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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
Q

Explain IMRT.

A

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

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26
Q

What is used to provide the 3D image of the tumor and nearby organs for IMRT and 3D-CRT?

A

CT scan

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27
Q

What are examples of internal radiation therapy?

A

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)

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28
Q

True or false: chemotherapy can only be used alone as a cancer therapy

A

false
can be alone or in combination with other therapies

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29
Q

What is adjuvant chemotherapy?

A

often used after primary treatments (such as surgery or radiotherapy)
destroy micro-metastasis
prevent or reduce cancer recurring

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30
Q

What is neoadjuvant chemotherapy?

A

given before the main treatment
reduce tumor size to make primary treatment easier or more effective

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31
Q

What are the types of chemotherapy?

A

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

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32
Q

What are examples of alkylating agents?

A

nitrogen mustards
-melphalan, cyclophosphamide, ifosfamide, chlorambucil, estramustine
nitrosureas
-carmustine, lomustine, nimustine, streptozocin
platinum drugs
-carboplatin, cisplatin, oxaliplatin
miscellaneous alkylating drugs
-busulfan, procarbazine

33
Q

What is the MOA of nitrogen mustard alkylating agents?

A

internal cylisation and guanine binding
-either intra or inter guanine binding

34
Q

What is the MOA of nitrosurea alkylating agents?

A

forms a chloroethylene ion which alkylates O6 of guanine

35
Q

What is the MOA of streptozocin?

A

forms CH3+ which alkylates O6 of guanine
-has three possible N-dealkylation spots but the formation of CH3+ is the main one

36
Q

What is the MOA of platinum alkylating agents?

A

alkylate and crosslink DNA (intra and inter)
-attaches to N7 of guanine
cell-cycle non-specific

37
Q

What is the MOA of busulfan?

A

remove mesylate to form R-CH2+
nonspecific alkylating agent (N7 guanine)
cause intra and inter crosslink of DNA

38
Q

What is busulfan used to treat?

A

chronic myelogenous leukemia

39
Q

What is the MOA of procarbazine?

A

form methyladiazonium ion and methyl cation
nonspecific alkylating agent which methylates guanine at O6
may inhibit protein, RNA, and DNA synthesis

40
Q

What is procarbazine used to treat?

A

Hodgkins lymphoma (stages III and IV)
non-Hodgkins lymphoma and gliomas

41
Q

What do the antimetabolites do?

A

prevent the biosynthesis of normal cellular metabolites
-pyrimidine antimetabolites, purine antimetabolites, folic acid analogues

42
Q

What are examples of antimetabolites?

A

5-Fluorouracil
capecitabine
gemcitabine
cytarabine
azacitidine

43
Q

What is the MOA of cytarabine?

A

inhibits conversion of cytidylic acid to 2-deoxycytidylic acid
DNA-dependent polymerase
miscoding due to incorporation into DNA/RNA
effective during S-phase

44
Q

What is the MOA of vinca alkaloids?

A

prevent microtubule polymerization (prevent assembly of mitotic spindles)

45
Q

What are vinca alkaloids used to treat?

A

Hodgkins lymphoma
non-small cell lung cancer
bladder cancer
melanoma

46
Q

What is the MOA of taxanes?

A

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
Q

What is the MOA of anthracyclines?

A

DNA intercalating agents
intercalate with DNA perpendicular to its longitudinal axis
cause single and double stranded DNA cleavage

48
Q

What is PARP?

A

poly ADP-ribose polymerase
involved in DNA repair

49
Q

True or false: PARP is under expressed in many types of cancers

A

false
overexpressed

50
Q

What is the MOA of PARP inhibitors?

A

blocks DNA repair in cancer cells and cause cell death

51
Q

Are normal cells damaged during PARP inhibitor repair?

A

no
normal cells dont solely rely on PARP
PARP is the only DNA repair in cancer cells

52
Q

What is the goal of targeted therapy?

