Chemotherapy- Systemic Anti-Cancer treatment Flashcards
What is more common in systemic anti-caner treatment?
Targeted treatments and immunotherapy
When are adjuvant treatments used?
- After surgery to reduce the occurence
- improves survival
When are neoadjuvant treatments used?
as a first step to shrink a tumour before the main treatment, which is usually surgery
How do you deliver systemic therapy?
- Orally or intravenous route
- Regular cycles with timing depending on the findings from pharmacokinetics (half life, excretion)
What type of tumours are better to deliver systemic therapy in?
non solid tumours
If toxicities develop…
- May be a need for delay delivering systemic therapy
Methods of assessing drug activity
CT scan, PET scan and/or clinical examination
How do we know if the treatment has improved the progression of cancer?
- Overall survival
- Progression-free survival
- Improved quality of life
Effects of neoadjuvant treatment?
may improve survival through increasing operability or reduce the “filed” of radical radiotherapy.
What are the modes of action of chemotherapy drugs?
- Alkyling agents
- Antimetabolites
- Vinca alkaloids
- Antimitotic antibiotics
How do alkyling agents work?
o Decreased entry or increased exit of agent
o Inactivation of agent in cell
o Enhanced repair of DNA lesions produced by alkylation
How do antimetabolites work?
o Similar chemical structure to essential metabolites required by cell prior to cell division
o May be incorporated into new nuclear material or bind irreversibly with vital enzymes to inhibit cell division
How do vinca alkaloids work?
o Metaphase arrest agents, bind to tubuli and block microtubule formation (essential for metaphase of mitosis)
o Taxanes promote spinles and “freeze” cells at that stage of cycles
How do Antimitotic antibiotics work?
o Anthracyclines and Non-anthracyclines:
o Intercalate and inhibit DNA and RNA synthesis
o Membrane binding and increase permeability to various ions
o Free radicals disrupt DNA chain and prevent mitosis
o Metal ion chelation resulting in cytotoxic compounds
o Alkyltion blocking DNA replication
Aim of combination therapy?
Increase efficacy while maintaining safety (compatible side effects) and activity.
