Chemotherapy Flashcards
Beracixumab is used to stimulate angiogenesis in tumours, true or false
False
True or false, tamoxifen is used to treat endometrial cancer
False
True or false, diethylstibestrol is an oestrogen analogue - stimulates mammary glands to proliferate
True
Vincristine is an example of a plant alkaloid, true or false
True
True or false, methotrexate is an anti-metabolite
True
True or false, flurouracil is a pyrimidine analogue. It competes with adenine and guanine in DNA synthesis
False, it competes with C&T bases which make up RNA and DNA
Why are cytotoxic drugs often given in combo
- 2drugs are always more effective
- General toxicity is reduced
- Decrease the chance of developing resistance
2 & 3
True or false cytotoxic antibiotics act directly on DNA
True
The drugs goserelin and buserelin can be used to treat advanced breast cancer, true or false
True
Cyclophosphamide is usually administered with a small volume of liquid, true or false
False, a large volume is administered
True or false, chemotherapy is designed to be selectively toxic to tumour cells
True
Alkylating agents form covalent bonds with DNA to impede destruction, true or false
False
How do tumours metastasise
Produce enzymes which break down the extracellular matrix
What is a common site for secondary tumour in breast Ca
Kidney
In a solid tumour cells occupy 3 compartments; diving cells, resting cells (G0) phase, cells no longer dividing but contribute to tumour volume. Which compartment are susceptible to most cytotoxic drugs
Diving cells
Alkylating agents target cells in what phase?
S phase - DNA synthesis
Which class of drugs form covalent bonds with DNA, preventing uncoiling which inhibits replication
Alkylating agents
What additional side effects do Alkylating agents have
Sterility (esp. In men)
Increase risk of non-lymphocytic leukaemia
Nitrogen mustards, nitrosoureas and platinum compounds are all classes of which type of anticancer drug
Alkylating agents
Mechlorethamine, cyclophosphamide, melphalan, chlorambucil, bendamustine and estramustine are all which type of drug
Cytotoxic, Alkylating events, nitrogen mustards
How are nitrogen mustards administered
IV
Which Alkylating agents can be used for CNS tumours
Nitrosoureas - highly lipophillic
What type of drugs are carmustine and lomustine
Nitrosoureas, Alkylating agents, cytotoxic
How is the nitrosourea carmustine administered
i.v
How is the nitrosourea lomustine administered
Orally
Name a drug which is a platinum compound
Cisplatin
Which anticancer drug binds to purine bases
Cisplatin, a platinum compound
Which types of cancer are more sensitive to cisplatin?
Testicular and ovarian, they have low levels of repair enzyme
How is cisplatin, the platinum compound administered
Slow i.v injection/ infusion
Which drug is a derivative of cisplatin, but has fewer side effects and can be given as an outpatient
Carboplatin
True or false, carboplatin is more myelotoxic than cisplatin
True
Name a platinum compound which is used to treat colorectal cancer
Oxaliplatin
Busulfan, an Alkylating agent is used to treat what?
Leukaemia, as it is selective for bone marrow
What is the Alkylating agent procarbazine used to treat
Hodgkin’s disease
What is the Alkylating agent trabectedin used to treat
Soft tissue sarcoma
Advanced ovarian cancer
Is trabectedin used to treat advanced ovarian cancer
Yes
Which drug is an example of an antimetabolite
Methotrexate
Which drug inhibits dihydrofolate reductase, which is essential for DNA synthesis
Methotrexate
True or false,methotrexate is a folate antagonist
True
How is methotrexate administered
Orally
I.M
I.V
Intrathecally
Methotrexate has low lipid solubility, what does this mean
Does not readily cross the blood-brain-barrier
Which drugs can interact with methotrexate, reducing excretion, increasing toxicity?
NSAIDs
True or false, methotrexate is mostly secreted unchanged in urine
True
Flurouracil, capecitabine, cytarabine and gemcitabine are examples of which type of drugs
Pyrimidine analogues, antimetabolites
Which drugs compete with C and T bases which make up RNA and DNA, inhibiting DNA synthesis
Pyrimidine analogues
How are pyrimidine analogues administered
Parenterally
Which drugs compete with A and G bases which inhibit purine metabolism?
