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PHAR123 > Cancers > Flashcards

Cancers Flashcards

1
Q

What are the different blood tests that may be performed in cancer diagnosis?

A

complete blood count
-count the # of different types of cells in the blood
-abnormality in # and morphology=possibility of cancer
-bone marrow biopsy: confirm blood cancer
blood protein staining
-test of abnormal immunoglobulins
tumor marker
-ex: CA-125
circulating tumor cell (CTC) tests
-uncommon
-test of cancer cells floating in the bloodstream

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2
Q

What are the different types of complete blood count tests?

A

red blood cell test
-RBC count, hemoglobin, hematocrit, reticulocyte count
white blood cell test
-WBC count and differential
platelets test
-platelet count, mean platelet volume, platelet distribution
width

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3
Q

What is the hematocrit?

A

volume proportion of blood that consists of RBC

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4
Q

What is a reticulocyte count?

A

count of immature RBCs

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5
Q

Explain blood protein staining.

A

serum electrophoresis
test protein abnormality and loss of proteins

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6
Q

What is blood protein staining useful in diagnosing?

A

lymphoma
chronic lymphocytic leukemia
multiple myeloma

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7
Q

What are examples of tumor markers? List what they sample, cancer type, and purpose.

A

CA-125
-sample: blood
-cancer type: ovarian cancer
-purpose: diagnosis and treatment
CD25
-sample: blood
-cancer type: non-Hodgkin lymphoma
-purpose: targeted therapy
EGFR gene mutation
-sample: tumor
-cancer type: non-small cell lung cancer
-purpose: treatment and prognosis
estrogen receptor:
-sample: tumor
-cancer: breast cancer
-purpose: hormone therapy & targeted therapy

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8
Q

What is CA-125?

A

cancer antigen 125
-glycoprotein with molecular weight >200kD

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9
Q

What is the normal range of CA-125 in the blood?

A

less than 46 U/ml

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10
Q

When are CA-125 levels higher than normal range?

A

ovarian cancer (diagnosis and treatment)
endometriosis
liver diseases
menstruation
pregnancy
uterine fibroids

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11
Q

What is 70-Gene signature used for?

A

predict metastasis and recurrence of breast cancer
test the activity of 70 different genes in the breast cancer tissue
aid to early-stage breast cancer treatment

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12
Q

When are CTCs commonly used?

A

breast cancer
colorectal cancer
prostate cancer

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13
Q

What are the different cancer diagnostic imagings?

A

breast mammogram
CT scan
MRI
PET scan

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14
Q

How do breast mammograms work?

A

low-dose X-ray imaging
two images of each breast at ~0.4 millisilverts
show abnormal areas in the breast
used for screening of breast cancer

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15
Q

What is a CT scan?

A

computerized tomography
X-ray scan from different angles and computer-processed cross-sectional images

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16
Q

What is a PET scan?

A

positron emission tomography
use a radioactive drug as a trace, such as fluorodeoxyglucose

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17
Q

What is an MRI?

A

magnetic resonance imaging
uses magnetism, radio waves, and a computer to produce images

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18
Q

What is the main way to diagnose most types of cancer?

A

cancer biopsy
remove a piece of tissue from body and analyze it
-bone marrow biopsy
-endoscopic biopsy
-needle biopsy
-skin biopsy
-surgical biopsy
biopsy analysis
-confirmation of cancer
-cancer grade
-targets for targeted therapy

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19
Q

What can be done to a tumor from surgery for cancer?

A

remove the entire tumor
debulk a tumor (removing whole tumor might damage organ)
ease cancer symptoms: remove painful tumors

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20
Q

What is smaller residual tumor volume associated with?

A

longer survival for cancer patients

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21
Q

What are the types of surgery for tumors?

A

open surgery
minimally invasive surgery (tiny incisions, non-robotic and robotic surgery)
cryosurgery (liquid nitrogen to treat skin cancers and retinoblastoma)
laser surgery (tumors on surface of the body)
hyperthermia (radiofrequency ablation)

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22
Q

What is radiation therapy? What is its purpose?

A

apply high doses of radiation to kill cancer cells and reduce tumor size
purpose: treatment and palliative care
can be external beam radiation therapy and internal radiation therapy

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23
Q

What are examples of external beam radiation therapy?

A

photons, protons and electrons
3D conformal radiation therapy (3D-CRT)
intensity-modulated radiotherapy (IMRT)

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24
Q

Explain 3D-CRT.

