Chemotherapy Flashcards
Whats it called when the primary tumour invades the blood vessel?
Intravasation
Whats it called when tumour cells invade out the blood vessles?
Extravasation
What happens if chemo isn’t delivered frequently enough?
Normal cells are damaged each time
Large interval allows tumour cell population to increase between courses
By what route are systemic therapies delivered?
IV & Oral
5 phases of mitosis?
Interphase
Prophase
Metaphase
Anaphase
Telophase
what are the 5 main types of cytotoxic agents?
- Alkylating Agents
- Anti-metabolites
- Mitotic Inhibitors
- Antibiotics
- “other”
At what point do antimetabolites act?
On DNA synthesis
Where do alkylating agents act?
On DNA itself
Where do intercalating agents act?
On DNA transcription & DNA duplication
When do spindle poisons act?
During mitosis, mitotic inhibitors
How do alkylating agents work?
Alkyl group allows covalent bonds to other molecules
DNA helix cross links between/within strands
Separate strands attach at N6 by free guanines
Prevents strands acting as templates for DNA replication (impairs replication)
How do antimetabolites prevent tumor cell division?
Incorporated into new DNA in place of normal nucleosides (nucleotide without Phos)
Bind irreversibly to viral enzymes
Name 2 types of anti-mitotic drugs?
Vinca Alkaloid
Taxanes
How do vinca Alkaloids inhibit mitosis?
Arrest metaphase
Bind to tubuli
Inhibit microtubule + spindle formation
How do taxanes inhibit mitosis?
Promote spindles, prevent disassembly & ‘freeze’ cells at that stage of cycle
What are the 2 types of antimitotic antibiotics?
Anthracyclines
Non-Anthracyclines
How do antibiotics inhibit DNA/RNA synthesis?
Directly blocking path of elongating RNA when transcript becomes 2-3 nucleotides in length
(intercalating)
How do antibiotics prevent mitosis via disrupting the DNA chain?
Produce free radicals which disrupt DNA chain
How do antibiotics block DNA replication?
By Alkylation
What 2 other ways do antimitotic antibiotics act?
Bind to membrane & increase permeability to certain ions
Metal ion chelation results in cytotoxic compound
(Chelation = type of bonding of ions and molecules to metal ions)
In combination chemo why use methods with different action mechanisms?
Reduce risk of resistance developing
Increased efficacy (synergistic or additive effect)
In combo chemo why use methods with dissimilar toxicity?
Both can be used to max dose without causing toxicity
(E.g. dont use two that both have neurotoxicity)
Name some side effects of chemo?
Mucositis
Alopecia
Nausea/vomiting
Sterility
Myalgia
Neuropathy
Renal failure
Cardiotoxicity
Pulmonary Fibrosis
Diarrhoea
Cystisis
Myelosuppresion
Phlebitis
What is alopecia
Hair loss
Mucositis?
Inflammation of mucous membranes
pulmonary fibrosis?
Lung scarring causes dificulty breathign
Cardiotoxicity?
Muscle damage to heart
Cystisis?
Bladder inflamamtion
Myalgia?`
muscle pain
Neuropathy?
problems with nerves
Myelosuppression?
Supression of cell production in the bone marrow (leukocytes, erythrocytes, thrombocytes)
phlebitis?
inflammed veins due to clots
CINV?
Chemotherapy Induced Nausea & Vomiting
Describe hormonal drugs used to treat brest cancer
Anti Oestrogen tamoxifen
Aromatase inhibitors
What kinds of hormonal drugs are used for prostate cancer?
Anti-androgen drugs (e.g. CPA)
Name two targets for targeted cancer drugs?
EGFR & VEGF
epidermal growth factor receptor & Vascular Endothelial Growth Factor
Example of VEGF targeted cancer drug?
Avastin
Example of EGFR targeted cancer drug?
Erlotinib
NSCLC?
Non-small cell lung cancer
Types of immunotherapies?
CTLA4 inhibitors
PD-1/PDL1 inhibitors
What type of immunotherapies are used for melanoma?
Ipilimumab (a CTLA4 inhibitor) & Nivolumab (PD-1/PDL1 inhibitor) together for treatment
