New advances in Treatment for blood cancers Flashcards
How does chemo work?
damages DNA of cancer cells in mitosis causing cell to undergo apoptosis
what protein is usually invovled in apoptosis?
p53
Why do lymphomas and leukaemias respond better to chemo than other cancers?
lymphocytes are keen to undergo apoptosis in the normal lymph node
What is a PET scan?
in ject radio-labelled glucose and then through the gamma camera
How do monoclonal antibodies work?
immune treatment that affects only cells which possess target protein
What si the action of rituximab?
naked antibody that binds to CD20 on B cells- found on all B cell lymphomas
What is the problem with rituximab?
relies on bodys immune system to kill malignant cells once tagged
How does Brentiuximab Vedotin work?
chemo drug conjugated to CD30 antibody
CD30 is found on what type of lymphomas?
Hodgkins cells and some T cell NHL
What is bioogical treatments?
dont affect cells as they divide- not chemo and arent targeted to malignant cells
What are examples of biological treatments?
proteosome inhibitors and IMIDs
What haem malignancy are biological treatments mainly used in?
multiple myleom
What is the proteosome?
dustbin for old proteins in cells to recycle amino acids
What does blockade of the proteosome cause?
accumulation of toxic proteins inside the cell causing apoptosis
What are the main SE of proteosome inhibitors?
nerve damage and low platelets
What are IMIDs derivatives of?
thalildomide
What type of cancer are tyrosine kinase inhibitors used in?
chronic myeloid leukaemia
What are the phases of untreated chronic myeloid leukaemia?
chronic phase (lots of immaure white cells in blood)—acclerated phase—blast crisis(transformed to acute leukaemia)
What is the cause of chronic myeloid leukaemia?
chromosomal translcation T(9:22) which creates a new oncogene
what is the name of the chromosomal translcation T(9:22)
philidelphia
What is the name of hte oncogene created by the philidelphia chromosome?
BCR-ABL
What is the normal function of a tyrosine kinase enzyme?
switches on proteins by phosphorylation
What drug targets the tyrosine kinase action of BCR-ABL?
imatinib by taking place of ATP in BCR-ABL molecule
What are the SE of tyrosine kinase inhibitors?
diarrhoea; fluid in lung; neutropenia
What happens in B cell receptors dont receive stimulation by antigen?
undergo apoptosis
What is the problem in CLL and lymphoma cells that causes them to avoid apoptosis?
abnormally active signalling mechanisms inside cell
What are drugs affecting B cell signalling pathways?
ibrutinib; idelalisib
When is idelalisib used?
CLL with p53 mutation- dont respond to chemo
What are the side effects of ibrutinib?
fever; low platelets; anaemia; SOB
What are the side effects of idelalisib?
diarrhoea; rash; fatigue; liver abnormality; fever
What is the problem with the immune response in Hodgkins?
Reed Sternberg cells cause immune reaction, but cells are unable to kill the malignant cells: immune evasion
How do Hodgkins cells avoid the immune system?
produce proteins that bind to PD1 receptors on T cells
What is the purpose of PD1 receptors on T cells?
tells T cell that it is a host cell and not to kill
What is the MOA of nivolumab?
sticks to the chemical produced by the cancer cell and stops it binding to the effector cell allowing attack of the cancer cell
What type of agen in nivolumab?
checkpointi nhibitor
What type of therapy is allogenic bone marrow transplant?
immune therapy
Why is bone marrow transplant an immune therapy?
T cell from donor are also given to attack the cancer cells : gradt vs leukaemia or lymphoma
What is the problem with graft vs leukaemia/lymphoma?
also graft vs host disease
What is adoptive immunotherapy?
make patients own immune cells recognise cancer as foreign and attack
What is hte most promising development in adoptive immunotherapy?
CAR t cell therapy (chimeric antigen receptor T cells)
How does CAR T cell therapy work?
use retroviruses to create cell surface receptor specific to eg CD19 to target cancer cell
