14th March - Future directions in therapeutics Flashcards

1
Q

What are the traditional forms of cancer therapy?

A

Surgery
Radiotherapy
Chemotherapy
Targeted Drugs

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2
Q

Give an example of a cytotoxic drug that targets DNA synthesis

A

cis-platin

Etoposide

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3
Q

Which cytotoxic drug is on WHOs list of essential medicines?

A

cis-platin

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4
Q

Give an example of a cytotoxic drug that targets cell division

A

Vinblastine

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5
Q

What is oncogene addiction?

A

The dependence of some tumours on a single oncogenic protein for sustaining growth and proliferation

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6
Q

What does Trastuzumab target?

A

(aka Herceptin)

Targets HER2 in breast cancer

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7
Q

What is personalised medicine?

A

Use of a biomarker for a target to define subgroups of patients and decide on the best therapeutic strategy

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8
Q

How are molecules chosen for drug development in targeted therapies?

A
  1. Find the protein target/pathway that is directly responsible for the disease i.e. understand the molecular basis of the disease
  2. Find a molecule that is able to abrogate the aberrant behaviour responsible for this disease and develop treatment based on this knowledge
  3. Perform an activity assay on compounds
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9
Q

What are the different compound libraries used in drug development?

A

Large compound library
Focused library
Fragment library
Virtual screening

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10
Q

Describe a large compound library

A

About 100 000 diverse compounds
Mw about 500 Da
Requires an inexpensive high throughput assay

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11
Q

Describe a focused compound library

A

Hundreds to thousands of compounds that are known to inhibit an enzyme calss
Efficient but lacks novelty

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12
Q

Describe a fragment library

A

About 1000 compounds
Mw about 200 Da
Efficient coverage of a chemical space
Requires a very sensitive assay

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13
Q

Describe virtual screening

A

Conformational docking of compounds into the target structure
essentially unlimited compounds
requires a high resolution structure of the target

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14
Q

What drug targets the common Thr315Ile mutation in BCR-ABL?

A

Ponatinib

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15
Q

What protein fusion is common in NSCLC patients?

A

EML4-ALK

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16
Q

What drug targets ALK?

A

Crizotinib

17
Q

What are the effects of using Crizotinib in NSCLC?

A

Tumours stabilized or shrank in 90% of patients in phase 1 trial
All patients relapsed

18
Q

What were the different mechanisms of resistance that developed in response to Crizotinib treatment?

A

1 in 3 patients relapse with mutations in ALK kinase domain
Amplifications of the rearranged chromosomal region carrying the oncogenic ALK-gene fusion
Various other pathway alterations that led to bypassing of ALK

19
Q

Name a next generation ALK inhibitor

A

Ceritinib