Oncology: Chemotherapy Flashcards
Define Cure
tumour gone, no further therapy needed
Define complete remission (CR)
no evidence of tumour on physical exam, haematology, biochemistry, or imaging
Define partial remission (PR)
reduction in the sum of the longest diameters of ≥ 30% with no new lesions at 4 weeks
Define stable disease
no change at 4 weeks
Define progressive disease
increase of 20% or more in longest diameter at 4 weeks, or new lesions
Define induction therapy
intensive period to try and reduce the number of cancer cells
Define maintenance chemotherapy
less intensive to maintain remission
Define rescue chemotherapy
re-induction with non first-line agents when one protocol has failed
Define median survival time
(median response duration) = half of patients relapsed or died and half still in remission
Define disease free interval
= time to progression after onset of therapy, eg mets after osteosarcoma amputation
Define adjuvant chemotherapy
= administered after surgery or radiotherapy, usually to limit metastasis formation
Define neoadjuvant chemotherapy
to shrink the mass before surgery or radiotherapy
What is nadir?
point at which lowest white blood cell count occurs
Define maximum tolerated dose
maximum recommended dose of an agent, either at one time or cumulatively
What tumour types have a high sensitivity to chemotherapy
Lymphoma, myeloma and leukaemia
What tumour types have a moderate sensitivity to chemotherapy?
Adjuvant therapy of sarcomas and carcinomas
Mast cell tumours
What tumour types have low sensitivity to chemotherapy?
slow growing sarcomas, some carcinomas, melanomas
What are the two classifications of chemotherapeutic drugs?
Cell cycle non-specific: E.g. Alkylating agents which disrupt the DNA double helix
Cell cycle specific: E.g. Vinca alkaloids which interfere with spindle formation disrupting mitosis
What do anti- metabolites do and give examples
Inhibit purine and pyrimidine syntheses
eg. cytarabine and 5-fluorouracil
S-phase specific
What are mitotic spindle inhibitors, give examples.
aka Vinca alkaloids
eg.Vincristine, vinblastine
M-Phase specific
Name the phase-non specific chemotherapy agents
- Alkylating agent (Disrupt the DNA)
- Anti-tumour antibiotic (bind DNA and stop replication)
- Other agents eg. cisplatin, carboplatin, L-asparaginase
What order pharmacokinetics are cytotoxic drugs?
Cytotoxic cell kill is by first order kinetics ( The number of cancer cells killed by a drug is proportional to the dose)
…Therefore use highest possible dose without killing offs all the bone marrow
What systems are affected the most by chemotherapy?
GI and bone marrow because they have lots of dividing cells
What are the side effects associated with:
Cyclophosphamide.
Doxorubicin.
Vincristine.
Cyclophosphamide. Sterile haemorrhagic cystitis
Doxorubicin. Cardiotoxicity
Vincristine. Peripheral neuropathy
