New and Future Treatments for Blood Cancer Flashcards
What protein found in the cell nucleus is involved with apoptosis?
P53
What is the problem with mutations of P53 in CLL?
Makes it harder to treat with chemo and radiotherapy
What are immediate effects of chemo and radiotherapy?
Hair loss
N + V
Neutropenic infection
Tiredness
What are long term effects of chemo and radiotherapy?
Heart damage
Lung damage
Other cancers
What supportive therapies are there for leukaemia?
Prompt treatment of neutropenic fever/infection
Broad spectrum antibiotics
Growth factors (GCSF)
Prophylactic antibiotics
What can be given as prophylactic anti-funglas?
Itraconazole
Posaconazole
What is one way to avoid side effects in treating Hodgkins lymphoma?
Miss out bleomycin in cycles 3-6
What are monoclonal antibodies?
Immune treatment
Affect only cells which possess target protein
With Rituximab, what does the murine variable regions bind to?
Specifically CD20 on B cells
Human IgG1 Fc domain works in synergy with what?
Human effector mechanisms
How is Ritximab administered?
5 minute injection under the skin
RCHOP improves responses and cure patients with what?
Grade B cell NHL
Name some other anti-B cell antibodies
Ofatumunab (Azerra)
Obinutumab (Gazyvaro)
What is CD30?
A protein on Hodgkin’s cells and some T cell NHL
With targeted therapy, are there still side-effects?
Yes
What do Proteosome inhibitors do?
Break down proteins to recycle them
What has good activity in mantle cell NHL?
Bortezomib (Velcade)
Where else is Bortezomib used?
Waldenstrom’s
What are IMID’s?
Derivatives of Thalidomide
What side effects/risks are there with thalidomide?
Nerve damage
Risk to the fetus
Effect on blood counts
Other cancers
What target treatment is used in Chronic Myeloid Leukaemia?
Tyrosine Kinase Inhibitors
What target treatment is used in CLL and NHL?
Ibrutinib and Idelalisb to target malignant B cells
What helps stop tumours from invading the immune system?
Nivolumab
What are some side effects of Tyrosine Kinase Inhibitors?
Diarrhoea
Fluid in lungs
Neutropenia
What are some side effects of Ibrutinib and Idelalisib?
Idelalisib - diarrhoea, rash, fatigue, liver abnormality, fever
Ibrutinib - fever, platelets, anaemia, SOB
How are Ibrutinib and Idelalisib administered?
Tablet, not injected
What is immune evasion?
When receptor is stimulated the immune cell is switched off and ‘ignores’ the tumour
What does Nivolumab prevent binding to?
The effector cell
What is the chemical that cancer cells release in order to be avoided by the immune system?
PD-1
What immune therapies are possible?
Allogenic bone marrow from a donor
T cells from donor attack tumour
What is adaptive immunotherapy?
Make the patients own immune cells recognise the cancer and attack it
