Chemotherapy

Question 1

What is chemotherapy

Answer 1

Compound which targets DNA,RNA & proteins
Forces cells into apoptosis
Non-specific

Question 2

What cells does chemotherapy affect

Answer 2

All dividing cells

Question 3

How is chemotherapy delivered

Answer 3

IV & Oral
Administered in cycle

Question 4

What determines chemo cycles

Answer 4

Pharmacokinetics

Question 5

What does combination chemo increase

Answer 5

Efficacy

Question 6

What are the three types of chemo

Answer 6

Alkylating agents+ platinum drugs- Block DNA repl.
Antimetabolites- Mimic molecules required for cell div.
Organic drugs- Alkaloids/taxanes/anthracyclines

Question 7

What does personalised systemic therapies involve

Answer 7

Hormonal therapies- anti-oestrogen, aromatase inhibitors
Targeted therapies- EGFR, VEGF, CDK 4/6
Immunotherapy- PD1, PD-L1, CTLA 4

Question 8

What does hormone therapy involve

Answer 8

Targets hormones directly
E.G. breast cancer- Prevents oestrogen overproliferation

Question 9

How do targeted therapies work

Answer 9

Use of EGF inhibitors E.g Tyrosine kinase inhibitors
Use of CDK4/6 Inhibitors

Question 10

What is an example of EGF inhibitor

Answer 10

tyrosine kinase inhibitors

Question 11

What are the side effects of tyrosine kinase inhibitor

Answer 11

Diarrhoea
Dry skin
rash
hypertension
liver dysfunction

Question 12

What are CDK 4/6 inhibitors

Answer 12

Cyclin dependant kinase inhibitors
Cyclin D pushes cells from G0->G1 phase
Cyclin D regulates Cyclin E - Pushes cells from G1->S phase
Inhibitors block progression of cells through cycle

Question 13

What is immunotherapy

Answer 13

Using bodies own immune system to fight cancer

Question 14

What are the cells involved in this

immunotherapy

Answer 14

Derived from Haematopoietic stem cells
B cells
T cells

Question 15

What is the role of the immune checkpoints

Answer 15

Ensure self-tolerance maintained
Activated by ligand binding
Eg PD-1-> PD-L1 &CTLA-4 -> B7
Immune checkpoint inhibitors remove immune system brakes to increase T cell activity

Question 16

What do immune checkpoint inhibitors cause

Answer 16

Increases T cell activity

Question 17

What is pembroluzimab

Answer 17

Therapeutic agent
IgG4 monoclonal antibody
Blocks binding to PD-L1

Question 18

What are immunotherapy side effects

Answer 18

Every itis
Most comon colitis
Least common neurological

Question 19

What are some indications in scotland

Answer 19

NSCLC - PDL1 >50%
With no EGFR/ALK mutation - pembrolizumab

Non Small Cell Lung Cancer

NSCLC - PDL1>1% - atezolizumab
Melanoma - adjuvant stage 3 resected setting -
nivolumab
Melanoma - ipilimumab & nivolumab-