Oncology Chemotherapy

Question 1

Metronomic Chemo/Cont. Low dose Chemo

NSAID+(CHLORAMBUCIL/LOMSUTINE/CYLOPHOSPHAMIDE)

Answer 1

slows growth
Inhibits angiogenesis
decreseases circulating T Cells
Promotes anti-tumour immunity
Acts on microenvironment
Give in cont. low doses to stabalise and prevent proliferation.
Good for tumours with resistance or MDR-1or love mitotic index as acts on ENVIRONMENT not cell itself

Question 2

Receptor Tyrosine Kinase Inhibitors
Stops KIT receptor activating cell signalling. Does NOT effect normal cells- although is a FOREIGN BODY
Give anti-histamine before second dose.
(TOCERANIB/MASITINIB)
(CANINE MCT)

Answer 2

inhibits angiogenesis
reduce prolioferation
promote apoptosis
stabalise and prevent profliferation

Question 3

FACTORS AFFECTING SUCCESS OF ANTICANCER DRUG THERAPY

Answer 3

1. Tumour type/sensitivity eg. Lyphoma v sensitive
2. Penetration of drug into tumour- depends of tumour blood supply (as drugs usually given systemically) and natural barrier
3. Development of drug resistance- using drugs selects for resistance. can occur via mutations. MDR occurs with MDR1 gene expression= increased P-glycoprotein which pumps drugs out the cell.

MDR-1 is activated by glucocorticoids (induce resistance)

Question 4

LYMPHOMA

Answer 4

1. COP- VINCRISTINE (irritant/neurpathies/catheter)/CYCHLOPHOSPHAMIDE (haemoragic cystitis)(orally)/ PREDNISOLONE (orally) (gloves to administer both tablets
2. COP- DOXORUBICIN (cardiotoxic)
3. Modified LOPP- LOMISTINE/PROCARBAZINE

Question 5

OSTEOSARCOMA

Answer 5

CARBOPLATIN (not cats) or DOXORUBICIN (cardiotoxic)

Question 6

the Cell Kill Hypothesis

Answer 6

a given dose of drug will kill a fixed % of tumour cells. Not a certain no. of tumour cells.
Indicates that more than one dose will be needed
Each dose at Max Tolerated Dose
Pulse doses to allow normal cells to recover(hey recover quicker than tumour cells)

Question 7

TRANSMISSABLE VENERAL TUMOUR

Answer 7

VINCRISTINE (irritant/neuropathies)

Question 8

Dosing

Answer 8

Dose via body surface area unless its a small cat/dog- then do it by modyweight

Question 9

METABOLISM AND EXCRETION

Answer 9

Screen for any liver/kidney problems before doing as these are needed for drug metabolism and excretion

Question 10

MAST CELL TUMOUR

Answer 10

1. VINBLASTINE/LOMUSTINE + PRED
2. VINBLASTINE + CYCLPHOPHOSPHOMIDE +PRED
3. CHLORAMBUCIL+ PRED

IF NON-RESECTABLE

1. MASITINIB (grade 2/3. KIT mutation +)
2. TOCERANIB(grade 2/3, metastatic)

Question 11

HISTIOCYTIC SARCOMA

Answer 11

LOMUSTINE

Question 12

THYROID CARCINOMA

Answer 12

DOXORUBICIN (cardiotoxic)

Question 13

HAEMANGIOSARCOMA

Answer 13

(A)- DOXORUBICIN
(AC)- DOXORUBICIN + CYCLOPHOSPHAMIDE
(VAC)-DOXORUBICIN+ CYCLOPHOSPHAMIDE+ VINCRISTINE

Question 14

MAMMARY CARCINOMA

Answer 14

(AC) DOXORUBICIN+ CYCLOPHOSPHAMIDE

Question 15

FELINE INJECTION SITE SARCOMA if dirty margins after surgery. Hoever no chemo needed after radical surgery and hyperfractionated RT

Answer 15

DOXORUBICN or CARBOPLATIN