Concepts of Chemotherapy

Question 1

How treat solid tumors

Answer 1

• adjuvant therapy: chemotherapy after surgery

- neoadjuvant therapy: chemotherapy before surgery

Question 2

How treat hematological tumors

Answer 2

• induction therapy: to eradicate the cancer
• consolidation therapy: to ensure no remaining cancer
• maintenance therapy: to prevent remission

Question 3

5 year survival rate of cancer

Answer 3

68%

Question 4

Most tumor suppressors are ___________ and need homozygous deletion/mutation. Because of this, ___________ mutations can be inherited and families show increased susceptibility to cancers.

Answer 4

recessive; heterozygous

Question 5

BRCA mutations in breast cancer increase susceptibility to _____ inhibitors

Answer 5

PARP

Question 6

Olaparib is what type of inhibitor

Answer 6

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

Question 7

What is R point?

Answer 7

Restriction point. Is the critical time point when cells decide whether or not to enter the cell cycle

Question 8

Which phase of the cell cycle do you think is targeted by most of the kinase inhibitors

Answer 8

G1/G0

Question 9

Proteins driving cell cycle can act as __________

Answer 9

oncogenes

Question 10

Proteins halting cell cycle act as _____________

Answer 10

tumor suppressors

Question 11

Cyclin D and CDK4,6 are…

Answer 11

…master regulators of cell cycle initiation

Question 12

Palbociclib is a

Answer 12

CDK4/6 kinase inhibitor

AE: neutropenia, nausea, fatigue, diarrhea, vomiting (similar to traditional chemotherapies)

also in this class of CDK4/6 inhibitors = abemaciclib, ribociclib

Question 13

a chemotherapy that interferes with DNA synthesis is…

Answer 13

…cell cycle specific

Question 14

Define growth fraction

Answer 14

the fraction of cells in a tumor that are actively proliferating

Question 15

Proliferating tumor cells grow _____________, not arithmetically - each cycle of cell division leads to _________ of the proliferating cell population

Answer 15

exponentially; doubling

Question 16

Cancer chemotherapy kills tumor cells with first order kinetics - drugs kill a constant ________, not a constant _______, of tumor cells

Answer 16

fraction; number

Question 17

Chemotherapy, like antibiotics, selects for…

Answer 17

…cells resistant to drug

Question 18

a tumor mass is usually ____ if detected by standard detection methods (imaging or feeling)

Answer 18

> 10^9 (1 g) cells

Question 19

a tumor mass is usually ____ before the patient experiences symptoms

Answer 19

10^10 cells

Question 20

a tumor mass of ____ is considered lethal

Answer 20

10^12 cells

Question 21

What is the most common reason for resistance to multiple chemotherapies at once?

Answer 21

drug transport out of cells

Question 22

What is the therapeutic index?

Answer 22

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