Therapeutic Options in Cancer

Question 1

Prevention

Answer 1

environmental /behavioral change
Diet
Screening
Genetics
medication/vaccination

Question 2

Treatment

Answer 2

Surgery
Radiotherapy
Systemic therapy
Immunotherapy

Question 3

what drug is given to women who are at risk of developing primary breast cancer?

Answer 3

tamoxifen - has dangerous side effects

Question 4

in what cancer is applying 3 times the dose for radiotherapy a good thing

Answer 4

head and neck cancer

Question 5

5 R’s of radiotherapy

Answer 5

radiosensitivity
repair
repopulation
reoxygenation
reassortment

Question 6

what specific breast cancer does tamoxifen target?

Answer 6

ER positive breast cancer

Question 7

interleukin 2 (IL-2)

Answer 7

acts as cell signalling btw WBCs and help the immune system grow more quickly and fight off cancer

Question 8

how does interferon alpha treat cancer?

Answer 8

innate immunotherapy - helps boost the ability of certain immune cells to attack cancer cells

Question 9

where is PD1 and PDL 1

Answer 9

PD1 is on T cells

PDL1 is on tumor cells and other normal body cells

Question 10

what are the 3 immunomodulating drugs

Answer 10

thalidomide
lenalidomide
pomalidomide

Question 11

examples of specific immunotherapy

Answer 11

monoclonal antibodies
CAR T cell therapy
checkpoint blockage

Question 12

what does rituximab target

Answer 12

binds to CD20 receptors of B cells to treat NHL B cell lymphomas

Question 13

what does transtuzumab target

Answer 13

treats HER2 positive breast and gastric cancer

Question 14

intravasation vs extravasation

Answer 14

intra - cancer cells entering blood flow

extra - cancer cells leaving the blood flow to be arrested in another tissue else where

Question 15

3 enzymes related to tumor invasion to the EC matrix

Answer 15

• MMP (like gelatinases)
• plasmin
• cathepsin

Question 16

3 enzymes related to cell adhesion of tumor

Answer 16

• cadherins
• intergrins
• CD44

Question 17

what does bevacizumab do? (anti-VEGF MAb Avastin)

Answer 17

monoclonal antibody, prevents the interaction of VEGF with its receptors (VEGF receptor-1 and 2) on the surface of vascular endothelial cells. This prevents activation of downstream signalling pathways which will lead to angiogenesis and stops cancer growth

Question 18

what does nivolumab do?

Answer 18

inhibits PD1

Question 19

tumor suppressor genes summary

Answer 19

during G1, the cell would slowly accumulate cyclin, which will bind to CDKs and form complexes. when the concentration of these complexes reach a threshold, G1 phase will end and DNA replication of S phase begins.
G1/S checkpoint is basically tumor suppressor proteins like Rb. when unphosphorylated, it will bind to E2F transcription factor and stop the cell cycle from moving forward.
the cyclin/CDK complex will phosphorylate Rb and release E2F.
p16 reinforces Rb action by binding to CDK complex and inhibiting its kinase phosphorylating action. This halts cell cycle in G1 phase.
p53 works at the G1 checkpoint.
it also induces transcription of p21 that binds to cyclins to prevent formation of CDK complexes that will prompt the cell cycle.

Question 20

how does transcription factor work?

Answer 20

it will move along the DNA until it encounters a wrong sequence which it will bind tightly to. this binding will induce expression of tumor suppressor genes that will halt the cell cycle until the damage is fixed.
in cancer cells, this mistake is not recognized by the transcription factor