Session 7 - Cancer and the Cell Cycle Flashcards

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1
Q

What are four different ways in which cancer can spread?

A

Local - Direct involvemnt of surrounding structures
Lymphatic
Blood
Implantation

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2
Q

What cancers spread via lymphatics?

A

Carcinomas and melanomas

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3
Q

What cancers spread via the blood

A

Sarcomas and Carcinomas

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4
Q

What cancers spread via implantation

A

Mechanical dump of tumour clump in peritoneum, ureters, CSF

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5
Q

What are two synonyms for primary therapy?

A

Curative treatment

Radical treatment

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6
Q

What is adjuvant chemotherapy?

A

Post-operativ treatment in a patient at high risk of microscopic metastases after removal of the primary tumour

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7
Q

What is neoadjuvant chemotherapy?

A

Primary treatment of patients with a clinically localised tumour. Can be used ot asses biological responsiveness of tumour and to reduce size for surgery.

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8
Q

What is always aimed for in neoadjuvant therapy?

A

PCR (pathological complete response)

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9
Q

What is palliative chemotherapy?

A

Not curative, symptomatic treatment only

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10
Q

In what malignancies is chemotherapy curative?

A

Haematological malignancies

Testicular cancr

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11
Q

What is fractional chemotherapy?

A

hemotherapy is used in very narrow range to kill cells in a fractional way. This means that chemo given in bursts with intervals, allowing healthy cell populations (bone marrow, etc) to recover while hammering down the malignant, poorly corrective cancer cells.

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12
Q

Give three types of cytotoxic agent?

A

Platinum compound
Anti-metabolites
Spindle Poisons

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13
Q

What do platinum compounds do?

A

Inhibit DNA synthesis via formation of platinated inter- and intrastrand adducts leading to inhibition of DNA synthesis

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14
Q

Name two anti-metabolites

A

Methotrexate

5-fluorouracil

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15
Q

What does methotrexate do?

A

Inhibits dihydrofolate reductase

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16
Q

What does 5-fluorouracial do?

A

Inhibits thymidylate synthase

17
Q

What do spindle poisons do?

A

Once chromosomes aligned at metaphase plate, spindle microtubules depolymerize, moving sister chromatids towards opposite poles. Nuclear membrane re-forms and cytoplasm divides.

18
Q

How do microtubule binding agents, such as spindle poisons, affect microtubule dynamics

A

Inhibit polymerization

Stimulate polymerization and prevent depolymerization

19
Q

What is the aim of combination therapy?

A

Activity vs safety

20
Q

Give two reasons to suggest why you would have two separate pharmacological agents in chemotherapy?

A
  • Different mechanisms of action
  • Different mechanisms of resistance
    However, must take into account compatability of side-effects
21
Q

Give a hormonal treatment in breast cancer other than tamoxifen

A

Aromatase inhibitors prevents Oestrogen conversion in fat from androgens – only work in post-menopausal women, as pre’s have functioning ovaries which will replace Oestrogen.

22
Q

What is arbiaterone?

A

A drug which inhibits enzyme CYP17A1, which is crucial in conversion of pregnenolone and progesterone to testosterone

23
Q

Name a drug which inhibits CYP17A1 and what is it used for?

A

Prostate cancer

Abiraterone

24
Q

In what ways doe a cnacer cell differ from a normal cell?

A
  • Lose contact inhibition
  • Increase in growth factor secretion
  • Increase in oncogene expression
  • Loss of tumour suppressor genes
25
Q

In what way do normal cells differ from cancer cells?

A
  • Oncogene expression rare
  • Intermittent or coordinated growth factor secretion
  • Presence of tumour suppressor genes
26
Q

Give an example of biologically targeted therapy

A

Philadelphia chromosome of chonic myeloid leukaemia

27
Q

What is the philadelphia chromosome and what does it do?

A
  • translocation of part of chromosome 9 to 22
  • abl oncogene on 9 adjacent to breakpoint cluster bcr gene on 22, fusion leads to transcription of a protein and leukaemic transformation
  • Provides target for anti-cancer therapy eg. STI 571
28
Q

Give a treatment for CML?

A

Imatinib, Bcr-Abl tyrosine kinase inhibitor targets Philadelphia cells in CML and has massively increased survivability.

29
Q

Give an antibody treatment for breast cancer

A
  • Trastuzumab is a recombinant humanised IgG1 monoclonal antibody against the human
  • epidermal growth factor receptor 2 (HER2).
  • Antibody dependent cell mediated cytotoxicity (ADCC)
30
Q

Give a biological therapy for colon cancer

A

Erbitux, an IgG antiboyd targets extracellular EGFR, altering signalling cascade

31
Q

What is a VEGF trap?

A

Abflibercept – VEGF trap
VEGF romotes angiogenesis in vivo by inducing endothelial cells to invade collagen gels and proliferate to form capillary-like structures. The trap binds to VEGF and inhibits it.