Purine analogues
Mercaptopurine/tioguanine are purine analogues used mainly in the treatment of what
Leukaemia
Mercaptopurine, pentostatin and fludarabine are examples of what type of drug
Purine analogues, antimetabolites
Doxorubicin is an example of which type of drug
Cytotoxic antibiotic
Which anticancer drugs bind directly to DNA, inhibiting DNA and RNA synthesis
Cytotoxic abx. Eg. Doxorubicin
True or false, doxorubicin inhibits topoisomerase II
True
How is the cytotoxic abx doxorubicin administered
IV infusion
Which drug can cause local necrosis, cardiac dysrhythmias/heart failure at high doses
Doxorubicin
Which cytotoxic abx degrades pre-formed DNA
Bleomycin
Which cytotoxic abx is active against non-dividing cells
Bleomycin
Which drug causes little myelosupression but causes pulmonary fibrosis in 10% of patients
- Doxorubicin
- Vinblastine
- Bleomycin
- Exemastine
Bleomycin
Dactinomycin, mitomycin, belong in and doxorubicin are all examples of what type of drug
Cytotoxic abx
Which cytotoxic drugs are derived from Madagascar periwinkle
Vinca alkaloids
Vincristine, vinblastin and vindesine are all examples of which type of drugs
Vinca alkaloids, cytotoxic drugs
Which phase of the cell cycle to vinca alkaloids effect
M phase - mitosis
Which plant derivative, cytotoxic drugs can be used to treat advanced breast cancer
Taxanes, eg. paclitaxel, docetaxel
Which cytotoxic drugs are derived from the bark of the yew tree
Taxanes
True or false, paclitaxel can be used to treat advanced breast cancer and ovarian cancer
True
Which Taxanes can be used to treat ovarian cancer
Paclitaxel and carboplatin
Paclitaxel, docetaxel, and carboplatin are all which types of drugs
Taxanes, cytotoxic drugs
Which cytotoxic drug is derived from mandrake root
Etoposide
Which cytotoxic plant derivative is used to treat testicular cancer and lymphomas?
Etopside
Which cytotoxic plant derivative must avoid skin contact?
- Taxanes
- Etoposide
- Vinca alkaloids
2
What is a side effects of the cytotoxic drug etoposide
Rapid fall in BP during IV infusion
Which type of anti cancer drugs rarely cure disease, but reduce symptoms
Hormones
Which anti cancer drugs are only used in treatment if cancers in hormone sensitive tissues; breast, ovaries, prostate
Hormones
Which hormone can you use to treat prostate cancer
Oestrogens
Ethinyloestradial and diethylstibestrol are what types of drugs used in the treatment of prostate cancer
Oestrogen hormones
True or false, Oestrogens (eg. ethinyloestradiol and diethylstibestrol) are agonists of androgen dependent prostate cancer
False, they are antagonists
Which anti cancer drugs cause side effects; nausea, fluid retention, thrombosis, impotence and gynaecomastia
Oestrogens - ethinyloestradiol and diethylstibestrol
Ostrogens; ethinyloestradiol and diethylstibestrol used in the treatment of prostate cancer stimulate resting mammary cancer cells to proliferate, why is this useful?
