systemic anti-cancer treatment Flashcards
what are the clinical settings associated with chemotherapy ?
neoadjuvant
adjuvant
primary
what is neoadjuvant therapy ?
chemo first followed by local treatment
thee am is to reduce the size of thee disease locally along with early treatment of micrometastasis
what is adjuvant therapy ?
local treatment followed by chemotherapy
aim is to allow early treatment of local disease before it becomes inoperable and then to treat micrometastasis
what are the types of dose limiting toxicities ?
1.haematological malignancies
2.non hematological systemic toxicity
3.cardiac toxicity
what are the stages of the cell cycle ?
G1- organelle replication
S - DNA replication
G2 - Cell prepares for M
M - Mitosis
what are antimetabolites ?
inhibit key synthetic enzymes by mimicking a natural substance or cofactor
what are the types of anti metabolites ?
pyrimidines
antifolates
Purine
what are examples of pyrimidine antifolates ?
5 FU
capecitabine ( oral 5-FU)
gemcitabine
Cytosine arabinoside
what are examples of antifolates ?
methotrexate
Pemetrexed
what are examples of purines ?
6-mercaptopurine
Cladribine
Fludarabine
what are the characteristic features of antimetabolites ?
cell cycle dependency
saturable effects
what is the mechanism of action of 5-FU ?
formation of 5FdUmp
formation of 5FTmp and hence the inhibition of the thymidylate synthase enzyme
( inhibition of TS)
what is the oral form of 5FU called ?
Capecitabine
what is the mechanism of methotrexate ?
by the inhibition of dihydrofolate reductase
what is the mechanism of action of pemetrexed ?
multitargeted antifolate
inhibits TS
inhibits DHFR and GARFT which is involved in purine biosynthesis
what must be given along with pemetrexed ?
b12 supplementation and folate
what type of cancers use pemetrexed ?
activee in mesothelioma
non small cell lung carcinoma
what type of chemotheerapeutic agnt is used in ALL ?
purines / anti metabolite
6-MP
what typee of chemotheerapeutiic agent is used in CLL ?
Anti-metabolite
Fludarabine
what type of chemotherapeutic agent is used in hairy cell leukemia ?
anti-metabolite
Cladribine
what are the types of anticancer antibiotics ?
Mitomycin
Mitoxantrone
Actinomycin
Anthracyclines
Bleomycin
what are examples of anthracycline antibiotics ?
doxorubicin
what is the mechanism of action of anticancer antibiotics ?
1.inhibition of topoisomerase II
2. formation of oxygen free radicals
3.inhibition of helicase
what are the toxicities of anthracyclines ?
-myelosuppression
-alopecia
-mucositis
-radiosensitizer
-radiation recall phenomenon
-cardiotoxicity
- extravasation - soft tissue necrosis
what is radiation recall phenomenon ?
an acute inflammatory reaction confined to an area that had been previously irradiated and is triggered after the administration of chemotherapeutic agents
what is the cumulative dose that significantly increases the incidence of toxicity of anthracyclines ?
after cumulative dose of 500mg/m
what are the types of alkylating agents ?
-classic alkylating agents
-non classical alkylating agents
what are the types of classic alkylating agents ?
nitrogen mustards
aziridines
alkyl alkane sulfonates
Nitrosourea
what are the types of non-classical alkylating agents ?
platinums
triazines
imdazotetrazines
what are the type of platinum alkylating agents ?
cisplatin
carboplatin
oxaliplatin
what are the general toxicities of alkylating agents ?
myelosuppression
alopecia
nausea and vomiting
what are other toxicities of alkylating agents ?
mutagenesis
carcinogens
Veno-occlusive disease
infertility
pulmonary fibrosis
what is the
function of topoisomerase ?
enzymes that catalyze the formation of transient single or double stranded DNA
what is the difference in function of topoisomerase I and II ?
