classical chemotherapy Flashcards
- Neoadjuvant
○ Given before surgery to shrink a tumour before surgery
- Adjuvant
○ Given after surgery to destroy remaining cells and prevent recurrence
- Induction
○ Given to induce remission, commonly used in the context of leukaemia treatment
- Consolidation
○ Given once remission is achieved
- Definitive
○ Curative
- Palliative
○ Not curative, used to symptoms management
Highly proliferative normal tissues
§ GI tract epithelial cells
§ Hair follicles
§ Bone marrow / haematopoietic cells
fixed proportional killing
A given dose of chemotherapy kills a fixed proportion not a fixed number
- To eradicate a tumour
§ Kill % must be greater than the cell number
- Non phase dependant drugs
§ Alkylating agents
§ Athracyclines
§ S phase dependant
□ Anti metabolites
§ M phase
□ Vinka alkaloids
□ Taxanes
§ G2 phase
□ Antibiotics
□ Irinotecan
§ G1 phase
□ Corticosteroids
§ Synergism
□ Drugs acting on different phases of the cell cycle kill more tumour cells when given together than the sum of each agent given alone
§ mechanisms of Chemical damage to DNA
□ DNA adducts and strand crosslinking
□ Impaired synthesis of DNA bases
® Pyrimidines and purines
□ Inhibition of transcription and translation
□ Disruption of cell division mechanics
® Mitotic spindle
alkylating agents Method of action
- Alkylate (methyl/ethyl) guanine bases to form DNA adducts or cross linking of DNA strands
§ Base excision repair of guanine adducts
□ Strand breaks
§ Cross linked DNA cannot be replicated or transcribed
4 types of DNA damage
mono adduct
inter strand cross link
intrastrand cross link
protein DNA cross link
mono functional agent than can cross brain brain barrier
temozolomide
makes mono adducts
- Anti-metabolites
- Deprive cells of building blocks required for growth and division
folic acid antagonists method of action
□ Block dihydrofolate reductase
§ Deplete cellular folates
□ Needed for purine synthesis
2 types antimetabolites
folic acid antagonists and DNA base analogues
- DNA base analogues
§ Pyrimidine, purine and nucleoside analogues
§ Disrupt DNA synthesis and function
2 types mitotic inhibitors
Vinca alkaloids
taxanes
- 2 types Cytotoxic antibiotics
anthracyclines
bleomycins
