Oncology Flashcards
Most common site of spread of ER+ve Breast Ca
Bone
What is the commonest targetable in non-squamous NSCLC
EGFR > ALK > ROS1
General mgmt of pancoast tumour
Neoadjuvant Chemo/RTx followed by resection to get the tumour away from the nerve bundle
Standard rx for mgmt of Stage III unresectable NSCLC
chemoradiotherapy + adjuvant Durvalumab
Clinical Trial Phase 1:
dose ranging on healthy volunteers for safety; find PK/PD
Clinical Trial Phase 2
Assess efficacy and side effects
Trial Phase 3
intervention to current gold standard
Cell cycle: G0 is
cell is chilling
Cell cycle, G1 is:
replicating contents but not chromosomes
Cycle cycle, S is:
chromosomes duplicating
Helicase function
splits dsDNA
Topoisomerase function
unwinds DNA
DNA polymerase function
matches base pairs -> purine and pyramidine analogues
Ligase function
joins fragments
Cell cycle, G2 is
double checking chromosomes
Cell cycle, mitosis is
Mitotic spindles pulling apart
Alkylating agents MOA
alkylate guanine -> disorts structure directly and cross links so helicase can no longer unwind
examples of alkylating agents
cyclophosphamide, melphalan, dacarbazine, cyclosporin, temozolomide, chlorambucil; and platinums
anti-metabolites MOA
anti-folates: prevent all NS/NT formation
anti-metabolits examples
MTX, permetrexed; purine analogues- fludarabine, 6-MP,; pyrimidine analogues- 5FU, Capecitabine, gemcitabine
Deficiency of what can make 5-FU fatal?
dihydro pyramidine dehydrogenase (breaks down 5-FU)
Alkaloids MOA
microtubule poisons- bind tubulin and stop microtubule formation
Alkaloids examples
Vinca alkaloids (vincristine, vinblastine, vinorelbine); taxanes; topoisomerase poisons- etoposide, irinotecan
Anthracyclines act on which part of cell cycle?
not cell cycle specific
Platinums side effects
neuropathy and nausea esp. cisplatin
High emetogenicity chemo
Cisplatin > anthracyclines + cyc, cyc alone
Medium emetogenicity chemo
other platinums, irinotecan
Cancers with highest somatic mutation burden
melanoma >SqCC lung > adeno lung >bladder> small cell lung
Lynch mutations
MSH2 >MLH1 > PMS2, MSH6
Lynch mechanism of inheritance
AD