Lung Cancer π« Flashcards
Main types or lung cancer 2
- Non small cell lung cancer (85%)
= epithelial cell derived (adenocarcinoma)
Like colorectal cancer cells - Small cell lung cancer 15%
Epidemiology
3rd most common cancer GLOBALLY
MORE men
Mostly associated with smoking
Risk Factors
1 smoking, former or current
2 other pollutants = occupational and environmental risks
> radon, asbestos, coal, silica and composite stone
Signs and symptoms
- Coughing blood
- New changed cough
- Chest, shoulder pain or discomfort
- Trouble breathing
- Hoarse voice
- Weight loss
- Loss of appetite
Lung carcinogenesis
Mutations in lumg cancer 2
- KRAS
(MEN) Most common mutation
Role: gatekeeper
Holds signal from epithelium to inside of thr cell, tells cell to grow or not
- CTNNB1
important in the way cells join together.
Mutations here cause cells to disorientate.
Treatment
Molecularly targeted therapy:
- Name the drugs that target EGFR
1st generation TK nibs
- Gefitinib (EGFR)
- Erlotinib (EGFR)
Explain SELECTIVE PRESSURE with EGFR blockade by TK nibs
Major resistance of drugs (Gefitinib, Erlotinib) over time of use.. due to SELECTIVE PRESSURE leading to colonial expansion.
3 nibs, tyrosine kinase Inhibitors
- Brigatanib = ALK
- Lorlatinib = ALK/ROS TK
- Alectinib = multi- TK inhibitor
ALK/EML4 translocations?
Translocations in chrom 2 =>
ALK and EML4 sit in different spots but switch around and fuse together.
ALK fusions are oncogenic drivers of carcinogenesis
ROS1 gene fusions?
ROS1 fusion (chrom 6)
= fusion activates carcinogenesis
2 nibs, ROS1 TK Inhibitors
Lorlatinib (ALK/ROS TK)
Alectinib (multi TK Inhibitor)
VEGF inhibitor
Name
Bevacuzimab
Side effects of CHEMOTHERAPY drugs used
Oxaliplatin
EGFR Inhibitors
Capecitabine
Oxaliplatin = parasthesias, neuropathies
EGFR Inhibitors and Capecitabine =
Skin toxicity