Oncology begining Flashcards
Semi-synthetic Estrogen preparations
5- Fluorouracil Inhibits?
What is its mechanism
What type do drug is it?
Sensitive to?
Toxicities? 5
Blocking the Metabolism of 17a-Hydroxyprogesterone
Estrogen preparations: Natural estrogens and their esters
Structure activity relationship of Estrogens
What nucleus with what type od A ring?
3-Hydroxy group
- Metabolism of this?
- What is used to block this
Then 17bhydroxyl group
Mitomycin: DNA Alkylating Agent
MOA:
- Inert until? Generates what?
- What else is generated that can damage the DNA?
Unstable to?
What colored excretion?
Forms?
Natural Estrogens: Estradiol
Amongst the natural?
Metabolic vulnerability?
Forms?
Chlorotrianisene
What type of drug? Agonist or antagonists and for what hormone?
No free ___ which blocks what? This also means it can be what form?
Distance of what?
What are the biosynthetic steps for Estradiol from Androstenendione
—> Aromatase gives Estrone
17b-HSD —> Estradiol
Trastuzumab/HER2
Prototypical Example of Drug targeting what factor?
Humanized what?
Strategy for this drug?
Heterodimer of this Receptor triggers?
This is all talking about cancer not really the drug but the reason for the drug
Megesterol Acetate
(Megace)
What on the B ring increases activtiy?
How much of oral dose is metabolized?
How does it differ from Medroxyprogesterone?
How does it block metabolism
DNA methyltransferase inhibitors
3
DAN
MOA
19-Norandrostane Derivative products
SAR
19-nortestosterone
What does the NOR mean?
What type of effect does this favor then?
Phytoestrogens
Soy isoflavone B-glycosides are?
Methyltestosterone
What are its featureS?
What block oxidation at 17 keto
Activity compared to testosterone? An improvement is?
androgenic or anabolic?
what metabolism?
Imatinib
Prototypical Small Molecule Kinase Inhibitor
MOA
Inhibits what growth factor and what kinase?
Anabolic Agents
flow chart
Androgenic + anabolic agents
flow chart
Nibs are inhibitors of?
Distinct chemical structure facts
6 Drug interactions, Mutations, distinct __ interaction, Dustinct ___ profiles, Distinct ___ - ___ interactions
Norethindrone Acetate Combipatch
Ester __? Metabolized where to form?
Prolonged action in what form?
Oxandrolone
WHat blocks 17 keto? what else does this do form wise?
What is going on wiht the A ring?
what form?
Ither Kinase Inhibitors
Androstane Nuc
what are the parts?
What 4 carbons are important for the 19-norandro derivatives
5a-Reductase where does it act?
what is its product formation with testosterone?
Ethisterone and Analogues
_ derivative of what?
SAR summary of Progesterone and Derivatives
Progestational effects depend on wha 4 things
What mays it fit better to the receptor?
Alkene
Progesterone
Prometrium
Duration? Due to?
Where from?
What places are susceptible for metabolism?
MonoclonalAntibodies vs. Kinase Inhibitors
Kinase
- Cytosolic vs. ?
- REversible vs?
- ____ target
Monoclonal
- Extracellular what region of ?
*
Synthetic Estrogenic Agonist
DES
A very ____ ____ estrogen
What Isomer is 10 x more potent than?
Formerly used to?
Now?
Raloxifene
What type of activity? And what two things does this help?
What effect on breast tissue?
No ___ effect on the uterus?
form?
MAB with a warhead
Desogestrel
Progesterone
Progestasert
Despite?
What does the 17 ethynyl 19-Norandrostane do ofr activity across the board?
SAR Summary of Progesterone and Derivatives Synthetic Mods
2 main mods and talk about their effects
Estrogens: 17 a group hydroxl
What happens at the 17b group and what enzyme causes it?
Hepatic oxidation by 17b-hydroxysteroid dehydrogenase
Makes a less active ketone and limits oral activity
Where is the focus of progesterone drug in the pathway?
Chemotherapy targets
- Combine the selectivity of ___ ___ inhitors with the potent action of another class
- Are generally broad in spectrum and can be moderately toxic
- Are useful for the metastic cancers but are nonselective and have many side effects
- Are more selective and generally less toxic
- Are more selective and have varying levels of toxicity
- Draw the picture of where they act
There are now proposed cancer hallmarks
Emerging hallmarks and Enabling characteristics
4
Progestin Products: Progesterone and Derivatives
Starting at Nat Progestins then from there
Anastrozole
Specific?
Tx of?
Where is 17a-Hydroxyprogesterone in the Steroid Hormone Syn pathway
Medroxyprogesterone Acetate
at teh C6 position ___ is added and this decreases?
This blocks?
Intelligent therapy
Selective estrogen Receptor Modulators
SERM
What are these trying to circumvent
Stanozolol
What does it contain?
blocks oxidatio?
forms? What type of activity?
Topo I and II slide
Role of the cell cycle in chemotherapy
What controls cell cylce phase transitions? Failre causes?
Control growth and differentiation of targeted distant cells
What controls only nearby cells?
Coming from the cell itself?
Cells in what phase are least senstive to drugs?
Many drugs have what type of selectivty?
Tamoxifen and Raloxifene
Which one requires activation?
Progestin Products: Progesterone Derivatives
3
Epothilones
Complement what other drug?
MOA?
Improved?
What do you not need?
Chemical Stability
19-Norandrostane
SAR at c17 what is added and what does it block?
Analogues with what are inactive?
AntiAndrogen Chart
Anthracyclines DNA intercalation
5 of them all end with
2 MOA
Red quinones
Rings strucvute gives it away
Cholane?
