Chemotherapy

Question 1

What are the toxic effects of chemotherapy?

Answer 1

Bone marrow suppression – outcome?
Impaired wound healing
Loss of hair
Damage to GI epithelium (inc. mouth)
Growth stunted (children)
Reproductive system → sterility

Question 2

What are the 4 classes of anticancer drugs ?

Answer 2

1. Cytotoxic (alkylating, antimetabolites, antibiotics, plant derivatives) – block DNA synthesis/ prevent cell division
2. Hormones (+ their antagonists) – suppress opposing hormone secretion or inhibit their actions
3. Monoclonal antibodies – target specific cancer cells
4. Protein kinase inhibitors – block cell signalling pathways in rapidly dividing cells

Question 3

Alkylating Agents target cells in the…

Answer 3

S phase.

Question 4

Cyclophosphamide is administered…

Answer 4

orally → activated in liver

Question 5

Cisplatin is a…

Answer 5

Platinum compounds

Question 6

What are the side effects of Cisplatin?

Answer 6

V. nephrotoxic – requires hydration/ infusion
Causes severe nausea/ vomiting
Risk of tinnitus, peripheral neuropathy, hyperuricaemia (gout) + anaphylaxis

Question 7

Antimetabolites are classed as…

Answer 7

Folate antagonists

Question 8

Folate is essential for

Answer 8

DNA synthesis/ cell division

Question 9

Pyrimidine analogues compete with…

Answer 9

With C and T bases which make up RNA + DNA → inhibits DNA synthesis

Question 10

An example of a Pyrimidine analogue?

Answer 10

Fluorouracil

Question 11

Purine analogues compete with…

Answer 11

With A + G – inhibit purine metabolism.

Question 12

An example of a Purine analogues?

Answer 12

Mercaptopurine

Question 13

How do Cytotoxic antibiotics work?

Answer 13

Binds to DNA + inhibits DNA/ RNA synthesis.

Question 14

Where are hormones used in chemo?

Answer 14

Used in treatment of cancers in hormone-sensitive tissues (e.g. breast, prostate, ovaries)

Question 15

How do Glucocorticoids work in chemo?

Answer 15

Inhibit lymphocyte proliferation → treatment of lymphomas/ leukaemias

Question 16

How does Rituximab work?

Answer 16

Binds to CD20 protein, expressed on certain lymphoma cells → lysis of B-lymphocytes

Question 17

What are the side effects of Rituximab?

Answer 17

Hypotension, chills + fever

Question 18

Cytotoxic drugs often given in combination – why?

Answer 18

↑ cytotoxicity without ↑ general toxicity (i.e. drugs have diff. side-effects)
Less chance of developing resistance to individual drugs

Question 19

Often given in large doses every 2-3 weeks (usually over 6 months) – why?

Answer 19

• allows bone marrow to regenerate
• ↓ chance of developing resistance to individual drugs
• more effective than several small doses

Question 20

What is Myelosuppression?

Answer 20

Stem cell transplant

Question 21

What does Autologous mean?

Answer 21

Stem cells harvested* from patient + infused back after chemotherapy

Question 22

What does Allogenic mean?

Answer 22

Stem cells from a matched donor

i.e. collected from blood (by dialysis) or bone marrow