Chemotherapy Flashcards
What is combination chemotherapy
Combination of drugs with different MOA and SE profiles to reduce the likelihood of resistance and toxicity
Cytotoxic activity
Different MOA
Non-overlapping toxicity
Different mechanisms of resistance
What is adjuvant chemotherapy?
After other initial treatment to reduce the risk fo relapse e.g. following surgical removal
What is neoadjuvant chemotherapy
Used to shrink tumours prior to surgical or radiological treatment
May allow later treatment to be more conservative
What is palliative chemotherapy
No curative aim
Offers symptom relief
May prolong survivial
What are classes of cytotoxic drugs?
Alkylating agents e.g. cyclophosphamide
Angiogenesis inhibitors e.g. bevacizumab
Antimetaboltes e.g. methotrexate, 5-fluorouracil
Antioestrogens - aromatase inhibitors (letrozole,anastrolzole), oestrogen receptor antagonists (e.g. tamoxifen)
Antitumour antibiotics (e.g. doxorubicin, bleomycin)
Monoclonal antibodies
Topoisomerase inihibitors
Vinca alkaloids and taxanes e.g. vincristine
What is the MOA and ADRs of cyclophosphamide?
Alkylating agent - causes cross linking of DNA leading to apoptosis
Haemorrhagic cystitis,
Myelosuppression,
Transitional cell carcinoma
Give with Mesna - binds to toxic metabolite acrolein to help prevent haemorrhagic cystitis
What is MOA and ADR of bleomycin
Cytotoxic antibiotic
Degrades preformed DNA
Lung fibrosis
What is MOA and ADR of doxorubicin?
Cytotoxic abx
Stabilises DNA topoisomerase complex - inhibits DNA and RNA syntheiss
Cardiomyopathy
What is MOA and ADR of methotrexate?
Antimetabolite
Inhibits dihydrofolate reductase interferes with cell metabolism, DNA synthesis
Myelosuppression
Nephrotoxic
Liver fibrosis
Lung fibrosis
What is MOA and ADR of 5-fluorouracil?
Antimetabolite
Induces cell cycle arrest and apoptosis
Myelosuppression
Mucositis
Dermatitis
What is MOA and ADR of 6-Metacaptopurine
Antimetabolite
Reduced purine sythesis
Myelosuppression
What is MOA and ADR of vincristine, vinblastine
Vinca alkyloids - spindle poison
Inhibits formation of microtubules
Vincristine - peripheral neuropathy
Vinblastine - myelosuppression
MOA and ADR of doxetaxel
Taxane - spindly poison
Interferes with microtubules
Neotrpenia
MOA and ADR of cisplatin?
Causes DNA cross-linking
Ototoxic
Nephrotoxic
Peripheral neuropathy
What are side-effects of cytotoxic drugs?
Due to cytotoxic effect on non-canaer cells
Vomiting - give prophylaxis Ondansetron
Alopecia - consider cold-cap, wig services
Neutropenia - 7-14d after chemotherapy
May cause damage to spermatogenesis, hasten oocyte depletion leading to primary ovarian failure - offer sperm conservation/oocytes/embryos