Small sidechaine than cholestane 4 carbons
two methyls 18 19
Estrane nucleus has no?
C19 carbons
Testosterone esters
longer the chain longer the?
What type of drugs are they?
what is inhibited?
Miscellaneous: Bleomycin-Oxidative Cleavage of DNA
MOA
SE
Pregnane nucleus what are the important features? For derivates
Etheyleneimines
ThioTEPA
MOA:
Selectivtiy
Activated in?
Deactivation?
Active in the?
Medroxyprogesterone Acetate
What SC is introduced? What does this cause?
Slow reduction of the keto and double bond 4-5
Saw palmetto
BLM-Fe Complex
Damages DNA via?
Rescue therapy for methotrexate
Toxicity of Methotrexate
Hallmarks of Cancer
6 well defined hallmarks
Tretoin: Differentiation Therapy
MOA?
SE? Important notes
testosterone esters are subject to?
What is there physiological concentration like?
admin?
Activations of Capeitabine
Prodrug
Selectivity
SE profile
Additional considerations on therapeutic txs
What is necessary so a patient has the best chance of survival?
What is particularly dangerous?
- This puts stress on?
- How the these treated?
How long does it have to be to be a new cancer?
Cure means?
Practice
Letrozole
What does it do?
Tx of? Second line to?
Progestin Products
19-Norandrostane Derivatives
The rapid metabolism of progesterone triggered?
Esterified estrogens
Estra-cyp
Mutations and Biochemical Basis of Cancer
Many paragraphs
Most commonly cancer is caused by what type of mutations?
What is used to rationalized the difference between initiation and transformation?
So whats the deal with increasing age and cancer?
Biclutamide
Administered as a?
what enantiomer is inactive?
What does it bind to?
Role of aromatase?
Dienestrol (Synestrol)
What has been maintained?
Active in what wat? But how is it used primarily?
esterogen group at 3 position?
Subject to?
What does this limit?
- Phenolic hydroxyl
- Subject to biotransformation, which limits the duration of action, sulfation and glucuronidation
Estrogens 17 alpha ethinylation
Blocks?
Permits?
Number the cholesterol
Androstane
Fluoxymesterone
Bloicks what?
what makes it 5-10x more potent than testosterone?
Other Platinum Metal Complexes
Carboplatin and Oxaplatin
MOA?
STructural changes 2
Why does this make them better?
Carboxylic acid improves the safety profile and the
Cyclohexan 1,2 diamine overcomes resistance and once it gets to the right site it is more toxic
These drugs have different toxicities so onces put into a cocktail can get complement toxicities
Saw palmetto
Taxanes
MOA
Distinct
Lipophilicity and Implications
Moderately lipophilic need Emulsfying agent
Conversion of dUMP to dTMP
Phytoestrogens
What activity do they have?
The two hydroxyl groups?
Antiandrogenic peptides
Leuprolide
Goserelin
These drugs contain what?
GnRH
Incorporation of D AMino actids helps this
Classic Chemotherapy and the Cell Cycle
Hallmarks
- What must the drugs do?
Kinetics of Cell Division
- How can processes occur in cancer cells?
- Drugs can?
Classical Agents
- How do they interfere with these processes
Newer Agents
- Interfere with what pathways?
- Inhibit signals associated with? What type of cells?
Selectivty
For each class consider what?
Notes: How do tumor cells grow? How do cocktail target them?
Picture
Terminal Differentiation—>?
Phases of the cell
Tamoxifen
What isomer is used? What type of compound is it?
Used to treat?
form?
Retinoid Therapies to Stimulate Differentiation
Triphenylethylene Analogs
What structure is retained? But features what type of moeity that is critical for antiestrogenic activity?
Epipodophyllotoxins: Inhibition of?
Teniposide is more lipophilic more distribution more potent you can have less drug to get same effect
Dutasteride
What does it do?
and how
forms?
17a-Methyltestosterone
What are the key features?
What is blocked?
What does this mean for the drug?
General Notes about N-Mustards
MOA
- What generates an active electrophile and what does this react with? What is the fast and slow process
- What leads to mutation of DNA? And what is the mutation?
- What are the two steps prior to chain fragementation and destruction of DNA
- What is more difficult to repair mono or bi alkylation?
- How does deactivation occur?
- Selectivity Occurs from?
- Selectivity and Activity are Influences by?
- What are group is more reactive?
- How is potency influenced?
- Two ways that aziridinium formation is depressed?
- Prototype Mechlorethamine
Leuprolide and Goserelin DisruptEndogenous Hormonal Feedback systems
Action of Androgenic Peptides
- Stimulates
- Increase
- Initially
- Loop?
- Deprive tumor of?
SAR
19-Nortestosterone derivatives
What effect predominate and why?
A combination of what two things provides and overall ____ effect?
Fluoxymesterone
Androgen or anabolic acitivy?
more resistant to?
Nitrosoureas: Prodrugs
Carmustine
MOA?
Instability
Log P?
It is fragmented into twon parts what are they? They are the active DNA parts
How is this drug prepared for use?
Vinyl Cation and the 2-Chloroethylamine so you are mutating DNA at two sites
Nandrolone Decanoate
Absence of? gives it what activity?
what form?
Substitution with EWGs attenuate reactvitiy in what way?
P=?
This provide a similar activity to?
What are the drugs/
Th
Abx and higher derived natural products
3 classes
Topoisomerase Inhibitors
Mitosis Inhibitors
Msc
Dactinomycin: DNA Intercalation
MOA?
DMPK thing cyclic amides