classical chemotherapy

Question 1

• Neoadjuvant

Answer 1

○ Given before surgery to shrink a tumour before surgery

Question 2

• Adjuvant

Answer 2

○ Given after surgery to destroy remaining cells and prevent recurrence

Question 3

• Induction

Answer 3

○ Given to induce remission, commonly used in the context of leukaemia treatment

Question 4

• Consolidation

Answer 4

○ Given once remission is achieved

Question 5

• Definitive

Answer 5

○ Curative

Question 6

• Palliative

Answer 6

○ Not curative, used to symptoms management

Question 7

Highly proliferative normal tissues

Answer 7

§ GI tract epithelial cells
§ Hair follicles
§ Bone marrow / haematopoietic cells

Question 8

fixed proportional killing

Answer 8

A given dose of chemotherapy kills a fixed proportion not a fixed number

Question 9

• To eradicate a tumour

Answer 9

§ Kill % must be greater than the cell number

Question 10

• Non phase dependant drugs

Answer 10

§ Alkylating agents

§ Athracyclines

Question 11

§ S phase dependant

Answer 11

□ Anti metabolites

Question 12

§ M phase

Answer 12

□ Vinka alkaloids

□ Taxanes

Question 13

§ G2 phase

Answer 13

□ Antibiotics

□ Irinotecan

Question 14

§ G1 phase

Answer 14

□ Corticosteroids

Question 15

§ Synergism

Answer 15

□ Drugs acting on different phases of the cell cycle kill more tumour cells when given together than the sum of each agent given alone

Question 16

§ mechanisms of Chemical damage to DNA

Answer 16

□ 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

Question 17

alkylating agents Method of action

Answer 17

• 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

Question 18

4 types of DNA damage

Answer 18

mono adduct
inter strand cross link
intrastrand cross link
protein DNA cross link

Question 19

mono functional agent than can cross brain brain barrier

Answer 19

temozolomide

makes mono adducts

Question 20

• Anti-metabolites

Answer 20

• Deprive cells of building blocks required for growth and division

Question 21

folic acid antagonists method of action

Answer 21

□ Block dihydrofolate reductase
§ Deplete cellular folates
□ Needed for purine synthesis

Question 22

2 types antimetabolites

Answer 22

folic acid antagonists and DNA base analogues

Question 23

• DNA base analogues

Answer 23

§ Pyrimidine, purine and nucleoside analogues

§ Disrupt DNA synthesis and function

Question 24

2 types mitotic inhibitors

Answer 24

Vinca alkaloids

taxanes

Question 25

• 2 types Cytotoxic antibiotics

Answer 25

anthracyclines

bleomycins