Intro to cancer therapy Flashcards
What is adjuvant therapy?
Means to aid in achieving cure
Neo- adjuvant means before surgery
What is the best conceptual advance in cancer therapy?
artful combination of local and systemic therapy
What are the 5 curative systemic therapy via drugs?
- acute lymphocytic leukemia
- some pediatric sarcomas
- germ cell tumors
- Aggressive and intermediate lymphomas
- Acute myeloid leukemia
What are 3 ways which systemic therapies are classified?
- chemo
- signal transduction inhibitors
- immune therapy
What do most pharms act against?
Proteins
What is ubiquination?
To selectively lyse proteins inside the cell
What are some ways in which apoptosis is very important?
- formation of free and independent digits
2. development of reproductive organs
What is cancer a representation of?
Failure of cells to response to normal regulator signals
- most importantly the escape of apoptosis
What is the role of most chemo drugs?
stress the cell to activate apoptosis
- they do not kill cells directly
What are capases?
proteins that once activated cleave and shift a cell towards commitment of apoptosis
What are 3 classic and common characteristics of cancer?
- very high interstitial pressure
- low oxygen tension
- low pH
- tumors have organ level complexity
What are 2 regulators of cells in the cell cycle?
Oncogenes
Tumor suppressors
What are 2 ways which cancer can present?
Growth regulation
DNA repair
- accumulated genetic damage
What does in vitro testing mean?
Testing in cell culture
What does in vivo testing mean?
non-human species studying
-pre-clinical testing
What is the goal of phase 1 of human oncology trials?
Define the dose and schedule
- typically less than 40 pts
- aim to define Dose limiting toxicity
What is pharmacokinetics and pharmacodynamics?
- How body affects drugs like distribution, metabolism and excretion
- how drug affects body like how drug interacts with living system
What is phase 2 of human oncology trials?
Define an anti cancer effect in some defined group of patient
- hypothesis generating
- define the rate of benefit
- are strongly related to the details of who was selected to be in the study
What is the goal of phase 3 of human oncological testing?
Formally compare some novel treatment with an existing standard
- hypothesis testing 300-1200 pts
- requires “lucky you test”
What is a toxicity assessment?
toxicity accounted for in terms of adverse effects
- No phys or clinical consequences
- phys relevant
- potentially associate with major morbidity
- life threatening
What is prognostic factors?
Most cancers have well described features that are strikingly related to prognosis like neuts or lymphs ratio
- low albumin
- high ferritin
- high platelets
- elevated CRP
- Increase sed rate
- Elevated beta-2- microglobulin
- Elevated IL-6
- age
- particular genetic lesions