A

allows doctors to direct radiation beams (photons) to conform the shape of a tumor
beams are arranged to avoid normal organs and target the tumor

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25
Explain IMRT.
multiple beams are positioned for the therapy each big beam is divided into many small beams (beamlets) special software is used to identify beamlet patterns for precise radiation can be used for HARD-TO-TREAT AREAS
26
What is used to provide the 3D image of the tumor and nearby organs for IMRT and 3D-CRT?
CT scan
27
What are examples of internal radiation therapy?
brachytherapy (sealed container of radioactive material into tumors) radioisotope therapy (such as I-131 for thyroid cancer) radioimmunotherapy (combination of radioisotopes and monoclonal antibodies) radioembolization (radioactive beads along with embolization, reduced blood supply)
28
True or false: chemotherapy can only be used alone as a cancer therapy
false can be alone or in combination with other therapies
29
What is adjuvant chemotherapy?
often used after primary treatments (such as surgery or radiotherapy) destroy micro-metastasis prevent or reduce cancer recurring
30
What is neoadjuvant chemotherapy?
given before the main treatment reduce tumor size to make primary treatment easier or more effective
31
What are the types of chemotherapy?
DNA-damaging agents: alkylating agents antimetabolites: purine or pyrimidine antagonists antimitotics: taxames and vinca alkaloids antitumor antibiotics: intercalating agents (anthracyclines) DNA-repair enzyme inhibitors: PARP inhibitors
32
What are examples of alkylating agents?
nitrogen mustards -melphalan, cyclophosphamide, ifosfamide, chlorambucil, estramustine nitrosureas -carmustine, lomustine, nimustine, streptozocin platinum drugs -carboplatin, cisplatin, oxaliplatin miscellaneous alkylating drugs -busulfan, procarbazine
33
What is the MOA of nitrogen mustard alkylating agents?
internal cylisation and guanine binding -either intra or inter guanine binding
34
What is the MOA of nitrosurea alkylating agents?
forms a chloroethylene ion which alkylates O6 of guanine
35
What is the MOA of streptozocin?
forms CH3+ which alkylates O6 of guanine -has three possible N-dealkylation spots but the formation of CH3+ is the main one
36
What is the MOA of platinum alkylating agents?
alkylate and crosslink DNA (intra and inter) -attaches to N7 of guanine cell-cycle non-specific
37
What is the MOA of busulfan?
remove mesylate to form R-CH2+ nonspecific alkylating agent (N7 guanine) cause intra and inter crosslink of DNA
38
What is busulfan used to treat?
chronic myelogenous leukemia
39
What is the MOA of procarbazine?
form methyladiazonium ion and methyl cation nonspecific alkylating agent which methylates guanine at O6 may inhibit protein, RNA, and DNA synthesis
40
What is procarbazine used to treat?
Hodgkins lymphoma (stages III and IV) non-Hodgkins lymphoma and gliomas
41
What do the antimetabolites do?
prevent the biosynthesis of normal cellular metabolites -pyrimidine antimetabolites, purine antimetabolites, folic acid analogues
42
What are examples of antimetabolites?
5-Fluorouracil capecitabine gemcitabine cytarabine azacitidine
43
What is the MOA of cytarabine?
inhibits conversion of cytidylic acid to 2-deoxycytidylic acid DNA-dependent polymerase miscoding due to incorporation into DNA/RNA effective during S-phase
44
What is the MOA of vinca alkaloids?
prevent microtubule polymerization (prevent assembly of mitotic spindles)
45
What are vinca alkaloids used to treat?
Hodgkins lymphoma non-small cell lung cancer bladder cancer melanoma
46
What is the MOA of taxanes?
binds to free tubulin produces stable microtubules inhibits microtubule disassembly (works in M phase) microtubules arrange in a parallel fashion rather than a spindle
47
What is the MOA of anthracyclines?
DNA intercalating agents intercalate with DNA perpendicular to its longitudinal axis cause single and double stranded DNA cleavage
48
What is PARP?
poly ADP-ribose polymerase involved in DNA repair
49
True or false: PARP is under expressed in many types of cancers
false overexpressed
50
What is the MOA of PARP inhibitors?
blocks DNA repair in cancer cells and cause cell death
