CPS: Chemotherapy

Question 1

3 cancer cell. types

Answer 1

1. proliferating (cell cycle-specfic drugs target proliferating cells)
2. quiescent (but can start to proliferate) harder to treat
3. terminally differentiated.

Question 2

mechanism of a nucleoside analgue chemotherapy

Answer 2

• interferes with DNA synthesis. when it gets added to a proliferating DNA strand in the cancer cell, it prevents any more bases from being added on.

it’s a cell cycle specific agent.

Question 3

how to topoisomerase inhibitors act as a cell cycle specific chemotherapy?

Answer 3

interferes with the proper superboiling of DNA

Question 4

how do vinca alkyloids act as a cell cycle specific chemotherapy?

Answer 4

they disrupt the mitotic spindle formation

Question 5

2 general mechanisms of how cell cycle NON-specfic agents can work (they are toxic to cells whether they are dividing or not by interfering with existing DNA)

Answer 5

• Intercalate between DNA strands
– ie. anthracyclines
– ie. doxorubicin (adriamycin),
daunorubicin, epirubicin

• Cross-link strands of DNA – ie. alkylating agents
(cyclophosphamide)

Question 6

3 broad classes of NOVEL chemotherapeutic agents.

Answer 6

1. antibodies to the marker expressed on the tumor cell surface, ex/ retuximab: antiCD20 for B cell malignancies
   2) block neoplastic enzyme (TKIs for CML– where t(9;22)produces bcr-abl Tyrosine Kinase.
2. immunotherapy or checkpoint inhibotrs.Drugs that harness patients own T cells to better
   attack the tumour (nivolumab, pembrolizumab,
   ipilimumab)

Question 7

neoadjuvant, adjuvant, vs palliative

Answer 7

Question 8

T/F it helps to gibe anti-nauseants after chemo. most common anti-nauseant?

Answer 8

FALSE! YOU MUST GIVE THEM PREVNTATIVELY BEFORE CHEMOTHERAPY STARTS. then you continue it up to 4 days after chemo

common ones are 5;HT3 antagonist (ondansetron)

Question 9

in terms of post-chemo cytopenias, what’re the most to least common?

Answer 9

neutrophils>platelets> hemoglobin

Question 10

ADVERSE effects of chemo (not like hairloss or nausea, but more life threatening)

Answer 10

Question 11

T/f: chemo causes permanent hair loss

Answer 11

false. but it can be the most dreaded side ffects of chemo. it is highly drug and dose specific, and takes as little as 2-3 weeks to difference in hair. Not all hair follicles get affect, as it spares the one currently that are in telogen phase.

hair usually regrows after 3-6 months off of chemo, but 65% notice a change in color, texture or thickness.