Chemotherapy and Other Cancer Therapies

Question 1

how does chemotherapy work?

Answer 1

damages DNA of cancer cells as it divides so the cell recognises itself as damaged and dies by apoptosis

Question 2

cytotoxic drug classification

Answer 2

cell cycle specific

non-cell cycle specific

Question 3

what is cell cycle specific cytotoxic therapy?

Answer 3

tumour specific and duration of exposure more important than dose

Question 4

examples of cell cycle specific cytotoxic therapy?

Answer 4

antimetabolites e.g. methotrexate

mitotic spindle inhibitors

Question 5

what is non-cell cycle specific cytotoxic therapy?

Answer 5

not tumour specific

cumulative dose more important than diration

Question 6

examples of non-cell cycle specific cytotoxic therapy?

Answer 6

alkylating agents
platinum derivatives e.g. cisplatinum
cytotoxic antibiotics e.g. anthracyclines

Question 7

side effects of chemotherapy

Answer 7

rapidly dividing organs

• bone marrow suppression
• gut mucosal damage (sepsis risk)
• alopecia

Question 8

specific side effect of vinca alkaloids

Answer 8

neuropathy

Question 9

specific side effect of anthracyclines

Answer 9

cardiomyopathy

Question 10

specific side effect of cisplatinum

Answer 10

nephrotoxicity

Question 11

specific side effects of alkylating agents

Answer 11

infertility

secondary malignancy

Question 12

reasons chemotherapy can fail

Answer 12

slow dividing tumour

drug resistance

Question 13

why is intensifying chemotherapy limited?

Answer 13

causes myelosuppression (can use growth factors)

Question 14

sources of stem cell transplantation

Answer 14

autologous

allogenic

Question 15

what is adoptive immunotherapy?

Answer 15

makes the patients own immune cells recognise the cancer as foreign and attack it

Question 16

example of adoptive immunotherapy

Answer 16

CAR-T therapy

Question 17

examples of targeted therapies

Answer 17

1. monoclonal antibodies
2. biological agents
3. molecularly targeted treatments

Question 18

examples of monoclonal antibodies

Answer 18

rituximab (CD20) in high grade B cell NHL

brentuximab (CD30) in HL

Question 19

are there side effects in monoclonal antibodies?

Answer 19

no, very specific

Question 20

are there side effects in biological agents?

Answer 20

not targets, so yes

Question 21

examples of biological agents

Answer 21

proteosome inhibitors

IMIDs e.g. thalidomide

Question 22

examples of molecularly targeted treatments

Answer 22

tyrosine kinase inhibitors (CML)

ibrutinib= targeting malignant B cells

Question 23

do molecularly targeted treatments have side effects?

Answer 23

no as pathway specific