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Year 4 Oncology > Chemotherapy > Flashcards

Chemotherapy Flashcards

1
Q

Properties of cancer that causes increased cell proliferation

A 
Self-sufficiency in growth signals 
Evades apoptosis 
Insensitivity to anti-growth signals 
Tissue invasion and metastasis
Sustained angiogenesis 
Limitless replicative potential
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2
Q

Types of cancer therapy

A

Neoadjuvant
Adjuvant
Palliative

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3
Q

Neoadjuvant chemotherapy

A

Chemotherapy before definitive treatment to shrink the tumour and optimise outcomes

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4
Q

Adjuvant chemotherapy

A

Chemotherapy given after treatment to reduce the risk of disease recurrence

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5
Q

Palliative chemotherapy

A

Chemotherapy to relieve symptoms and improve quality of life but not cure the cancer

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6
Q

Treatments for cancer

A

Surgery
Chemotherapy
Radiotherapy
Immunotherapy - monoclonal antibodies or checkpoint inhibitors

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7
Q

5 - fluorouracil (5-FU)

A

Thymidylate synthase inhibitor

  • colorectal cancer
  • breast cancer
  • gastric/ oesophageal cancer
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8
Q

Platinum agents

A

Such as cisplatin
Forms adducts with DNA

  • colorectal cancer
  • lung cancer
  • gastric cancer
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9
Q

Vinka alkaloids

A

Inhibits the function of microtubules therefore permanently in metaphase and cannot undergo anaphase

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10
Q

Pathophysiology of drug resistance

A
  1. Decreased entry or increased exit of agent - membrane modification, efflux pumps or transporter loss
  2. Inactivation of agent within the cell - degradation
  3. Enhanced repair of the DNA damage
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11
Q

Prescribing cytotoxic drugs

A
  • Narrow therapeutic window
  • Dose specific to patient based on BMI, renal/liver function/ performance status
  • combination of drugs
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12
Q

Neurological side effects of chemotherapy

A

Peripheral neuropathy
Fatigue
Chemo brain - fuzzy
Alopecia

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13
Q

Cardiac side effects of chemotherapy

A

Neutropenic sepsis
Cardiomyopathy
Myelosupression

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14
Q

GI side effects of chemotherapy

A

Vomiting
Mucositis
Diarrhoea
Constipation

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15
Q

Bladder side effects of chemotherapy

A

Haemorrhagic cystitis - carbamazepine

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16
Q

Skin side effects of chemotherapy

A

PPE - Pruritic Papular Eruption
Rash
Nail loss

17
Q

Renal side effects of chemotherapy

A

AKI

Electrolyte disturbance

18
Q

Liver side effects of chemotherapy

A

Deranged LFTs

19
Q

Pulmonary side effects of chemotherapy

A

Pneumonitis

Pulmonary emboli

20
Q

Reproductive side effects of chemotherapy

A

Infertility
Decreased libido
Premature menopause

21
Q

Types of immunotherapy

A

Passive - ex vivo activated cells that was once inside the body, inserted to compensate for deficient immune functions such as peptide vaccines

Active - stimulate effector functions in vivo, requires pt’s immune system to respond

22
Q

Types of monoclonal antibody

A

HER2 inhibitor - Trastuzumab - breast cancer

VEGR inhibitor (vascular epithelial growth receptor) - Bevacizumab - ovarian an bowel cancer

EGFR inhibitor (epithelial growth factor receptor) - cetuximab - bowel cancer

23
Q

Side effects of targetted therapies

A 
Skin toxicity - acneform rash, dry skin 
Hair growth disorders
Pruritis 
Nail changes 
Delayed wound healing

Fatigue
Myelosuppression
Arterial thromboembolic event

Diarrhoea
Nausea
GI perforation

Hypertension
Proteinuria
Cardiac ischaemia

24
Q

Treatment of grades of rash

A

Grade I - keep skin well hydrated and avoid alcohol-based products

Grade II - topical antibiotics

Grade III - hold treatment, oral + topical antibiotics and corticosteroids

Grade IV - stop treatment

25
Q

Tumour cell PD - L1

A

Tumour cells have PD - L1 antigens that bind to PD-1 receptors on T cells which prevents them being phagocytosed

26
Q

Chemotherapy

A

Treatment that inhibits cell division by targeting proteins or DNA to cause apoptosis

27
Q

Fractional Cell Kill Hypothesis

A

Multiple sessions of chemotherapy to balance the cell death of cancer cells and normal cells

More cancer cells are affected than normal cells

28
Q

Types of chemotherapy

A 
Alkylating agents 
Taxanes 
Vinka alkaloids 
Platinum complexes 
Antimetabolites 
Anthracyclines 
Antitumour antibiotics 
Topoisomerase inhibitors
29
Q

Alkylating agent example

A

Cyclophosphamide

30
Q

Mechanisms of alkylating agents

A

DNA crosslinks

31
Q

Mechanisms of taxanes

A

Cell stays in metaphase due to stabilisation of microtubules

32
Q

Antimetabolite examples

A

Methotrexate

5- FU

33
Q

Anthracyclines examples

A

Doxorubicin
Epirubicin
Mitomicin

34
Q

Antitumour antibiotic example

35
Q

Principles of combination chemotherapy

A
  • reduce resistance
  • maximise therapeutic effect without high toxicity
  • use drugs with different MOA
  • use optimal dose and schedule
  • minimise toxicity overlap
  • pulsed intermittent treatment to allow recovery

Year 4 Oncology (21 decks)

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