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ME2019 PART 2 > Chemotherapy > Flashcards

Chemotherapy Flashcards

1
Q

What are treatment options for cancer?

A

Surgery

Radiotherapy

Chemotherapy

Targeted therapies

Immunotherapy

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2
Q

What are the steps of the cell cycle?

A

G1 (gap 1, preparation for DNA replication)

R (restriction point, point in G1 where the cell becomes committed)

S (DNA replication)

G2 (preparation for mitosis)

M (mitosis, cell divsion)

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3
Q

What happens during G1 (gap 1)?

A

Preparation for DNA replication

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4
Q

What is R during the cell cycle?

A

Restriction point, where the cell become committed

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5
Q

What happens during S?

A

DNA replication

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6
Q

What happens during G2?

A

Preparation for mitosis

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7
Q

What happens during M?

A

Mitosis, cell division

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8
Q

What are things that make the cell cycle go around?

A

Growth factors

Oncogenes

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9
Q

What makes the cell cycle stop?

A

Tumour suppresor genes

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10
Q

What does chemo delivery do?

A

Reduces the amount of cells

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11
Q

What happens if the interval between chemo delivery is to long?

A

The cells grow back

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12
Q

How is systematic therapy delivered?

A

Oral or intravenous route

Regular cycles with timing dependent on the findings from pharmacokinetics (half life, excretion)

May need to delay treatment if toxicites develop

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13
Q

What needs to happen to chemotherapy if toxicities develop?

A

It needs to be delayed

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14
Q

What are methods of assessing drug therapy?

A

CT scan

PET scan

Clinical examination

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15
Q

What may assessing drug activity help?

A

Overall survival (OS)

Progression-free survival (PFS)

Improved quality of life (QoL)

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16
Q

What is progression free survival?

A

Length of time during and after treatment of a disease that a patient lives with the disease but it does not get any worse

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17
Q

What is overall survival?

A

The length of time from either the diagnosis or the start of treatment for a disease that the patient is still alive

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18
Q

What does an adjuvant do?

A

Improve survival

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19
Q

What does a neoadjuvant do?

A

May improve survival through increasing operability

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20
Q

What is adjuvant treatment?

A

Treatment given in addition to a primary treatment

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21
Q

What is neoadjuvant chemotherapy?

A

Medicines administered before surgery for the treatment of cancer

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22
Q

What are some different classes of cytotoxic agents?

A

Alkylating agents

Anti-metabolites

Mitotic inhibitors

Antibiotics

Other

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23
Q

What are some sites of action for cytotoxic agents?

A

Anti-metabolites prevent RNA synthesis by binding to DNA

Alkylating agents cross link guanine nucleobases, directly attacking DNA

Intercalating agents wedge between bases along DNA to stop polymerase and other proteins from binding (preventing DNA transcription and DNA duplication)

Spindle poisons act on tubulin, which forms the microtubules that attach to chromosomes during mitosis

24
Q

What do alkylating agents do?

A

Attach to free guanines on seperated DNA strands, impairing DNA replication

25
Q

What does the alkyl group of an alkylating agent allow?

A

Covalent bonds with other molecules

26
Q

What is an example of an alkylating agent?

A

Cisplatin

27
Q

What are some mechanisms of resistance against alkylating agents?

A

Decreases entry or increases exit of agent in cell

Inactivation of agent in cell

Enhanced repair of DNA lesions produced by alkylation

28
Q

How do antimetabolites work?

A

Similar structure to essential metabolites required by cell prior to cell division

Can be incorporated into new nuclear material or bind with vital enzymes

29
Q

What are examples of antimetabolites?

A

Antagonise folic acid

Antagonis purine

30
Q

What are examples of spindle poisons?

A

Vinca alkaloids

Taxanes

31
Q

What do vinca alkaloids do?

A

Metaphase arrest agents, blocking microtubule formation and spindle formation

32
Q

What do taxanes do?

A

Promote spindles and freeze cells at that stage

33
Q

What are the 2 classes of antimiotic antibiotics?

A

Anthracyclines

Non-anathracyclines

34
Q

What do antimiotic antibiotics do?

A

Intercalate and inhibit DNA and RNA synthesis

Bind to membranes and increase permeability of ions

Free radicals disrupt DNA chain and prevent mitosis

35
Q

Where during the cell cycle do alkylating agents act?

A

All of the stages

36
Q

Where during the cell cycle do antibiotics act?

A

End of G1 through to the start of G2

37
Q

Where during the cell cycle do antimetabolites?

A

S

38
Q

Where during the cell cycle do metabolic inhibitors act?

A

During M

39
Q

What is the aim of combination therapy?

A

Increase efficacy

40
Q

What are the principles underlying combination therapy?

A

Different mechanisms of action

Dissimilar toxicity profile (such as both do not act with neurotoxicity)

41
Q

What does having different mechanisms of action during combination therapy allow?

A

Synergistic or at least additive

Reduce risk of developing resistance

42
Q

What are some possible side effects of chemotherapy?

A

Vomiting

Nausea

Alopecia (loss of hair)

Tiredness

43
Q

What does moderately emetogenic chemotherapy refer to?

A

Moderate incidences of nausea and vomiting

44
Q

What does highly emetogenic chemotherapy refer to?

A

High incidents of nausea and vomiting

45
Q

What is CINV?

A

Chemotherapy induced nausea and vomiting

46
Q

What is peripheral CINV?

A

Where drugs act on enterochromaffin cells in the gastric glands which release serotonin which acts on vagal afferent 5-HT3 receptors

47
Q

Where do the gastric glands release during peripheral CINV?

A

Serotonin

48
Q

What does serotonin act on during peripheral CINV?

A

5-HT3 receptors

49
Q

What is central CINV?

A

Drugs act on brainstem NK3 receptors and cause CINV

50
Q

What are examples of hormonal drugs?

A

Anti-oestrogen for breast cancer

Gonadorelin analogue

Anti-adrogen for prostate cancer

51
Q

What is anti-oestrogen used for?

A

Breast cancer

52
Q

What is anti-adrogen used for?

A

Prostate cancer

53
Q

What are some things targeted drugs act against?

A

Epidermal growth factor receptor (EGFR)

Vascular endothelial growth receptor (VEGR)

54
Q

What receptors do T lymphocytes have?

A

Activation and inhibitory receptors

55
Q

How does immunotherapy work?

A

Cancer cells hide from the immune system by binding to the self receptor PD1, but drugs can inhibit this

ME2019 PART 2 (45 decks)

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