Integrative Support During Antineoplastic Drug Therapy Flashcards
What is induction chemotherapy? When is it used?
Chemo given to induce remission
Used in acute leukemia
What is consolidation chemotherapy? When is it used?
Chemo given to sustain remission
Used in acute leukemia
What is myoablative chemotherapy? What is it followed by?
High-dose chemo that obliterates bone marrow
Bone marrow or stem cell transplant
What is adjuvant chemotherapy? When is it used?
Chemo given to destroy microscopic spread after primary tumor is surgically removed
To prevent recurrence
What is neoadjuvant chemotherapy? What is it used for?
Chemo given before surgery
To shrink tumor
What is chemoradiosensitization?
Small doses of chemo given to increase efficacy of radiation
What is palliative chemotherapy?
Chemo given for symptom management, not to reduce cancer
What is dose-dense chemotherapy? Example?
Same dose in shorter cycles, i.e. dose-dense ACT
What is fractionated chemotherapy? Example?
Same dose per cycle in multiple administrations, i.e. fractionated paclitaxel
What is the most common route of chemotherapy administration?
Peripheral vein intravenous
When is a central venous catheter used?
Pt receiving extended rounds of therapy, continuous infusion therapy, or with fragile/ hard to find veins
What are the two most common types of central venous catheter?
Peripherally inserted central catheter (PICC)
Implantable venous access port (“port”)
Where is the PICC placed? What are the downsides?
How long does it stay?
Through the basilic vein into the SVC
Cannot get wet
Weeks to months
Where is the port placed?
How long does it stay?
Directly into the SVC
Years
How does tumor burden affect response to chemo tx?
Small tumor burden are more sensitive b/c a higher percentage of cells are dividing and being exposed to chemo
How does rate of tumor growth affect response to chemo tx?
Faster growth = more responsive
How does tx regimen and dosing affect response to chemo tx?
More sensitive to combination regimens
Dose reductions or delays negatively affect response
What is innate drug resistance to chemo? Why does it happen?
Initial exposure to drugs doesn’t produce a response because of mutations in the genome (i.e in tumor suppressor genes in >50%)
What is acquired drug resistance? Why does it happen?
From mutations/ gene expression as cancer evolves and is exposed long-term to tx
Mechanisms include induction of drug efflux pumps, decreased affinity/ overexpression of target enzymes, decreased drug activation or increased drug inactivation
What is one the primary drug efflux pumps involved with drug resistance?
P-glycoprotein
When are cell cycle specific drugs most effects? What regimen is best?
In rapidly divided tumors
Continuous or frequent divided doses
When are cell cycle non-specific drugs most effective? What regimen is best?
In tumors with more slowly dividing cells
Large bolus doses
