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Haematology HK > Cancer treatment > Flashcards

Cancer treatment Flashcards

1
Q

what is used to detect remission in hodgkins

A

PET scan

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2
Q

what are the 2 types of cytotoxic drugs

A

cell cycle specific

non-cell cycle specific

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3
Q

what are cell-cycle agents good for

A

proliferating tumours

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4
Q

how do cell-cycle agents work

A

PREVENTS MITOSIS AND CELL REPLICATION
antimetabolites - impair nucleotide syntheses/incorporation
mitotic spindle fibre inhibitors

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5
Q

examples of antimetabolites and what they act on

A

methotrexate - inhibits dihydrofolate reductase
mercaptopurine/cytosine arabinoside/fludarabine - artificial bases incorporated into DNA
hydroxyurea - impaired deoxynucleotide synthesis

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6
Q

examples of mitotic spindle inhibitors

A

vinca alkaloids

taxotere

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7
Q

examples of non-cell cycle agents

A 
alkylating agents (chlorambucil, melphalan)
platinum derivatives (cis-platinum, carboplatin)
cytotoxic antibiotics (anthracyclines: daunorubicin, doxorubicin)
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8
Q

how do alkylating agents work

A

bind covalently to bases of DNA - induces apoptosis

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9
Q

general side effects of cytotoxic drugs

A 
bone marrow suppression (anaemia, bleeding, infection)
gut mucosa damage 
hair loss 
fatigue
nausea vomiting
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10
Q

side effect of vinca alkaloids

A

neuropathy

infertility and secondary malignancy (long term)

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11
Q

side effect of anthracyclines

A 
cardiotoxicity 
cardiomyopathy (long term)
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12
Q

side effect of cis-platinum

A

nephrotoxicity

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13
Q

why might chemotherapy fail

A 
slow tumour growth 
drug resistant mechanisms:
decreased accumulation 
increased drug metabolism 
increased DNA repair
altered gene expression
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14
Q

why is CLL more difficult to treat

A

mutation of P53 gene

P53 allows cells to recognise when they have been damaged by chemo and induces apoptosis

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15
Q

supportive therapy during cytotoxic therapy

A

broad spectrum antibiotics
red cell/platelet transfusions
growth factor
prophylactic antibiotics and antifungals (itraconazole or posaconazole)

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16
Q

examples of targeted therapy

A

monoclonal antibodies
biologic agents
molecularly targeted treatments

17
Q

how do monoclonal antibodies work

A

only affect cells which possess target protein

antibody attaches to cell initiating complement cascade and NK cells

18
Q

when are monoclonal antibodies used

A

alongside chemotherapy

19
Q

example of monoclonal antibodies

A

rituximab

20
Q

what is rituximab used for

A

high grade NHL

improves survival and prolongs remission in CLL

21
Q

why might monoclonal antibodies not work

A

relies on immune system (NK cells and complement) to be functioning

22
Q

what is brentuximab vedotin

A

monoclonal antibody and chemotherapy combines

used in hodgkins and some T cell NHL

23
Q

examples of biological treatments

A

protosome inhibitors

IMIDs

24
Q

what are biologics used in

A

multiple myeloma

25
Q

how do protosome inhibitors work

A

causes build up toxic proteins in cells initiating apoaptosis

26
Q

what are IMIDs

A

derivatives of thalidomide

orevent tumours from evading the immune system

27
Q

when are IMIDs used

A

remission of low grade NHL and CLL

28
Q

examples of molecular treatments

A

tyrosine kinase inhibitors

ibrutinib - targets malignant B cells

29
Q

when are tyrosine kinase inhibitors used

A

acute and chronic myeloid leukaemia

30
Q

examples of tyrosine kinase inhibitors

A

imatinib
nilotinib
dasatinib
ponatinib

31
Q

side effects of tyrosine kinase inhibitors

A

diarrhoea
fluid in lungs
neutropenia

32
Q

side effects of B cell drugs (ibrutinib)

A 
diarrhoea 
rash 
fatigue 
liver abnormality 
fever
33
Q

what are checkpoint inhibitors

A

nivolumab

prevents immune evasion

34
Q

when is nivolumab used

A

malignant melanoma

lymphoma relapses

35
Q

what is immune therapy

A

bone marrow transplant - T cells from donor cause immune attack on cancer

36
Q

adverse effect of bone marrow tansplant

A

also attacks normal host cells

37
Q

what is adoptive immunotherapy

A

makes patients own immune cells recognise the cancer as foreign
CART therapy

38
Q

when is adoptive immunotherapy used

A

ALL

NHL

Haematology HK (22 decks)

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