Chemo Flashcards
Goal of chemo
kill 100% cells
- if not possible, control growth and palliative
growth fraction
ratio of proliferating cells to resting cells
higher GF means…
higher chance of chemo working
- more malignant tumor
lower GF means…
bigger tumor, dec GF and slower growing
Barriers to chemo
- need 100% kill
- tox
- tumor response
- late detection
- drug resistance
- cell heterogeneity (leads to resistance)–find right combo to kill all cells
tumor heterogeneity increases with…
AGE
tumor resistance
Mutations become very resistance; 1 tumor can have 1 million bits
same dose therapy
- need same dose for cancer every time (high dose) bc same dose kills same # of cells each time
chemo most toxic drugs EVER
- often late detection, lead to mets, less responsive, worsen debilitation (may not tolerate)
- earliest detection is 1 cm tumor
- solid tumor responds worse bc dec GF and limited blood supply
Intermittent chemo
- lets normal cells recover but not too long before next dose
- GI and epi recover quicker
combo therapy
- multiple drug better than one
- dec resistance and normal cell injury
- don’t want to give multiple drugs with similar toxicity (ex: 2 nephrotox)
optimal dosing therapy
- keep active drug present in body as long as can
- maximize result
Regional drug therapy
- target tumor and not normal cells
- dec systemic tox
Usual chemo toxicities
- n/v–trigger CTZ
- dec WBCs, RBCs, plts 2W post-tx (neutro, erythrocytopenia, thrombo)
- diarrhea
- fatigue
- alopecia (reversible–7-14d post-surg)
- reprod–fetus, germinal epi of testes, don’t get preg, may do sperm bank
- hyperuricemia–cell death and destroy (allopurinol)
- bone marrow supp
- stomatitis
- digestive tract injury–mouth to rectum
- extravasation
- carcinogenic organ damage to kidneys, heart, and lungs
Anticancer agents
cytotoxic, hormonal, biologicals, targeted drugs
- often combined to kill cancer and dec SE
Cell cycle specific drugs
- worse at treating prolif cells
- treats G0 or S
immune checkpoint inhibitors
lets immune cells respond strongly
t-cell transfer therapy
boosts t cell activity by adding lab grown cells to the body
monoclonal antibody therapy
marks cancer cells so they are seen better
Immune system modulators
enhance response; slow tumor growth
