Targeted Cancer Therapies Flashcards
What are the three stages of immunoediting?
Elimination
equilibrium
escape
How is metastatic cancer treated?
Surgery
chemotherapy
radiotherapy
immunotherapy
What are the general approaches to immunotherapy?
Vaccination strategies
non-specific therapies
antibody therapies
cell based therapies
What is aldara?
A viral mimic
Interleukin 2 is a non-specific immunotherapy which acts to drive the T cell response. What is the problem with this therapy?
It has a very narrow therapeutic index and can be very toxic
What are the possible cell therapies which can be used in cancer treatment?
Haematopoietic stem cells tumour infiltrating T cells dendritic cell vaccines NK cells gamma delta T cells virus specific T cells genetically engineering T cells
PDL-1 blockers are monoclonal antibodies which can be used in the treatment of some cancers. What does PDL1, expressed on some cancers do?
PDL1 binds to its receptor on T cells to ‘switch off’ the T cell and down regulate the immune response to the cancer
CTLA-4 blockers are monoclonal antibodies which can be used in the treatment of some cancers. What does CTLA-4, expressed on some cancers do?
CTLA4 binds to its receptor on T cells to ‘switch off’ the T cell and down regulate the immune response to the cancer
What is involved in the process of haematopoietic stem cell transplants in cancer therapy?
Mobilisation of the donor/patient
storage of haematopoetic stem cells
killing of the cancer
re-infusion of haematopoetic stem cells into the ‘clean system’
recovery of innate and adaptive immune systems
What are the advantages of using autologous stem cells in haematopoietic stem cell transplants for cancer patients?
No chance of graft vs host disease
What are the disadvantages of using autologous stem cells in haematopoietic stem cell transplants for cancer patients?
Increased chance of remission compared to use of allogeneic cells
What is involved in provenge cancer therapy?
Isolation of monocyte dendritic cell precursors
generation of these cells which are simultanously loaded with cancer antigens
rein fusion of cells to generate an anti-tumour response
What are CAR-T cells?
Genetically engineered to produce an artificial T cell receptor
Give an example of a CART cell used in the treatment of B cell lymphoma?
Kymriah
Specific T cells which are sensitive to the EBV virus can be used in the treatment of transplant patients with what type of cancer?
B cell lymphoma
In chronic myeloid leukaemia there is over expression of Abl leading to uncontrolled cell division. Which targeted therapy drug can be used to block Abl to prevent this?
Imatinib
What are the advantage of newer targeted treatments for cancer?
More selective for cancer cells and less selective for normal cells
less side effects
can given higher doses
potentialy. more anti-cancer effects
What are the disadvantages of newer targeted treatments for cancer?
Hard to find drugs which switch pathway back on i.e. when there are mutations in tumour suppressor genes
Targeted drugs are not available for most patients
Requires biopsies to be performed (carries risk)
Most tumours not driven by single, draggable mutation
Cancers can mutate to become resistant to specific therapies
Give examples of specific target therapy drugs used in the treated of non small cell lung cancers?
Cirzotinib
Erlotinib
What is a predictive marker?
A marker which predicts which patients will benefit from a specific treatment which helps choose which drug to use and is the basis of precision medicine
What is a prognostic marker?
A marker which informs about the outcome regardless of treatment so can help decide which patients to treat but not how to treat them