Oncology disease modifying therapies Flashcards
1
Q
What are the goals of disease modifying therapies?
A
- Curative
- Palliative
- improve QOL
- stabilize progression
- prolong survival
2
Q
List advanced cancers that can be cured with chemotherapy
A
- ALL peds
- AML
- Choriocarcinoma
- Non hodgkins Lymphoma
- Hodkin’s lymphoma
3
Q
List cancers than could be cured with chemotherapy and radiation therapy
A
- Anal cancer
- Cervical cancer
- Head and neck cancers
- Lymphoma
- NSCLC
- SCLC
4
Q
Role of surgery in cancer treatment
A
- cure, better disease control
- Metastatic RCC
- regression of lung mets
- Breast cancer
- Colorectal cancer
- Lung mets removed if primary is controlled and stable and not widespread disease
- Liver mets in CRC
- Solitary brain met
- Metastectomy of adrenal mets, bone for palliation.
5
Q
Radiation treatment : role in outcome and survival
A
- SCLC
- chemo = better survival and local control
- prophylactic whole brain rads
- Solitary brain mets
- SRS or WBRT
- better than surgery alone
- Recurrent head and neck
- re-radiation if possible can be beneficial
- Metastatic thyroid cancer
- radioactive iodine controls metastatic disease
- Carcinoid tumours
- Castration resistant prostate cancer
6
Q
Breast Cancer : Hormonal Treatment
A
- 70% of breast cancers are ER or PR positive
- Aromatase inhibitors (ER+) OR
- Estrogen blockers
- improve disease free progression
- POST menopausal:
- AI (letrozole, anastrazole, exemestane)
- block peripheral estrogen production
- PRE menopausal
- Tamoxifen
- Ovarian suppression
7
Q
Endometrial Cancer Treatment : Hormonal treatments
A
- Progesterone
- Tamoxifen
8
Q
Prostate Cancer : Hormonal Treatments
A
- Androgen Deprivation Therapy
- Orchiectomy
- LHRH agonists / antagonists
- reduces disease progression
- No clear survival benefit
- castration resistant –> effective
- Abiraterone
9
Q
Thyroid Cancer Treatment
A
- L-thyroxine to suppress TSH
10
Q
Neuroendocrine Cancer treatment
A
- Somatostatin Analogues (octreotide, lanreotide)
- symptomatic treatment
- progression free survival
11
Q
Cytotoxic chemotherapy
A
- impacts cell division (mitosis)
- therapeutic index narrow (activity and toxicity)
- often combined with radiation and surgery
- Curative for:
- testicular, germ cell, lymphoma
- Palliative for:
- disease control
- extended survival
- QOL
- Common side effects:
- myelosuppression
- mucositis
- alopecia
- Paclitaxel, docetaxel, doxrubicin
12
Q
Targeted Agents:
A
- Monoclonal antibodies against EGFR receptor
- Cetuximab
- Panitumumab
- Tyrosine Kinase inhibitors
- Gefitinib, erlotinib
- Monoclonal antibodies against HER2 receptors
- Trastuzumab, pertuzumab
- Epidermal grwoth factor recptor family
- VEGF receptor
- Bevacizumab, sorafinibm sutinib