Chemotherapy Flashcards
Why does the cell cycle matter in chemotherapy?
If cells are cycling then chemotherapy can have an effect
What stage of the cell cycle is chemotherapy unlikely to have an effect?
G0
Why does the frequency of chemo delivery matter?
Need to balance killing tumour cells and allowing normal cells to grow - if treatment given late then tumour cells can recover as well as the normal cells
How is systemic therapy delivered?
Oral or IV route
What are the methods of assessing drug activity?
Objective examination or improved: overall survival (OS), progression-free survival (PFS), quality of life (QoL)
What is adjuvant treatment?
Additional treatment given after a primary treatment to improve survival e.g. Chemotherapy after surgery
What is neoadjuvant treatment?
Treatment given before the main treatment to aid e.g. Radiotherapy before surgery to shrink tumour
What are the main classes of cytotoxic agents?
Alkylating agents, anti-metabolites, mitotic inhibitors, antibiotics and ‘others’
What is the site of action of an alkylating agent?
Direct effect on DNA and stops DNA formation
What is an example of an alkylating agent and what does it do?
Cisplatin - interferes with DNA replication
What are the three mechanisms of resistance of alkylating agents?
- Decreased entry or increased exit of drug
- Inactivation of drug in cell
- Enhanced repairs of DNA lesions produced by alkylation
What is an example of an antimetabolite and what does it do?
Methotrexate - interrupts cell cycle and inhibits cell division and synthesis of DNA
What are examples of mitotic inhibitors?
Vinca alkaloids and taxanes
What do vinca alkaloids do and give an example?
Block microtubule and spindle formation - vindesine
What do taxanes do?
Promotes spindles and ‘freeze’ cells at that stage of the cycle
