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MO2 > principles of cancer treatment > Flashcards

principles of cancer treatment Flashcards

1
Q

what is systemic anticancer therapy? 4 of them

A
  • Cytotoxic chemotherapy
  • Biological (targeted) therapies
  • Hormonal therapies
  • Immunotherapy
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2
Q

what is the general principle of cancer chemo?

A

Chemotherapy is a chemical that is toxic to multiplying cells (in the cell cycle)

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3
Q

Do all chemotherapy drugs work the same way?/place?

A

Different chemotherapy drugs affect different stages
of the cell cycle
Hence chemotherapy protocols often have a
combination of treatments

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4
Q

what does FOLFOX contain?

A
  • Oxaliplatin (alkylating agent) – non cell cycle
    specific
  • Fluorouracil (antimetabolite) – cell
    cycle specific
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5
Q

what is cell cycle non-specific chemo?

A
  • Kills cell at all phases of cell cycle, including resting
  • Often given as a large bolus dose on day 1
    works even when cells are resting and not dividing- will kill cells no matter what phase they are in
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6
Q

what is cell cycle specific chemo?

A
  • Kills cell at specific point in cell cycle
  • Often given more than once over several days
  • Can be given as continuous infusion over several days
    this is a more targeted type of chemo
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7
Q

what level does chemotherapy need to reach in order to work?

A

Chemotherapy needs to reach a high enough level in the blood to kill cancer cells but not too much so that the patient cannot tolerate it

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8
Q

what is the benefit of repeated administration of chemotherapy?

A

Repeated administration results in a proportional cell kill
* Tumour burden may be reduced to undetectable levels
* Further courses required to reduce tumour cell count to an absolute minimum

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9
Q

when can cancer relapse?

A

when there is a few cells remaining and the body’s immune system cannot destroy it.
these cells regrow

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10
Q

how do we monitor the toxicity associated with chemotherapy?

A

frequent blood counts
close clinical support

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11
Q

why do we monitor toxicity?

A

as chemo will damage healthy cells too

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12
Q

what are the 4 different aims of chemo?

A

curative
adjuvant- after definitive treatment
neoadjuvant- prior to procedure eg shrink tumour
palliative- control symptoms and improve QOL

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13
Q

when does curative chemo work best?

A

in acute leukaemia

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14
Q

what do you have to consider when balancing the risks and benefits?

A

are they well enough to have this chemo?
how can they manage their side effects?

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15
Q

how do cells become resistant to chemo?

A

some cells that are left over are able to mutate and develop resistance to the drug/ learn how to repair their DNA breaks

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16
Q

how long is chemo usually given for?

A

usually 3-4 week time period

17
Q

what does the number of cycles depend on?

A

depends on treatment intention and may vary for different cancers

18
Q

how does metabolism and excretion vary between patients?

A
  • Renal and hepatic function
  • Absorption orally
  • Drug interactions
19
Q

how does toxicity vary?

A
  • May be related to efficacy
  • Treatment intention important when assessing
    toxicities
20
Q

what do we have to monitor during chemo?

A

monitor the response to treatment
toxicity review

21
Q

how would you monitor the patients response to treatment?

A
  • Dependent on:
    – Disease
    – Treatment intention
  • Tumour markers
  • Imaging
22
Q

how would you review a patients toxicity?

A
  • Full blood count
  • U&Es
    – Renal function
    – Liver function tests
  • Symptom review
  • Weight
  • Doses adjusted depending
    on response to treatment
    and blood profile
23
Q

how can hormone therapy be used?

A

Can be used for hormone driven cancers
* To shrink a tumour
* To slow down or stop growth (instead of surgery or
radiotherapy), or reduce symptoms
* Combined with other treatments
* To make cancer less likely to return/spread
* To reduce the risk of breast cancer in healthy ‘at risk’
women

24
Q

what is the general principle of hormone therapy?

A

Either reduce amount of hormone or antagonist at hormone receptor

25
Q

how long do you give hormone therapy for? give an example

A

unlike chemo, tend to give for longer time periods
eg-surgery and adj chemo and tamoxifen- reducing the risk of returning for 10 years
- combination for best result

26
Q

what is targeted therapy?

A

Targets the changes in cancer cells that help
them grow, divide, and metastasise

27
Q

what are the variable MOA of targeted therapy?

A

– Induce immune response
– Inhibit cancer cell growth
– Inhibit angiogenesis
– Release cytotoxic agents at site of action
– Induce apoptosis
– Inhibit hormone dependent growth

28
Q

what is the benefit of targeted therapy?

A

More precise treatment with (hopefully) fewer side effects

29
Q

what are the two main types of targeted therapy?

A

Monoclonal antibody- MAB
Small molecule

30
Q

how does monoclonal antibody targeted therapy work?

A
  • Some block receptors on surface of cancer cell
  • Some activate WBC (immunotherapy)
  • Manufactured using living cells (biological therapy)
  • Some delivery chemotherapy to cancer cells
  • Normally IV every one to three weeks
31
Q

how does small molecule targeted therapy work?

A
  • Less specific than antibodies
  • Most block kinase (tyrosine kinase inhibitors)
  • Normally taken orally every day
32
Q

what is immunotherapy and what are the 3 main groups?

A
  • Treatment that works via the immune
    system
  • Three main groups:
  • Monoclonal antibodies
  • Checkpoint inhibitors
  • CAR T cell therapy
33
Q

how does immunotherapy work?

A

normal T cells- normally help to identify and kill cancer cells
checkpoints turn T cells on and off
cancer cells can affect this function- as they keep them turned off

34
Q

what is CAR T cell therapy?

A

removing normal T cells and reintroducing into blood in hope they can fight cancer

35
Q

what is radiotherapy?

A

Radiotherapy uses high-energy rays, such as x-
rays, to treat cancer
It destroys cancer cells in the area where it is
given, but can also destroy healthy cells in
that area

36
Q

why may radiotherapy be given?

A

– Radical
– Chemoradiation
– Adjuvant
– Neoadjuvant
– Palliative

37
Q

what are the two types of radiotherapy?

A

external beam- using machine to aim beams at cancer
internal beam- from inside the body- eg radioactive liquid-iodine- accumulates in thyroid

38
Q

when may surgery be used?

A

– diagnose cancer
– remove cancer
– find out how big the cancer is and if it has spread to other
parts of the body
– control symptoms of cancer
– restore parts of the body (for example, bladder
reconstruction)
– improve the appearance of part of the body (for example,
breast reconstruction)

MO2 (55 decks)

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