Treatment of cancer - targeted biological therapies

Question 1

Limitations of conventional cytotoxic chemotherapy

Answer 1

• Lack of specificity
• Toxicity
• Lack of effectiveness
• Lack of individualisation

Question 2

Classification of targeted therapies in cancer

Answer 2

• Cell cycle signalling
• Immune checkpoint inhibitors
• Angiogenesis
• Epigenetic modifiers

Question 3

Which cancers are associated with EGFR mutations

Answer 3

Mutations that up-regulate the EGFR or overactivity have been associate with:

1. Squamous-cell carcinoma of lung
2. Anal cancers
3. Glioblastoma
4. Epithelial tumours of the head and neck

Question 4

Anti-cancer therapies of the EGFR

Answer 4

EGFR identification as an oncogene led to development of:
1. Monoclonal antibody inhibitors - Cetuximab, panitumumab = block the extracellular ligand binding domain

2. Small molecule kinase inhibitors - gefitinib, erlotinib = inhibit EGFR tyrosine kinase activity on the cytoplasmic side

Question 5

Side effects associated with EGFR inhibitors

Answer 5

• The most common adverse effect of EGFR inhibitors, found in more 90% of patients, is a papulopustular rash that spreads across the face and torso
• Other side adverse effects: diarrhoea, nausea, vomiting, fatigue, dehydration

Question 6

Side effects of angiogenic inhibitors

Answer 6

Bleeding
Increased BP
Rash and/or itchy skin
Diarrhoea
Fatigue
Low blood counts

Question 7

Chemotherapy

1. Target
2. Method
3. Side effects
4. Treats

Answer 7

1. Target - Proliferating cells
2. Method - Drugs
3. Side effects - Hair loss, reduced immune system, nausea, vomiting
4. Treats - More than one part of the body, sometimes whole body

Question 8

Radiotherapy

1. Target
2. Method
3. Side effects
4. Treats

Answer 8

1. Target - Tumour
2. Method - High energy waves
3. Side effects - Sores, swelling, fatigue, hair loss, dryness
4. Treats - Single part of the body

Question 9

Biological therapy

1. Target
2. Method
3. Side effects
4. Treats

Answer 9

1. Target - Immune cells
2. Method - Drugs
3. Side effects - Flu-like symptoms
4. Treats - Specific targets