Therapeutic Options in Cancer Flashcards
What is cell turnover?
The constant shedding of dead skin cells and subsequent replacement with younger cells.
What does it tell us about cell turnover if mutations occur as a result of errors during cell division?
The model suggests that a low cellular turnover rate protects both against aging and the development of cancer.
What are the ways to prevent cancer?
- Environmental/behaviour change
- Diet
- Screening
- Genetics
- Medication
General cancer treatment
- Surgery
- Radiotherapy
- Systemic therapy
- Immunotherapy
- Medication
Local or regional cancer treatment
- Surgery
- Radiotherapy
- Ablation (freezing, radio-frequency)
- Isolated limb perfusion
Systemic cancer treatment
- Hormonal therapy
- Chemotherapy
- Biological therapy
- Immunotherapy
- CAR T-cell therapy
What can be used to locate the cancer?
- Examination
- Use of radiology/imaging - CR, MRI, PET, USS
How can radiotherapy be used in cancer treatment?
- Needs anatomical coverage
- Can treat inoperable lesions
- Can make surgery possible
- Can be combined with chemotherapy - anal cancer, rectal cancer
What are the 5 R’s of radiobiology
Radiosensitivity, repair, re-population, re-oxygenation, re-assortment
What % of cancers cured are cured with radiotherapy?
Of cancers cured, 40% are by radiotherapy - eg head & neck, uterus, skin, lymphoma
What does radiotherapy have an important role in?
Pain
Bleeding Swollen limbs
What % of cancers cured are cured with surgery?
50%
What % of cancers cured are cured with chemotherapy?
5%
What % of cancers have palliative chemotherapy?
50%
Medical treatment of cancer - systemic
- Beneficial for widespread disease
- Can result in widespread toxicity
- Now a mixture of chemotherapy and now targeted agents
Medical treatment of cancer - targeted agents
- Potential to be very specific
- Hormone therapy: tamoxifen & ER+ve breast cancer
- Targeted a tumour mutation: EGFR mutations & TKI agents
Non-specific immune therapy?
Innate - macrophages/natural killer cells
Programmed cell death pathway (PD-1) - uses immune system to attack “foreign cancer cells”
Specific immune therapy?
Monocolonial antibodies
Chimeric antigen receptor (CAR) T-cells
What is compound targeting in chemotherapy?
Compound targeting DNA, RNA and proteins
What is the aim of chemotherapy?
The aim is to force cells into apoptosis
What is the frequency of chemotherapy administration?
Cycles determined by pharmacokinetics
What are the types of chemotherapy?
Alkylating agents and platinum drugs
Antimetabolites
Organic drugs
How are alkylating agents and platinum drugs used in chemotherapy?
From DNA adducts blocking DNA replication (all phases of cell cycle)
How do antimetabolites work in the treatment of cancer therapy?
Structurally mimic essential molecules required for cell division (S phase of cell cycle)
What are organic drugs used in chemotherapy?
vinca alkaloids/ taxanes/ anthracyclines
What are the classes of anti-cancer therapies?
- Hormonal therapies - anti-oestrogen, aromatase inhibitors
- Targeted therapies - EGFR, VEGF, CDK 4/6
- Immunotherapy - PD 1, PD -L1, CTLA - 4
Discuss oestrogen and breast cancer
Oestrogens promote cell proliferation within the breast tissue (higher rate of cell division = more chances for mutations)
Prolonged exposure to oestrogen - increased risk
What are breast cancer drugs?
- Anti-oestrogen: Tamoxifen - binds to the oestrogen receptor
- Aromatase inhibitors: Letrozole - block conversion to androgens to oestrogen
What are CDK 4/6 inhibitors?
Cyclin-dependent kinase inhibitors
What do cyclins and CDKs do?
Cyclins and cyclin-dependent kinases control the passage of cells through each phase of the cell cycle
What pushes cells out of G0 G1 phase?
Cyclin D along with CDK 4/6 pushes cells out of G0 G1 phase
What does cyclin D do?
Cyclin D along with CDK 4/6 pushes cells out of G0 G1 phase
