principles of treatment 2 Flashcards
what are the different ways of treating cancer?
- chemotherapy
- monoclonal antibody therapy
- targeted therapy
- immunotherapy
what is the standard therapy for diffuse B cell lymphoma and what can make it better?
- CHOP
- it is significantly improved with the addition of rituximab
what are the different target spots for targeted therapy?
- growth factor kinase inhibitors
- apoptosis induction
- damage response inhibition
- epigenetic reprogramming
- telomerase inhibition
- redox modulation
- metabolic programming
- proteasome inhibition
- csc transdifferentiation
- immunomodulation
why are mot new targeted therapies for harm cancers?
- blood is easier to access and target then tumours- its easier to take several blood tests that=n several biopsies
what is the genetic abnormality causing CML?
Philadelphia chromosome
translocation of chr9 and 22
resulting in bcrAbl fusion gene
this causes transformation of haematopoetic progenitor into malignant clone
how does imatinib treat CML?
- binds to ATP binding site of BcrAbl and inactivates it
what are different ways that resistance to imatinib can arise?
- Abl kinase domain mutations
- amplification of BcrAbl
- clonal evolution with less reliance on BcrAbl
- drug efflux mechanism- imatinib is a pgp substrate, if pgp is increased it will reduce the bioavailability of imatinib
what are examples of second generation TKI?
- nilotinib
- dasatinib
- bosutinib
what percent of NSCLC patients have a mutation in EGFR kinase?
10%
what is the target treatment for people that express EGFR kinase in NSCLC?
gefitinib
what percentage of NSCLC patients have anapaestic lymphoma kinase mutations?
5
what is the treatment for ALK NSCLC?
crizotinib
what is the treatment for melanoma px with braf mutation?
vemurafinib
what type of drug is ibrutinib and who is it used for?
Bruton’s tyrosine kinase (BTK) inhibitor
relapsed/refractory CLL and mantle cell lymphoma
which targeted therapy targets angiogenesis?
Bevacizumab
- blocks veg f receptor
