Oncology disease modifying therapies Flashcards

1
Q

What are the goals of disease modifying therapies?

A
  • Curative
  • Palliative
    • improve QOL
    • stabilize progression
    • prolong survival
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2
Q

List advanced cancers that can be cured with chemotherapy

A
  • ALL peds
  • AML
  • Choriocarcinoma
  • Non hodgkins Lymphoma
  • Hodkin’s lymphoma
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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
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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.
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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
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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
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7
Q

Endometrial Cancer Treatment : Hormonal treatments

A
  • Progesterone
  • Tamoxifen
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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
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9
Q

Thyroid Cancer Treatment

A
  • L-thyroxine to suppress TSH
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10
Q

Neuroendocrine Cancer treatment

A
  • Somatostatin Analogues (octreotide, lanreotide)
  • symptomatic treatment
  • progression free survival
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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
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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
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