CHAPTER 35: ANTICANCER DRUGS- Chemotherapy Intro

Question 1

Cancer
- define
- anaplasia
- angiogenesis

Answer 1

• abnormal cells grow uncontrollably and spread to other parts of the body (metastasis)

anaplasia: loss of differentiation leads to loss of ability and normal function

Angiogenesis: provide oxygen and nutrients to the cancer cells/help it grow

Question 2

immune system effect on cancer cells

Answer 2

• can damage or destroy tumor cells before the neoplasm grows and becomes uncontrollable

Question 3

principles of cancer therapy
- goal
- therapy

Answer 3

goal: lethal cytotoxic event or apoptosis in cancer cells to stop growth

therapy; Directed toward DNA or against metabolic pathways essential to cell replication

Question 4

immunotherapy

Answer 4

• agents that block checkpoints and allow the PTs own immune system to attack cancer cells

concerns: auto immune toxicity

Question 5

Chemotherapy: adjuvant, neoadjuvant, maintenance

Answer 5

Adjuvant: given after surgery and radiation treatments

neoadjuvant: given PRIOR to surgical procedures (shrink tumor)

maintenance: low doses to assist remission

Question 6

tumor susceptibility

Answer 6

dividing cells are more sensitive to chemotherapy than dormant or slow proliferating tumor cells

• chemotherapeutic agents are CELL CYCLE SPECIFIC effective on replicating cells or either cell cycle NON SPECIFIC

Question 7

Chemotherapy treatment

Answer 7

• combo of drugs w diff MoA and toxicity at FULL doses give higher response rates

Question 8

advantages of drug combos

Answer 8

• max cell killing within range of tolerated toxicity
• effective against large range of cell lines
• delay/prevent development of resistance

Question 9

R-CHOP protocol

Answer 9

• developed for a particular neoplastic state

Rituximab, Cyclophosphamide, Hydroxydaunorubicin, Oncovin, Prednisone

Question 10

Intermittent therapy

Answer 10

21 days apart to allow immune system to recovery reducing risk of serious infections

Question 11

chemotherapy: toxicity

Answer 11

• drugs affect normal rapid dividing cells: GI mucosa, hair follicles (alopecia), bone marrow (immune sys supressed)
• myelosupression: predisposes to infection
• nausea/vomiting
• fertility
  IRREVERSIBLE: cardiotoxicity, bladder toxicity, pulmonary fibrosis

Question 12

Chemotherapy: resistance

Answer 12

• caused by mutating after prolonged administration of suboptimal drug doses
• minimized by short term, intensive, intermittent therapy w drug combos

Question 13

chemotherapy agents: cytotoxic vs non cytotoxic

Answer 13

cytotoxic: antimetabolites, alkylating, antitumor antibiotics, antimitotics, topoisomerase inhibitors, misc.

noncytotoxic: hormonal agents, antibodies, tyrosine kinase inhibitors

Question 14

myelosuppression

Answer 14

dec in bone marrow activity results in reduced production of blood cells