Unit 2: Chemotherapy Flashcards
3 types of chemotherapy
Primary chemotherapy
Neoadjuvant chemotherapy
Adjuvant chemotherapy
Primary Chemotherapy
Chemo is the primary treatment.
Usually — not curative — for advanced metastatic disease — for symptom relief Curative in a small subset of patients
Neoadjuvant chemotherapy
Idea: shrink cancer and then resect the tumor
Adjuvant chemotherapy
Idea: resect tumor and then use chemo to kill any remaining cancer cells
All chemo is given based on what premise about cells?
Chemo is poison that is most effective when given to cells that are dividing. Since cancer cells divide rapidly and chaotically, chemo hopefully kills off more cancer cells than healthy cells.
3 Groups of Chemo Drugs
Cytotoxic drugs
Hormonal agents
Signal transduction inhibitors
Cytotoxic drugs include…
Alkylating agents Antimetabolites Antibiotics Antibodies Others
How do cytotoxic drugs work?
Kill cells when they are dividing
Via first order kinetics: each time a dose is given, the same % of cancer cells are killed
Cell cycle: S phase
DNA synthesis occurs
Cell cycle: M Phase
Cellular division occurs
Since cancer cells can become resistant to chemo, how do we combat it?
Give multiple chemotherapeutic agents
Adverse effects of cancer drugs are most pronounced where?
on cells that divide the fastest
Chemo adverse effects on bone marrow
Bone marrow:
—low WBC —> risk for severe infection
—low RBC —> anemia; possibly need transfusion
—low PLT —> risk for bleeding
Chemo adverse effects on GI tract
causes Nausea & Vomiting; sometimes patients show up in the ER with intractable nausea and vomiting
Chemo adverse effects on hair
Hair loss
Methotrexate can have toxic effects on what organ?
Kidneys
Cardiac toxicity is common with what drugs? Name 2 of these drugs.
Anthracyclines like doxorubicin and danorubicin
What cancer drug can cause pulmonary fibrosis?
Bleomycin
What cancer drug can cause nervous system toxicity?
Vincristine
How do the alkylating agents work?
Add an alkyl group to DNA —> prone to cause local tissue damage and necrosis and hopefully results in apoptosis
How do the antimetabolites work?
Compete with binding sites on enzymes
OR
Can be incorporated into DNA or RNA
ESPECIALLY HELPFUL if they bind to an enzyme that affects cell replication pathways
What kind of drug is methotrexate?
Antimetabolite
What is methotrexate used to treat?
Psoriasis
rheumatoid arthritis
Variety of cancers
How do antibiotics treat cancer?
Interrupt cell DNA function
What two groups of antibiotics treat cancer?
Anthracyclines and others
What is plicamycin used to treat? How does it work?
Life-threatening hypercalcemia associated with malignancy. It inhibits resorption of bone by osteoblasts, and lowers serum calcium.
What do vinca alkaloids do?
bind to tubulin and disrupt spindle apparatus during cell division
Name 3 vinca alkaloids
Vincristine
Vinblastine
Vinorelbine
Antibodies often end in …?
-mab
What is hydroxyurea used for?
Prevention of sickle cell crises
Tamoxifen is used for…
Hormonal therapy for up to 5 years after breast cancer treatment
What kind of sensitivity should breast cancer cells have in order for the patient to receive tamoxifen?
Estrogen
GnRH stands for…
What releases GnRH?
Gonadotripin-releasing hormone (released by the hypothalamus)
What do GnRH drugs often end with?
-relin
What are GnRH analogues and antagonists used to treat?
Breast cancer and prostate cancer
Many signal transduction inhibitors end with …?
-nib
