Concepts of Chemotherapy Flashcards
How treat solid tumors
- adjuvant therapy: chemotherapy after surgery
- neoadjuvant therapy: chemotherapy before surgery
How treat hematological tumors
- induction therapy: to eradicate the cancer
- consolidation therapy: to ensure no remaining cancer
- maintenance therapy: to prevent remission
5 year survival rate of cancer
68%
Most tumor suppressors are ___________ and need homozygous deletion/mutation. Because of this, ___________ mutations can be inherited and families show increased susceptibility to cancers.
recessive; heterozygous
BRCA mutations in breast cancer increase susceptibility to _____ inhibitors
PARP
Olaparib is what type of inhibitor
Poly ADP ribose polymerase (PARP) inhibitor
primarily for cancers with BRCA1/2 mutations
Could also enhance the toxicity of DNA-damaging therapies
Also in this class: rucaparib, niraparib, talazoparib
What is R point?
Restriction point. Is the critical time point when cells decide whether or not to enter the cell cycle
Which phase of the cell cycle do you think is targeted by most of the kinase inhibitors
G1/G0
Proteins driving cell cycle can act as __________
oncogenes
Proteins halting cell cycle act as _____________
tumor suppressors
Cyclin D and CDK4,6 are…
…master regulators of cell cycle initiation
Palbociclib is a
CDK4/6 kinase inhibitor
AE: neutropenia, nausea, fatigue, diarrhea, vomiting (similar to traditional chemotherapies)
also in this class of CDK4/6 inhibitors = abemaciclib, ribociclib
a chemotherapy that interferes with DNA synthesis is…
…cell cycle specific
Define growth fraction
the fraction of cells in a tumor that are actively proliferating
Proliferating tumor cells grow _____________, not arithmetically - each cycle of cell division leads to _________ of the proliferating cell population
exponentially; doubling
Cancer chemotherapy kills tumor cells with first order kinetics - drugs kill a constant ________, not a constant _______, of tumor cells
fraction; number
Chemotherapy, like antibiotics, selects for…
…cells resistant to drug
a tumor mass is usually ____ if detected by standard detection methods (imaging or feeling)
> 10^9 (1 g) cells
a tumor mass is usually ____ before the patient experiences symptoms
10^10 cells
a tumor mass of ____ is considered lethal
10^12 cells
What is the most common reason for resistance to multiple chemotherapies at once?
drug transport out of cells
What is the therapeutic index?
ratio of the dose of a drug that is toxic to normal cells and the dose of a drug that is toxic to cancer cells
