kinase inhibitors (e.g., imatinib for chronic myeloid leukaemia).
Monoclonal antibodies (e.g., trastuzumab for HER2-positive breast cancer).
Angiogenesis inhibitors (e.g., bevacizumab, which targets VEGF to prevent the growth of blood vessels supplying tumors).
side effects:
- diahrroea
- skin rashes
- fatigue
Immunotherapy
Immunotherapy is a treatment that stimulates or enhances the body’s immune system to fight cancer. It works by targeting immune checkpoints or boosting immune responses to recognize and attack cancer cells.
immunotherapy types
Immune Checkpoint Inhibitors: These drugs block proteins (e.g., PD-1, PD-L1, and CTLA-4) that prevent immune cells from attacking tumors. Examples include nivolumab and pembrolizumab.
Cytokine Therapy: Drugs like interleukin-2 (IL-2) and interferon-alpha are used to stimulate immune cells directly.
CAR-T Cell Therapy: This involves modifying a patient’s T cells to express a receptor specific for cancer cells, which are then reintroduced into the body to fight the tumor.
immunotherapy side effects
- autoimmune reactions
- fever
- fatigue
- immune-related adverse events
such as inflammation in organs like liver and lungs
