Chemotherapy Flashcards
What are the objectives of chemotherapy?
- cure
- decrease tumor size, reduce symptoms (palliative)
- adjuvant
- neoadjuvant
What is adjuvant chemotherapy?
Chemotherapy is given after definitive therapy (surgery, radiation)
Why is adjuvant therapy given?
To eliminate remaining disease
What is neoadjuvant chemotherapy?
Chemotherapy given before definitive therapy (surgery, radiation)
Why is neoadjuvant therapy given?
Decrease the tumor burden before definitive therapy
How is response to chemotherapy defined?
- complete response (CR): 100% clearance
- partial response (PR): >50% reduction
- stable disease: tumor size neither grows nor shrinks <25% change in size
- progression or no response: > 25% increase in tumor size or appearance of new lesions
How is response rate (RR) defined?
Response rate (RR) = complete response (CR) + partial response (PR)
Classification of chemotherapeutic agents?
- alkylating agents
- antitumor antibiotics
- anti metabolites
- mitotic inhibitors
- topoisomerase inhibitors
- enzymes
- protein tyrosine kinase inhibitors
- hormones
- biological response modifiers
MOA of alkylating agents?
Inhibit dna replication by causing cross-linking and abnormal base pairing of dna strands
Alkylating agents are Classified as?
Phase non-specific agents
Examples of alkylating agents:
Cyclophosphamide
Ifosfamide
Carmustine
Lomustine
Cisplatin
Busulfan
Chlorambucil
MOA of antitumor antibodies?
Inhibits dna synthesis by sliding between base pairs
Antitumor antibodies are classified as?
Phase non-specific agents
Examples of antitumor antibodies:
Doxorubicin
Bleomycin
MOA of antimetabolites?
Inhibit dna synthesis by acting as false substitutions in the production of nucleic acids
Antimetabolites are classified as?
S-phase specific agents
Examples of antimetabolites?
Methotrexate
6-mercaptopurine
5-fluorouracil
Cytarabine
Azacitidine
Capecitabine
MOA of mitotic inhibitors?
Inhibit cell division by preventing microtubule formation
Mitotic inhibitors are also known as?
Taxanes
Mitotic inhibitors are classified as?
M-phase specific
Examples of mitotic inhibitors?
Vincristine
Vinblastine
Paclitaxel
MOA of topoisomerase inhibitors?
Inhibit topoisomerase enzyme necessary for dna replication and rna transcription
Topoisomerase inhibitors are classified as?
G2-specific agents
Examples of topoisomerase inhibitors?
Topotecan
Irinotecan
Etoposide
Example of enzyme based chemotherapeutic agents?
Asparaginase
Asparaginase is classified as?
G1-specific agent
Example of protein tyrosine kinase inhibitors?
Imatinib mesylate