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Bmsc > Chemotherapy and radiotherapy > Flashcards

Chemotherapy and radiotherapy Flashcards

1
Q

Exposure to toxins encourages body to…

A

switch on metabolising enzymes.

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2
Q

Drugs now prescribed with…

A

associated biomarker test.

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3
Q

Active drug

A

Metabolism reduces activity

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4
Q

Prodrug

A

Activates when metabolised

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5
Q

Pharmacodynamics

A

Focusses on drug targets

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6
Q

What is the mainstay of cancer treatment?

A

SACT

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7
Q

What are some benefits of IV drug delivery?

A

Avoids first pass metabolism and therefore variation

Hospital setting - better monitoring

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8
Q

Capecitabine

A

Taken orally and metabolised to 5fu

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9
Q

Which is better tolerated: carboplatin or cisplatin?

A

carboplatin

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10
Q

Tamoxifen is metabolised to endoxifen, by ______, which is more biologically active.

A

cip2d6

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11
Q

What is a monoclonal antibody against EGFR (prescribed with biomarkers?)

A

Cetuximab

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12
Q

cip2d6

A

more likely to be inactive or overactive in some ethnicities

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13
Q

Drugs targeting ras could be effective for which cancer?

A

Pancreatic

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14
Q

What is the problem with a wider range of targets (kras)

A

Loses cell activity for cancer

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15
Q

Phase 1 metabolism

A

Oxidation by CP450

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16
Q

Phase 2 metabolism

A

Conjugation by transferases

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17
Q

Phase 3 metabolism

A

Extrusion by ABC and SLC

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18
Q

Which cancers are most chemosensitive?

A

Haematological
Germ cell

Lung
Breast, ovarian, Cervical
Lymphoma
Melanoma

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19
Q

Which cancers are least chemosensitive?

A

Renal
Cholangiocarcinoma

Pancreatic
Gastric
Liver
Bladder
Nasal

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20
Q

Chemotherapy side effects

A

Myelosuppression
Immunosuppression
Fatigue
Anaemia
Mucositis
Alopecia

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21
Q

Support drugs for chemotherapy

A

Analgesics
Anti-emetics
Steroids
Laxatives
Sometimes antibiotics

22
Q

What does radiotherapy use?

A

Ionising radiation

23
Q

What is a benefit of radiotherapy?

A

Less selective than surgery and chemotherapy

24
Q

What makes energy dangerous?

A

Quantisation (highly condensed energy)

25
Q

Radiotherapy ________ could be reduced without negatively impacting outcomes.

A

fractions

26
Q

Why do we need to wait for a half life to be completed before another dose?

A

To allow complete cell repair

27
Q

Which cells are more radioresistant?

A

Hypoxic cells that proliferate

28
Q

What does leaving time between doses allow?

A

Previously hypoxic cells receive oxygen and become radiosensitive

29
Q

Which method of treatment is preferred because it makes repopulation more difficult?

A

Shorter treatment (3-4 weeks)

29
Q

Radiotherapy risk

A

Can form cancer stem cells

30
Q

Radiotherapy can stimulate or inhibit immune responses. How can it stimulate the immune system?

A

Cytokines, MHC expression

31
Q

Flash radiotherapy

A

Treatment times of seconds rather than minutes - cell killing is oxygen independent

32
Q

Brachytherapy

A

Radioactive sources in tumours

32
Q

Hyperthermia

A

Heat doesn’t get conducted away from the tumour due to poor blood flow

33
Q

Hyperbaric oxygen

A

Feeding more oxygen to the tumour

34
Q

Proton beam therapy

A

Energy is delivered as particles which gives peaks of energy

35
Q

Microwaves upset pacemakers

A
36
Q

Theranostics

A

Combine diagnostic nuclear medicine imaging, to validate target expression and estimate radiation dose, with therapeutic approaches, to identify suitable patients for treatment.

36
Q

How does radiation damage DNA?

A

Directly
Indirectly (ROS)

37
Q

How are SSBs repaired?

A

BER (base excision repair)

38
Q

How are DSBs repaired?

A

NHEJ

39
Q
A
40
Q

What are DAMPs?

A

damage-associated molecular patterns that act as pro inflammatory signals

41
Q

What determines the biological effect of radiation?

A

Type of radiation

Number of fractions Interval between fractions

Overall time

Dose rate

Tissue type

Individual variation

41
Q

Densely ionising energy causes more biological damage. Give some examples.

A

neutron beam therapy
carbon-ions
alpha particles

42
Q

Give an example of a DAMP produced by radiation

A

Calretinin which binds to dendritic cells

43
Q

Dangers of radiotherapy

A

fibrosis
impaired growth
atrophic skin
telangiectasia
ulceration

44
Q

What is the biological advantage of high dose rates?

A

cell killing is independent of the oxygen concentration

45
Q
A
46
Q

Well done!

A

Bmsc (17 decks)

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