New and Future Treatments for Blood Cancer

Question 1

What protein found in the cell nucleus is involved with apoptosis?

Answer 1

P53

Question 2

What is the problem with mutations of P53 in CLL?

Answer 2

Makes it harder to treat with chemo and radiotherapy

Question 3

What are immediate effects of chemo and radiotherapy?

Answer 3

Hair loss
N + V
Neutropenic infection
Tiredness

Question 4

What are long term effects of chemo and radiotherapy?

Answer 4

Heart damage
Lung damage
Other cancers

Question 5

What supportive therapies are there for leukaemia?

Answer 5

Prompt treatment of neutropenic fever/infection
Broad spectrum antibiotics
Growth factors (GCSF)
Prophylactic antibiotics

Question 6

What can be given as prophylactic anti-funglas?

Answer 6

Itraconazole

Posaconazole

Question 7

What is one way to avoid side effects in treating Hodgkins lymphoma?

Answer 7

Miss out bleomycin in cycles 3-6

Question 8

What are monoclonal antibodies?

Answer 8

Immune treatment

Affect only cells which possess target protein

Question 9

With Rituximab, what does the murine variable regions bind to?

Answer 9

Specifically CD20 on B cells

Question 10

Human IgG1 Fc domain works in synergy with what?

Answer 10

Human effector mechanisms

Question 11

How is Ritximab administered?

Answer 11

5 minute injection under the skin

Question 12

RCHOP improves responses and cure patients with what?

Answer 12

Grade B cell NHL

Question 13

Name some other anti-B cell antibodies

Answer 13

Ofatumunab (Azerra)

Obinutumab (Gazyvaro)

Question 14

What is CD30?

Answer 14

A protein on Hodgkin’s cells and some T cell NHL

Question 15

With targeted therapy, are there still side-effects?

Answer 15

Yes

Question 16

What do Proteosome inhibitors do?

Answer 16

Break down proteins to recycle them

Question 17

What has good activity in mantle cell NHL?

Answer 17

Bortezomib (Velcade)

Question 18

Where else is Bortezomib used?

Answer 18

Waldenstrom’s

Question 19

What are IMID’s?

Answer 19

Derivatives of Thalidomide

Question 20

What side effects/risks are there with thalidomide?

Answer 20

Nerve damage
Risk to the fetus
Effect on blood counts
Other cancers

Question 21

What target treatment is used in Chronic Myeloid Leukaemia?

Answer 21

Tyrosine Kinase Inhibitors

Question 22

What target treatment is used in CLL and NHL?

Answer 22

Ibrutinib and Idelalisb to target malignant B cells

Question 23

What helps stop tumours from invading the immune system?

Answer 23

Nivolumab

Question 24

What are some side effects of Tyrosine Kinase Inhibitors?

Answer 24

Diarrhoea
Fluid in lungs
Neutropenia

Question 25

What are some side effects of Ibrutinib and Idelalisib?

Answer 25

Idelalisib - diarrhoea, rash, fatigue, liver abnormality, fever
Ibrutinib - fever, platelets, anaemia, SOB

Question 26

How are Ibrutinib and Idelalisib administered?

Answer 26

Tablet, not injected

Question 27

What is immune evasion?

Answer 27

When receptor is stimulated the immune cell is switched off and ‘ignores’ the tumour

Question 28

What does Nivolumab prevent binding to?

Answer 28

The effector cell

Question 29

What is the chemical that cancer cells release in order to be avoided by the immune system?

Answer 29

PD-1

Question 30

What immune therapies are possible?

Answer 30

Allogenic bone marrow from a donor

T cells from donor attack tumour

Question 31

What is adaptive immunotherapy?

Answer 31

Make the patients own immune cells recognise the cancer and attack it