Anti-Cancer Drugs Flashcards
(27 cards)
What is the difference between Neo-adjuvant and adjuvant therapy?
Neo-adjuvant: Pre-operative to downstage tumor before surgery or radiotherapy
Adjuvant: Post operative
Intraperitoneal therapy are used for _____ cancer
Ovarian
Intravesical therapy are used for ____ cancer
Bladder
Name 2 Alkylating agents
- Cyclophosphamide
- Chlorambucil
Are alkylating agents cell cycle phase specific or non-specific?
Non-specific
Cell cycle-specific drugs kill cells only during ___ phase or ___ phase
S and M phase
Are platinum analougues cell cycle phase specific or non-specific?
Non-specific
LIst 3 examples of platinum analouges
- Cisplatin
- Carboplatin
- Oxaliplatin
Are anti-matabolites cell cycle phase specific or non-specific?
S phase specific
Methotrexate is commonly used for ____ cancer and ____
Breast cancer and lymphoma
List 3 examples of Anthracyclines (cytotoxic antibodies)
- Doxorubicin
- Daunorubicin
- Idarubicin
- Epirubicin
Are Anthracyclines cell cycle phase specific or non-specific?
Non-specific
LIst 3 examples of Microtubule inhibitors
- Paclitaxel
- Docetaxel
- Cabazitaxel
Are microtubules inhibitor cell cycle phase specific or non-specific?
M phase specific
Which 2 group of medications are cell cycle phase specific?
- Anti-metabolites (e.g Methotrexate, 5-fluorouracil)
- Microtubule inhibitors (e.g. Paclitaxel)
What is one tyrosine kinase inhibitor?
Imatinib
Used in treatment against Philadelphia Chromosome Positive Chronic Myelogenous Leukemia
Prevents the binding of ATP, without ATP the energy source, BCR-ABL will not be able to function and signal downstream
Name one neutralizing antibody
Bevacizumab (Avastin)
Exaplain the MOA of Bevacizumab
Anti-VEGF therapeutic antibodies bind to and neutralise VEGF receptors, which are key receptors on endothelial cells. Normally. VEGF-A binds to VEGFR-2, causing activation of downstream signalling pathways that drive angiogenesis. The anti-VEGF antibodies bind to VEGF-A and inhibit VEGF extracellularly, thus blocking angiogenesis.
Name a antibody-drug conjugate (ADC)
Brentuximab
Briefly explain Molecular-targeted radiotherapy
Similar to external beam therapy:
- cancer cell destruction is achieved by means of radiation-induced DNA damage
Similar to chemotherapy
- A systemic treatment that uses a molecule, in this case bearing a radiolabel to deliver cytotoxic substance to disease state
Has a bystander or crossfire effect
- potential destruction of adjacent cells, important as tumors are heterogenous tissues
For primary and metastatic tumors
- including malignant cell populations undetectable by diagnostic imaging
Briefly explain CAR T-cell Immunotherapy
- Extract T cells - collect T Cells from patient
- Reprogramming T cells - viral vector inserts CAR gene into T cells
- Manufacturing CAR T-cells - Car T cells are proliferated in vitro to a specific clinically relevant quantity and quality
- Patient pre conditioning- patient are treated with chemo to lower white blood cell count to more readily accept T cells
- Treatment - Patient is given CAR T-cells
Name one immune checkpoint inhibitor
Ipilimumab (Human monoclonal Ab)
It blocks CTLA-4 and acts as immunotherapy by activating T cells response and immune surveilance
List 2 examples of treatment options available for cancer
- Surgery
- Radiotherapy
- Chemotherapy
- Molecular targeted therapy
List 3 advantage of chemotherapy combinations
- Maximal cell kill below toxicity threshold for each drug
- Broader cell killing across heterogenous tumor cell populations
- Prevent or slow development of drug resistance
Principles:
1. Efficacy: only drugs with single agent efficacy for a particular tumor should be combined
2. Toxicity: non-overlapping toxicity as minimizes lethal effect and allows maximization of dose intensity
3. Optimum Scheduling: should be used at optimal dose and schedule, shortest time for recovery
4. Mechanism of interaction: clear understanding of drug interactions to allow maximum effect
5. Avoidance of dose changes: reduction of dose of one drug to add other drugs to combination may lower efficacy