A

slow down cancer growth
kill cancer cells
relieve symptoms caused by cancer

53
Q

What are the targeted therapy agents?

A

tyrosine kinase inhibitors
-imatinib, gefitinib, ibrutinib
monoclonal antibodies
-trasztuzumab, pertuzumab, T-DM1, bevacizumab, rituximab
apoptosis-inducing agents
-bortezomib, oblimersen
angiogenesis inhibitors
-bevacizumab, sunitib

54
Q

What is tyrosine kinase?

A

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
Q

What is the MOA of imatinib?

A

inhibit BCR-ABL tyrosine kinase
inhibit proliferation and induce apoptosis in BCR-ABL positive cells

56
Q

What is the MOA of gefitinib?

A

inhibitor of epidermal growth factor receptor (EGFR)
signaling via EGF-EGFR promotes DNA synthesis, proliferation, migration and survival

57
Q

What is the MOA of trastuzumab?

A

targets Her2
binds to subdomain IV of Her2 protein
-subdomain IV is responsible for dimerization of Her2

58
Q

What is the MOA of pertuzumab?

A

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
Q

What is the combination therapy for metastatic and recurrent Her2 breast cancer?

A

trastuzumab + pertuzumab + docetaxel

60
Q

What is the MOA of the apoptosis inducing agent, bortezomib?

A

proteasome inhibitor and apoptosis-inducing agent
bind to 26S proteasome, prevent proteosome-mediated degradation of pro-apoptotic factors and induce apoptosis

61
Q

What is the difference between Hodgkin and non-Hodgkins lymphoma?

A

presence of Reed-Sternberg cells

62
Q

What is the MOA of bevacizumab?

A

anti-angiogenesis monoclonal antibody block VEGF
starve cancer cells
VEGF and its receptors can induce and promote angiogenesis

63
Q

What is the MOA of sunitinib?

A

multiple-targeted tyrosine kinase inhibitor
inhibit VEGF, PDGFR, CSFR, and KIT
angiogenesis inhibitor

64
Q

What is PD-1?

A

programmed cell death protein 1
-surface protein on T cells
-prevent T-cells from other cells upon binding PD-L1
-check immune responses

65
Q

What is PD-L1?

A

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
Q

What is immunotherapy?

A

stimulate immune system to fight cancer
-immune checkpoint inhibitors
-T-cell transfer therapy
-monoclonal antibodies
-treatment vaccines
-immune system modulators

67
Q

How can hormones promote cancer growth?

A

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
Q

What is the MOA of tamoxifen?

A

block ER and inhibit breast cancer cell growth
may slightly increase the chance of getting uterine cancer

69
Q

What are examples of taxanes?

A

paclitaxel-breast, lung, ovarian cancers
docetaxel-breast, lung, stomach, prostate, head and neck cancers

70
Q

What are examples of antitumor antibiotics?

A

daunorubicin
doxorubicin
epirubicin
idarubicin
mitoxantrone

71
Q

What do all PARP inhibitors end in?

A

-parib

72
Q

What is imatinib used to treat?

A

acute lymphocytic leukemia
chronic myelogenous leukemia

73
Q

What is gefitinib used to treat?

A

non-small cell lung cancer

74
Q

What is trastuzumab used to treat?

A

Her2-subtype breast cancer

75
Q

What is the MOA of T-DM1?

A

conjugate of trastuzumab (T) and emtansine (DM1)
emtansine is a cytotoxic agent that cleaves from T-DM1 and released inside breast cancer cells

76
Q

What is T-DM1 used to treat?

A

Her2+ metastatic breast cancer
early-stage breast cancer after surgery

77
Q

What is bortezomib used to treat?

A

multiple myeloma
Mantle cell lymphoma

78
Q

What is bevacizumab used to treat?

A

colon cancer
lung cancer

79
Q

What is sunitinib used to treat?

A

renal cell carcinoma
imatinib-resistant GI stromal tumor
metastatic pancreatic cancer

PHAR123 (15 decks)

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