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interactions > introduction to cancer therapy 1 > Flashcards

introduction to cancer therapy 1 Flashcards

1
Q

what are the traditional treatments for cancer

A

surgery, radiation, chemotherapy

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2
Q

what are examples of precision medicine

A

targeted therapy and immunotherapy

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3
Q

what is cancer chemotherapy

A

therapy that involves administration of chemical agents to destroy cancer cells

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4
Q

what was the first cancer drug developed from

A

mustard gas

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5
Q

mustard gas is a type of what agent

A

alkylating agent

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6
Q

how did they discover the first cancer drug

A

from mustard gas accident during WW2, the men exposed had a lower white count

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7
Q

why can cancer change their genomes rapidly

A

due to a lack of DNA repair machinery and they are very plastic

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8
Q

cancer don’t have DNA repair machinery this allows them to quickly develop

A

resistance

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9
Q

neoadjuvant chemotherapy is what?

A

administrated prior to surgery to facilitate resection and prevent metastasis

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10
Q

adjuvant chemotherapy is what

A

after surgery, reduce risk of distant relapse and increase disease-free survival

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11
Q

palliative chemotherapy is

A

improve patients quality of life by controlling symptoms in a patient where a cure in unlikely

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12
Q

salvage chemotherapy is

A

potentially curative, high-dose regimen given to a patient who has failed/reccurred in prior regimen

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13
Q

what are the four types of chemotherapy

A
  1. neoadjuvant
  2. adjuvant
  3. palliative
  4. salvage
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14
Q

what are cytotoxic drugs

A

these kill dividing cells, as a consequence these kill healthy cells which makes the patient immunosuppressed

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15
Q

what are the 5 functions of chemo drugs

A
  1. antimetabolites
  2. topoisomerase enzymes
  3. structural damage
  4. disturbed function of the mitotic spindle
  5. hormonal agents
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16
Q

what are antimetabolites

A

limit the synthesis of nucleic acid precursors, and structural analogues. S phase specific

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17
Q

what is the function of topoisomerase enzymes

A

participate in the winding and unwinding of DNA are inhibited

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18
Q

what are structural damage drugs

A

structural damage to mature DNA

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19
Q

what are example of a drug that affects the mitotic spindle

A

vinca alkaloids

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20
Q

what is the function of hormonal agents drugs

A

block proliferation of hormone-response cells

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21
Q

what is the mechanism of alkylating agents

A

target DNA, produce alkylation through formation of intermediate. the drug enters through a chloride transporter and inside the cell they are hydrolysed. the hydrolysis results in an active species which binds to DNA in a way that can’t be repaired.

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22
Q

which type of chemotherapy drug is not cell cycle phase specific

A

alkylating agents

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23
Q

what are intermediates

A

block damaged DNA

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24
Q

what is the mechanism of antimetabolites

A

interfere with DNA synthesis

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25
Q

which type of drug is S-phase specific

A

antimetabolites

26
Q

what are mitotic spindle agents mechanism of action

A

bind to microtubular proteins inhibiting microtubule assembly thereby interrupting the mitosis phase of cell division

27
Q

what are topoisomerase inhibitors mechanism of action

A

DNA topoisomerase I and II are essential for transcription and replication and mitosis. Regulates structure and winding of DNA

28
Q

what are the 5 principles of combination chemotherapy?

A
  • use drugs as a single agent
  • use drugs with different mechanisms of resistance
  • use drugs with different side effects
  • be aware of drug to drug interactions
  • use drugs with different mechanisms of action
29
Q

what types of cancer can be found in category 1 responsiveness to efficacy

A

germ cell, lymphomas, leukemias

30
Q

what types of cancer can be found in category 2 responsiveness to efficacy

A

breast, colorectal, ovarian

31
Q

what types of cancer can be found in category 3 responsiveness to efficacy

A

lung, bladder, prostate, stomach, cervical

32
Q

what types of cancer can be found in category 4 responsiveness to efficacy

A

head and neck

33
Q

what types of cancer can be found in category 5 responsiveness to efficacy

A

liver, melanoma, brain, thyroid and renal

34
Q

what types of cancer have a high response and a high cure rate

A

childhood cancer, testicular, choriocarcinoma, Hodgkin Disease

35
Q

what types of cancer have a high response and low cure rate

A

breast, ovarian, small cell lung cancer, sarcoma, myeloma

36
Q

what types of cancer have a low response and a low cure rate

A

colon, stomach, prostate, pancreatic, glioblastic, non-small cell lung cancer

37
Q

what are the survival parameters

A
  1. disease-free survival

2. overall survival

38
Q

what is disease- free survival

A

from the time of treatment to first recurrence

39
Q

what is overall survival

A

from time of diagnosis to death

40
Q

how can chemo be delivered

A

intravenous or orally

41
Q

why can chemotherapy make someone immunosuppressed?

A

because chemo targets the bone marrow

42
Q

what factors can boost the immune system

A

G-CSF

43
Q

what can prevent a cancer patient from becoming immunosuppressed

A

blood fusion

44
Q

what type of drug induces sickness symptoms

A

platinum anthracylines alkylatings

45
Q

what is cardiotoxicity and who is most affected

A

when the heart muscle is injured, children

46
Q

what is pulmonary toxicity and how can you treat it

A

damaged to the lungs, treat with corticosteroids

47
Q

what is nephrotoxicity, how can you treat it

A

rapid deterioration of the kidney, treat by making sure the patient receives adequate hydration

48
Q

what is gondal damage, what should you do?

A

damage to the gonads, preserve the stem cells

49
Q

what should you do with secondary malignancies

A

avoid the responsible drug

50
Q

what is oral mucositis

A

a common complication of cancer where the mucosal lining of the mouth begins to atrophy and breakdown forming ulcers and sores.

51
Q

symptoms of mucositis

A

burning, oral pain, difficulty eating, drinking and talking and difficulty with mouth care

52
Q

how do you treat mucositis

A

protect lips with moisturiser, avoid acidic foods and regular mouthwash

53
Q

how can you become resistant to chemotherapy

A
  1. tumours can acquire resistance
  2. cytotoxic drugs revoke drug resistance
  3. effects drugs of similar structure
54
Q

resistance in chemotherapy is often due too

A

mutation or altered gene expression of genes which:

  1. transport drug in our out of the cell
  2. metabolism and intracellular concentration of the drug
  3. structure of the target protein which binds causing toxicity
  4. protection from apoptosis
55
Q

What are the characteristics of cancer stem cells

A

quiescent, increased expression of anti-apoptotic proteins and increased activity of pro-survival pathways

56
Q

what gene is a multi-drug resistance gene

A

MDR1

57
Q

what happens to MDR1 during cancer

A

it can be upregulated meaning it Can actively pump some drugs out of the cell, reducing intracellular concentration and meaning the drug can’t become cytotoxic

58
Q

what are the two types of resistance

A

intrinsic or acquired

59
Q

epigenetic are very resistant to what

A

very toxic platinum alkylating

60
Q

drug resistance is influenced by what parts of the microbiome

A
  1. vascular abnormality
  2. hypoxia and acidity
  3. fibroblasts
  4. immune cells
  5. extracellular matrix
  6. exosomes
61
Q

therapies to overcome resistance to alkylating agents

A
  1. increased delivery of platinum to the tumour
  2. combination of platinum drugs with molecularly targeted agents
  3. novel platinum drugs targeting resistance mechanism
  4. platinum resistance modulators

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