Treatment of Malignancies Flashcards
how is neutropenic sepsis managed?
immediate broad spectrum antibiotics
what is the first line treatment for neutropenic sepsis?
piperacillin + tazobactam
teicoplanin + aztreonam if pen allergic
what can be given to prevent neutropenia during chemotherapy cycles?
growth factors i.e. GCSF
how do monoclonal antibodies work?
target cells with the specific target protein
name a monoclonal antibody used for haematological malignancies
rituximab
how does rituximab work?
binds specifically to CD20 on B cells
how is rituxumab administered?
subcutaneous injection
name some other anti-B cell monoclonal antibodies
ofatumumab
obinutuzumab
what monoclonal antibody can be given in hodgkin’s lymphoma?
brentuximab vedotin
name two types of biological agents for haematological malignancies
proteosome inhibitors
IMIDs
what is the role of the proteosome?
breaks down old proteins into amino acids for recycling
how can proteosome inhibitors kill cancer cells?
blocking breakdown of proteins allows the accumulation of toxic proteins in the cells, causing apoptosis
name a proteosome inhibitor
bortezomib
what two malignancies can proteosome inhibitors be of benefit in?
mantle cell NHL
low grade NHL
what are two possible complications of proteosome inhibitors?
nerve damage
low platelets
name two IMIDs
lenalidomide
pomalidomide
what malignancies are IMIDs mainly used for?
myeloma
other plasma cell disorders
name a targeted treatment that can be used for CML
tyrosine kinase inhibitors
name some tyrosine kinase inhibitors
imatinib
nilotinib
dasatinib
what drugs can be used to target malignant B cells in CLL and mantel cell lymphoma?
ibrutinib
venetoclax
how does chemo/radiotherapy work?
damages the DNA of cancer cells as it divides, causing the cell to die by the process of apoptosis
what mutation can make treatment with chemo or radiotherapy harder?
mutations in p53
what are the two groups of cytotoxic drugs?
cell cycle specific
non cell cycle specific
which is more tumour specific - cell cycle specific or non specific?
specific
name two groups of cell cycle specific cytotoxic drugs
antimetabolites
mitotic spindle inhibitors
how do antimetabolites work?
impair nucleotide synthesis and incorporation
name three antimetabolites
methotrexate
6-mercaptopurine
hydroxyurea
what is the method of action of methotrexate?
inhibits dihydrofolate reductase
what is the method of action of 6-mercaptopurine?
incorporated into DNA causing strand breaks when it tries to replicate
what is the method of action of hydroxyurea?
impaired deoxynucleotide synthesis
name two mitotic spindle inhibitors
vinca alkaloids
taxotere
name two vinca alkaloids
vincristine
vinblastine
name three types of non cell cycle specific chemotherapy agents
alkylating agents
platinum derivatives
cytotoxic antibiotics
name two alkylating agents
chlorambucil
melphalan
what is the MoA of alkylating agents?
bind covalently to DNA bases causing strand breaks by free radical production
name two platinum derivatives
cis-platinum
carboplatin
what antibiotics are cytotoxic?
anthracyclines
name some anthracyclines
daunorubicin
doxorubicin
idarubicin
what are the general immediate side effects of cytotoxic drugs?
bone marrow suppression
gut mucosa damage
hair loss
what cytotoxic drug can cause neuropathy?
vinca alkaloids
what cytotoxic drug can cause cardiotoxicity?
anthracyclines
what cytotoxic drug can cause nephrotoxicity?
cis-platinum
