New And Future Treatments For Blood Cancers Flashcards
What is the principle of action of chemo and radiotherapy?
Damages cell DNA.
Cell recognises damage -> apoptosis.
Why do you get side effects in chemo and radiotherapy?
Normal cells also get their DNA damaged -> apoptosis
Some immediate side effects of chemo?
Hair loss
Nausea and vomiting
Neutropenic infection
Tiredness
Some long term side effects of chemo and radiotherapy?
Heart and lung damage
Other cancers
What supportive therapies can be given when using chemo or radiotherapy?
Prompt treatment of neutropenic fever/ infection Broad spectrum antibiotics Red cell and platelet transfusion Growth factors (GCSF) Prophylactic antibiotics and antifungals
What is emergency treatment of standard risk neutropenic sepsis?
Piperacillin / tazobactam
What is the emergency treatment of high risk neutropenic sepsis?
Piperacillin / tazobactam + gentamicin
A PET scan can be used in what cancer to help monitor chemo?
Hodgkin’s lymphoma
Benefit of monoclonal antibodies?
Only affect cells which possess target proteins so avoid side effects
Examples of monoclonal antibodies?
rituximab
Ofatumunab
Obinutumab
Brentuximab vedotin
Are biological treatments just targeted to malignant cells?
No so will get side effects
Examples of biological treatments?
Proteosome inhibitors
IMIDs (immunomodulatory imide drugs)
Action of proteosome inhibitors?
Proteosome has lots of old proteins in cell and breaks them down to amino acids for recycling.
Blocking this -> accumulation of toxic proteins in cell -> apoptosis
Example of a proteosome inhibitor?
Bortezomib
An example of an IMID?
Lenalidomide ( derivative of thalidomide)
What do IMIDs do?
Can produce remission when no more response to chemo
Tyrosine kinase inhibitors?
Imatinib
Nilotinib
Dasatinib
Ibnutinib
Are tyrosine kinase inhibitors well tolerated?
Yes - very few side effects
- diarrhoea
- fluid in lungs
- neutropenia
What is nivolumab?
A checkpoint inhibitor
What is an allogenic bone marrow transplant?
Cells from donor to cause immune attack on cancer.
But can also attack normal cells - graft versus host disease (GVHD)
What is adoptive immunotherapy?
Make the patients own immune cells recognise the cancer as foreign and attack it.
Advantages of adoptive immunotherapy?
Avoids toxicity and GVHD
