2. Introduction to cancer therapy

Question 1

What are the six hallmarks of cancer?

plus two

Answer 1

Self-sufficiency in growth signals
Insensitivity to anti-growth signals
Evading apoptosis 
Limitless reproductive potential 
Sustained angiogenesis
Tissue invasion and metastases

Deregulated metabolism
Evading the immune system

Question 2

What are the different types of therapy available to treat cancer?

Answer 2

Surgery 
Radiation 
Chemotherapy 
Antibodies
Small molecules
Adjunctive

Question 3

What are the different goals for cancer therapy?

Answer 3

Cure
Control
Palliation

Question 4

What is meant by ‘cure’ in cancer therapy?

Answer 4

Prolonged absence of detectable disease

Question 5

What is meant by ‘control’ in cancer therapy?

Answer 5

Where cure is unrealistic - prevent new cancer growth

Question 6

What is meant by ‘palliation’ in cancer therapy?

Answer 6

For end stage disease

Question 7

How might a tumour respond to therapy?

Answer 7

Complete response
Partial response
Stable disease

Question 8

What cells will be affected by low radiation?

Answer 8

Nerve cells

Muscle cells

Question 9

What cells will be affected by intermediate radiation?

Answer 9

Osteoblast
Endothelial cells
Fibroblast
Spermatids

Question 10

What cells will be affected by high radiation?

Answer 10

Spermatogonia
Lymphocytes
Stem cells
Intestinal mucosa cells
Erythroblast

Question 11

What are the different forms of radiation that can be used?

Answer 11

External beam radiation
Radioimmunoconjugates
Radioconjugates
Free isotopes

Question 12

What neurones are involved in external beam radiation?

Answer 12

Gamma photons

Neutron beams

Question 13

What is involved in radioimmunocojugates?

Answer 13

Antibody targeted radiation

Question 14

What is involved in radioconjugates?

Answer 14

Isotopes tagged to bone seeking material

Question 15

What is commonly used in free isotope therapy?

Answer 15

131 Gallium

Question 16

What are the targets for radiation therapy?

Answer 16

DNA

Water

Question 17

What was the first ever pharmaceutical treatment used for cancer and how did this occur?

Answer 17

Mustine

Mustard gas upon the SS John Harvey 1943

Question 18

What is a common component of current cancer pharmaceuticals and why?

Answer 18

Antifolates

Folate is one of the structural components necessary for the synthesis of nucleic acids in DNA

Question 19

What different agent types are used in chemotherapy?

Answer 19

Antimetabolites
Ankylators
Spindle poisons
Topoisomerase inhibitors

Question 20

Give three antimetabolites

Answer 20

Antifolates
Purine nucleosides
Nucleoside synthase inhibitor

Question 21

Give one ankylator

Answer 21

Platinum

Question 22

Give two spindle poisons

Answer 22

Vinca alkaloids

Taxanes

Question 23

Give two topoisomerase inhibitors

Answer 23

Anthracyclines

Etoposide

Question 24

Why are chemotherapy agents often used in combinations?

Answer 24

To minimise resistance and reduced toxicity

Also to be able to target the different hallmarks of cancer - limit as many biological mechanisms as possible

Question 25

Why are antibodies being used to treat cancer? - What are the advantages

Answer 25

Target the specific antigen They are more specific Have various mechanisms of actions by which they can work

Question 26

``` Purine nucleosides are what type of chemotherapeutic agent: Alkylator Spindle poison Antimetabolite Topoisomerase inhibitor ```

Answer 26

Antimetabolite

Question 27

Why are small molecules being used to treat cancer?What are the advantages of these?

Answer 27

These can target oncagene production These can inhibit signalling at key steps This is safer than chemotherapy

Question 28

Give three examples of adjunctives that can be used to treat cancer

Answer 28

Glucocorticosteroids Oestrogens/anti-androgens/SERMs Bisphosphonates

Question 29

Give three types of experimental therapy for cancer treatment

Answer 29

Gene therapy Personalised therapy Targeted therapy

Question 30

What type of experimental therapy are small molecules and antibody usage?

Answer 30

Targeted therapy

Question 31

Give three possible new targets that can be used for cancer therapy

Answer 31

Stroma Blood vessels - angiogenesis inhibitors Immune system