Chemotherapy

Question 1

Tyrosine kinase inhibitor - name, mechanism

Answer 1

imatinib - magic bullet, tumour selective, more efficacious, fewer side effects

Question 2

what is the fractional cell kill hypothesis?

Answer 2

bone marrow cells recover more quickly than tumour cells so give next dose when they have recovered

Question 3

where do antimetabolites, alkylating agents, intercalating agents and spindle poisons work?

Answer 3

antimetabolites work on DNA synthesis

alkylating agents work on the replication process

intercalating agents work on DNA transcription and duplication

spindle poisons work on mitosis

Question 4

how do platinum compounds working which type is more effective?

Answer 4

they form platinated inter and intra strand adducts leading to inhibition of DNA synthesis

DACH platinum adducts are bulky and more effective

Question 5

what are 2 types of antimetabolites and what do they work on?

Answer 5

methotrexate on DHFR

5-fluorouracil acts on 5-FdUMP

Question 6

what are two types of spindle poisons and how do they work?

Answer 6

taxoids - promote assembly of microtubules and prevent disassembly

vinca alkaloids prevent spindle formation

Question 7

what is the predicted repines to chemotherapy based on?

Answer 7

performance score, clinical stage, prognostic factors, molecular/cytogenic markers

Question 8

what are some side effects of chemotherapy?

Answer 8

acute renal failure (tumour lysis causing precipitation of urate crystals in renal tubules), GI perf at tumour site, DIC, vomiting, alopecia, skin toxicity (local = irritation and thrombophlebitis of veins, general =hyperkeratosis, ulcerated pressure sores, hyper pigmentation), mucositis, cardiotoxicity, lung toxicity, haematological toxicity