General Concepts Lapinsky

Question 1

What does unfixable DNA damage result in?

Answer 1

apoptosis

Question 2

What does fixable DNA damage result in?

Answer 2

cell continues dividing

Question 3

What are combination drug regimens chosen for?

Answer 3

Clinical efficacy
Drug synergy
Target cells with different drug resistance mechanisms
Target cells at different stages of replication

Question 4

Why is drug synergy important?

Answer 4

allows use of lowest effective dose to decrease toxicities and side effects

Question 5

What is drug synergy?

Answer 5

2 or more drugs are combined to produce an effect greater than the sum of their individual separate effects

Question 6

Why is chemo administered in cycles?

Answer 6

allows the patients to recover from side effects

Question 7

What are cell cycle specific drugs (CCS)?

Answer 7

kill cancer cells during a specific phase of the cell cycle

Question 8

What drug classes are examples of CCS?

Answer 8

Anti-metabolites (s phase)
Anti-mitotics (m phase)

Question 9

What are cell cycle nonspecific drugs (CCNS)?

Answer 9

kill cancer cells in ANY phase of the cell cycle including G0

Question 10

What drug classes are examples of CCNS?

Answer 10

DNA alkylating/ platinating agents, anthracyclines

Question 11

Traditional cytotoxic cancer therapeutic agents are more effective at killing cells that are actively undergoing ______ _________

Answer 11

cell division

Question 12

What is the rate theory of cancer chemotherapy?

Answer 12

cancers characterized by more rapid cell division are more susceptible to the cytotoxic effects of traditional cytotoxic chemotherapy

Question 13

Besides rapidly dividing cells, what are some cancer agents designed to recognize?

Answer 13

1. Specific biomarkers present on the surface of cancer cells (HER2 + breats cancer cells)
2. Other cells that are essential for cancer cell growth (monoclonal antibodies)

Question 14

What is the G0 phase of cell division?

Answer 14

a resting phase that can occur after mitosis/ cell division

Question 15

What is the G1 phase of cell division?

Answer 15

post-mitotic phase where cells grow and prepares to replicate DNA

Question 16

What is the s phase?

Answer 16

DNA synthesis/ replication

Question 17

What is the G2 phase?

Answer 17

pre-mitotic phase where the cell grows and produces RNA and proteins to prepare for cell division

Question 18

What is the m phase?

Answer 18

mitosis; parent cell divides into 2 daughter cells

Question 19

Liquid tumors tend to have a ______ growth factor

Answer 19

high

Question 20

Solid tumor tend to have a _______ growth factor

Answer 20

low

Question 21

What types of drugs are least effective at treating tumors with low growth factors? Why?

Answer 21

CCS drugs; most cells are in G0

Question 22

What type of drugs only kill proliferating cells, rapidly increasing in number?

Answer 22

CCS drugs

Question 23

What type of drugs kill proliferating and nonproliferating cells?

Answer 23

CCNS

Question 24

What type of drugs kill both low and high growth-fraction tumor cells?

Answer 24

CCNS

Question 25

What type of drugs kill high growth fraction tumor cells?

Answer 25

CCS

Question 26

What type of drugs are considered “schedule dependent” both timing and duration matter?

Answer 26

CCS

Question 27

What type of drugs are considered “dose dependent”?

Answer 27

CCNS

Question 28

What is the lower limit of cancer cell detection?

Answer 28

1 billion cells

Question 29

What is the log-kill hypothesis?

Answer 29

1-g tumor treatment with anticancer drug results in 3log kill/ 1log survive

Question 30

Why is it important to know the MOA of individual anti-cancer agents?

Answer 30

reduce overlapping toxicities
reduce drug resistance

Question 31

Why are CCNS drugs usually given before CCS drugs (recruitment schedule)?

Answer 31

achieve a significant log kill with CCNS drug, when cells are recruited back into the cell cycle use CCS to kill dividing cells

Question 32

When would a recruitment schedule not be used?

Answer 32

When CCNS drug prevents inactivation metabolism or elimination of the CCS drug leading to CCS drug toxicity

Question 33

What is an example of a recruitment schedule?

Answer 33

3 days of Daunorubicin + 7 days of Cytarabine

Question 34

What is an irreversible state of cell dormancy?

Answer 34

Cell senescence