51
Are normal cells damaged during PARP inhibitor repair?
no normal cells dont solely rely on PARP PARP is the only DNA repair in cancer cells
52
What is the goal of targeted therapy?
slow down cancer growth kill cancer cells relieve symptoms caused by cancer
53
What are the targeted therapy agents?
tyrosine kinase inhibitors -imatinib, gefitinib, ibrutinib monoclonal antibodies -trasztuzumab, pertuzumab, T-DM1, bevacizumab, rituximab apoptosis-inducing agents -bortezomib, oblimersen angiogenesis inhibitors -bevacizumab, sunitib
54
What is tyrosine kinase?
domain present in growth factor receptors, such as epidermal growth factor receptor (EGFR) and vascular endothelial cell growth factor (VGEFR), and signaling protein kinases such as Ras and Raf
55
What is the MOA of imatinib?
inhibit BCR-ABL tyrosine kinase inhibit proliferation and induce apoptosis in BCR-ABL positive cells
56
What is the MOA of gefitinib?
inhibitor of epidermal growth factor receptor (EGFR) signaling via EGF-EGFR promotes DNA synthesis, proliferation, migration and survival
57
What is the MOA of trastuzumab?
targets Her2 binds to subdomain IV of Her2 protein -subdomain IV is responsible for dimerization of Her2
58
What is the MOA of pertuzumab?
binds to subdomain II of Her2 protein block homodimerization of Her2 and heterodimerization of Her2-Her3 inhibit Her2-signaling pathway and decrease cell growth
59
What is the combination therapy for metastatic and recurrent Her2 breast cancer?
trastuzumab + pertuzumab + docetaxel
60
What is the MOA of the apoptosis inducing agent, bortezomib?
proteasome inhibitor and apoptosis-inducing agent bind to 26S proteasome, prevent proteosome-mediated degradation of pro-apoptotic factors and induce apoptosis
61
What is the difference between Hodgkin and non-Hodgkins lymphoma?
presence of Reed-Sternberg cells
62
What is the MOA of bevacizumab?
anti-angiogenesis monoclonal antibody block VEGF starve cancer cells VEGF and its receptors can induce and promote angiogenesis
63
What is the MOA of sunitinib?
multiple-targeted tyrosine kinase inhibitor inhibit VEGF, PDGFR, CSFR, and KIT angiogenesis inhibitor
64
What is PD-1?
programmed cell death protein 1 -surface protein on T cells -prevent T-cells from other cells upon binding PD-L1 -check immune responses
65
What is PD-L1?
programmed cell death ligand 1 -transmembrane protein -prevent T-cells from killing PD-L1 containing cells -suppress adaptive immune responses during events such as pregnancy -upregulated in cancer cells
66
What is immunotherapy?
stimulate immune system to fight cancer -immune checkpoint inhibitors -T-cell transfer therapy -monoclonal antibodies -treatment vaccines -immune system modulators
67
How can hormones promote cancer growth?
hormones can bind estrogen receptor (ER) and progesterone receptor (PR) to promote cancer cell growth hormonal therapies are used for breast cancer cells with expression of ER and PR
68
What is the MOA of tamoxifen?
block ER and inhibit breast cancer cell growth may slightly increase the chance of getting uterine cancer
69
What are examples of taxanes?
paclitaxel-breast, lung, ovarian cancers docetaxel-breast, lung, stomach, prostate, head and neck cancers
70
What are examples of antitumor antibiotics?
daunorubicin doxorubicin epirubicin idarubicin mitoxantrone
71
What do all PARP inhibitors end in?
-parib
72
What is imatinib used to treat?
acute lymphocytic leukemia chronic myelogenous leukemia
73
What is gefitinib used to treat?
non-small cell lung cancer
74
What is trastuzumab used to treat?
Her2-subtype breast cancer
75
What is the MOA of T-DM1?
conjugate of trastuzumab (T) and emtansine (DM1) emtansine is a cytotoxic agent that cleaves from T-DM1 and released inside breast cancer cells
76
What is T-DM1 used to treat?
Her2+ metastatic breast cancer early-stage breast cancer after surgery
77
What is bortezomib used to treat?
multiple myeloma Mantle cell lymphoma
78
What is bevacizumab used to treat?
colon cancer lung cancer
79
What is sunitinib used to treat?
renal cell carcinoma imatinib-resistant GI stromal tumor metastatic pancreatic cancer

PHAR123 (15 decks)

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