Cancer Flashcards
10 questions (83 cards)
1
Q
what drives the cancer progression?
A
oncogenes
2
Q
what inhibits cancer progression?
A
tumor suppressors
3
Q
what is cancer caused by?
A
DNA alterations
4
Q
what is critical in the prevention of cancer?
A
DNA proofreading and repair
5
Q
tumor suppressor proteins that are important for DNA repair; a mutation in these genes predisposes patients to cancer
A
BRCA 1 and 2
6
Q
what is the most effective treatment for localized disease?
A
surgery
7
Q
radiation that is done prior to surgery
A
neoadjuvant therapy
8
Q
radiation that is done after surgery for residual disease
A
adjuvant therapy
9
Q
what is chemotherapy dosing based on?
A
toxicities - the Maximal Tolerated Dose (MTD)
10
Q
what helps to prevent cancer resistance to drugs?
A
combination therapy
11
Q
what 2 kinds of cancer treatments are given orally?
A
hormonal-based therapy
kinase inhibitors
12
Q
drugs that inhibit DNA synthesis
A
antimetabolites
13
Q
drugs that inhibit mitosis
A
microtubule targeted agents
14
Q
MOA of doxorubicin and adriamycin?
A
inserts into DNA to disrupt topoisomerase II-mediated replication
15
Q
what 10 cancers is Doxorubicin/Adriamycin used in?
A
bladder
breast
leukemia
lung
lymphoma
myeloma
ovarian
sarcoma
stomach
thyroid
16
Q
ADR of doxorubicin/adriamycin?
A
cardiotoxicity
17
Q
in which patients should we not use doxorubicin/adriamycin?
A
patients with heart disease
18
Q
liposomal formulated doxorubicin that has altered distribution; more goes to skin and less goes to heart - leading to skin rashes
A
doxil
19
Q
-platin
and MOA?
A
platinum agents
crosslink DNA
20
Q
in which 7 cancers are platinum agents used in?
A
brain
breast
bladder
cervical
head/neck
lung
testicular
21
Q
which cancer is carboplatin used for?
A
ovarian
22
Q
which cancer is oxaliplatin used for?
A
colorectal
23
Q
2 ADR of cisplatin?
A
neurotoxicity
nephrotoxicity
24
Q
ADR of carboplatin?
A
myelosuppression
25
ADR of all platinum agents?
hearing loss
26
antimetabolite that is a thymidine synthase inhibitor; prevents DNA synthesis
5-FU
27
what 6 cancers is 5-FU used for?
breast
**basal cell carcinoma**
colon
rectum
stomach
pancreas
28
3 ADR of 5-FU?
inflammation of mouth/skin
CNS damage
diarrhea
29
what is it called when one pathway is lost in cancer cells, and they become dependent on other pathways that normal cells are not dependent on?
synthetic lethality
30
collateral DNA damage as a result of cancer treatment can give rise to _____ _____
secondary cancers
31
what patients are at a high risk for secondary cancers over time?
pediatric patients
32
antimitotics against rapidly dividing tumors, hematological malignancies slow-growing tumors (prostate) and in non-dividing cells due to trafficking and signaling defects
microtubule targeted drugs
33
name the 3 microtubule destabilizers
"on the EVV on an exam, I'm destabilized"
eribulin
vinblastine
vincristine
34
what are the 6 uses for microtubule destabilizers?
lung cancer
leukemia
lymphoma
**neuroblastoma**
sarcoma
testicular
35
name the 3 microtubule stabilizers
paclitaxel
docetaxel
ixabepilone
36
what are the 8 uses for microtubule stabilizers?
breast
cervical
head/neck
lung
ovarian
pancreas
**prostate**
stomach
37
what are the 4 ADR of microtubule targeting agents / antimitotic chemotherapies?
"**M** for **m**arrow dysfunction, **T** for (neuro)**t**oxicity/peripheral neuropathy, and **A** for **a**bdominal disturbance/**a**lopecia"
bone marrow dysfunction
GI disturbance
alopecia
peripheral neuropathy
38
what is the defining marker of lymphoma?