Causes them to enter compartment A, which is the compartment where most cytotoxic drugs can work
Which hormones can be used to treat endometrial cancer
Progestogens
Progestogens; megestrol, medroxyprogesterone, norethisterone can be used to treat which cancer
Endometrial
Which type of anti cancer drugs are megestrol, medroxyprogesterone and norethisterone
Progestogens
What is the hormone treatment GnRH analogues used to treat
Prostate cancer and advanced breast cancer in premenopausal women
How does the hormone treatment GnRH analogues work in the treatment of prostate and advanced breast cancer in premenopausal women
Inhibits the release of GnRH, which decreases the LH/FSH which decreases the amount if testosterone
What type of anticancer drugs are; goserelin, buserelin, leuprorelin, triptorelin
GnRH analogues
What type of hormone therapy is used to treat hormone-secreting tumours of the GI tract (eg. Thyroid)
Somatostatin analogues
How does the hormone treatment somatostatin analogues work
Inhibits cell proliferation / hormone (CCK/gastrin) secretion
What type of drugs are octreotide and lanreotide
Somatostatin analogues
What type of hormone therapy would you use to treat hormone-secreting tumours of the GI tract
Somatostatin analogues
What can be used to counteract some side effects of anticancer drugs
Glucocorticoids - prednisolone and Dexamethasone
When can the glucocorticoids prednisolone and Dexamethasone be used as anti cancer treatment
In the treatment of lymphomas/ leukaemias - they inhibit lymphocyte proliferation
Which cancer can the hormone antagonist tamoxifen be used for
Breast cancer
What can the hormone antagonist fulvestrant be used to treat
Breast cancer
How do the hormone antagonists tamoxifen and fulvestrant work in the treatment of breast cancer
Competitive antagonist at oestrogen Rs, inhibits transcription of oestrogen -responsive genes
What adverse effects can be caused by the hormone antagonist tamoxifen
Similar to menopausal effects
Can cause endometrial cancer
Increase risk of blood clots
Which cancer are the hormone antagonists letrozole and exemastine used to treat
Breast cancer
How do the drugs letrozole and exemastine work?
Block conversion of androgens to Oestrogens
Which cancer would you use the hormone antagonists flutamide, cyproterone, bicalutamide to treat
Prostate cancer
The anti cancer drugs monoclonal antibodies are produced how
By cultured hybridoma cells
Which type of anti cancer drugs work by reacting with specific target proteins expressed on cancer cells, which activates the immune system, causing lysis of cancer cells
Monoclonal antibodies
What is an advantage of monoclonal antibody treatment for cancer
Targeted therapy therefore fewer side effects
What is a disadvantage of monoclonal antibody therapy
Very expensive
True or false some monoclonal antibodies work by activating GF-Rs on cancer cells which inhibits their survival/promotes apoptosis
True
What type of anti cancer treatment is rituximab
Monoclonal antibody
How does the monoclonal antibody therapy rituximab work?
Binds to CD20 protein which is expressed on certain lymphoma cells, causing lysis of B-lymphocytes
What can the monoclonal antibody herald rituximab be used to treat
Non-Hodgkin’s lymphoma
How effective is the drug rituximab
40-50% when combined with traditional chemo
What are the side effects of rituximab
Hypotension
Chills & fever
Trastuzumab, ofatumumab, bevacizumab are all examples of what type of drug
Monoclonal antibodies
What is the monoclonal antibody trastuzumab used to treat
Breast cancer
What does the monoclonal antibody trastuzumab bind to to induce an immune response and cell cycle inhibitors
HER2
What percentage of breast cancer patients is HER2 over-expressed in?
~25%
Which monoclonal antibody can cause the following side effects; flu-like symptoms, itchy eyes, BP changes, palpitations
Trastuzumab
What is the monoclonal antibody ofatumumab used to treat
Resistant chronic lymphocytic leukaemia
What is the monoclonal antibody bevacizumab used to treat
Colorectal cancer
How is the monoclonal antibody bevacizumab usually administered
IV
What does the monoclonal antibody bevacizumab do?
Neutralises VEGF, preventing angiogenesis
What type of drug is the anti cancer drug imatinib
Protein kinase inhibitor
What is the protein kinase inhibitor Imatinib used to treat
Chronic myeloid leukaemia
How is the drug imatinib administered
Orally
What type of drugs are dasatinib, imatinib and nilotinib
Protein kinase inhibitors
Why are cytotoxic drugs usually given in combination
To increase the cytotoxicity without increasing the general toxicity
And to decrease the chance of a resistance developing
Why are anti cancer drugs often given in large doses every 2-3 weeks
To allow bone marrow to regenerate
Decrease chance of resistance developing
More effective than lots of small doses
What drug might be given to control the anxiety liked with chemotherapy
Lorazepam
Why might the drugs metoclopramide, ondansetron or granisetron be given along side chemotherapy
To help control the nausea and vomiting