CD30
39
microtubule destabilizer that is combined with CD30, which is then separated when inside the cancer cell by cathepsin cleavage
MMAE
40
what is the use for MMAE?
lymphoma
41
2 ADR of MMAE?
peripheral neuropathy
neutropenia
42
what is the most likely mechanism of drug resistance in cancer?
innate resistance
43
what cancer cells lead to relapse/resistance? (3)
slow growing
can pump out drug
can evade immune system
44
what are the 3 mechanisms of drug resistance in cancer?
specific (binding site change)
upregulation of complementary pathways (oncogene inhibited)
multidrug resistance (efflux pump)
45
what is a strategy to avoid drug resistance in cancer?
combination chemotherapy
46
luteinizing hormone releasing hormone agonist that upregulates the release of androgen, leading to feedback inhibition, eventually inhibiting the release of FSH and LH
leuprolide (lupron)
47
luteinizing hormone antagonist that prevents LHRH from binding to receptors in the pituitary gland
degarelix (firmagon)
48
what are the uses for LHRH agonists and LH antagonists?
androgen-depending prostate cancer
49
8 ADR of LHRH agonists and LH antagonists?
associated with androgen deprivation
hot flashes
decreased bone density
loss of muscle mass
weight gain
insulin resistance
ED
low libido
cognitive impairments
50
inhibitors of androgen receptor activity that directly bind and inhibit activity of testosterone receptors at multiple levels (2)
bicalutamide (cased)
enzalutamide (xtandi)
51
-lutamide
inhibitors of androgen receptor activity
52
what are the uses for inhibitors of androgen receptor activity? (2)
hormone-responsive prostate cancer
castration resistant prostate cancer
53
prostate cancer that continues to grow despite low levels of androgen
castration resistant prostate cancer
54
GnRh/LHRH agonists that stop the ovaries from making estrogen (2)
leuprolide (lupron)
goserelin (zoladex)
55
what is the use for GnRH/LHRH agonists?
hormone-positive breast cancer in premenopausal women
56
aromatase inhibitors that inhibit conversion of androgens into estrogens (3)
anastrozole (arimidex)
letrozole (femara)
exemestane (aromasin)
"**Ana Let's** her **Ex** do whatever he wants" = postmenopausal
57
what is the use for aromatase inhibitors?
hormone-positive breast cancer in postmenopausal women
58
selective estrogen receptor modulator that is an antagonist in breasts and an agonist in uterus and bone
tamoxifen (novadex)
59
what is the use for selective estrogen receptor modulators?
estrogen-positive breast cancer in premenopausal women
60
estrogen receptor antagonist that is used for hormone-positive breast cancer in postmenopausal women
fulvestrant (faslodex)
61
antibody that binds to HER2 receptors on tumor cells, preventing activation of HER2, blocking tumor growth and survival
Herceptin (trastuzumab)
62
what is the use for trastuzumab?
HER2 positive breast cancer
63
what is the most effective treatment option for triple negative breast cancer?
chemotherapy
64
kinase inhibitor that inhibits ABL tyrosine kinase activity, used for CML
gleevec (imatinib)
65
caused by a single chromosomal translocation event that generates a hybrid gene/fusion protein known as BCR-ABL
CML
66
molecularly targeted kinase inhibitors can be effective in _____ _____ molecular settings when the main pathway driving the tumor can be _____
well defined
inhibited
67
why aren't kinase inhibitors a good long-term treatment for other cancers, besides CML?
resistance occurs by upregulating complementary pathways
68
VEGF inhibitory antibody that inhibits the growth of vasculature in cancer
bevacizumab (a**vas**tin)
**VAS** for vasculature
69
what are the 5 uses of VEGF inhibitory antibody?
cervical
colorectal
**glioblastoma**
ovarian
renal
70
VEGF kinase inhibitors that inhibit the growth of vasculature in cancer (2)
sorafenib (nexavar)
sunitinib (sutent)
71
what are the 3 uses of sorafenib?
hepatocellular (liver)
renal
thyroid
"sora like sorry = HRT (hurt)"
72
what are the 3 uses of sunitinib?
GI
pancreas
renal
73
8 ADR of chemotherapies that block angiogenesis?
hemorrhage
clots
GI perforation
hypertension
healing defects
fatigue
diarrhea
cardiac failure
74
what anticancer drugs can promote long-term survival advantages in 30% of patients with high mutational burden?
checkpoint inhibitors
75
work by inhibiting mechanisms that cancer cells use to evade detection by the immune system / "take the brake off the immune system"
checkpoint inhibitors
76
name the 4 PD-1 inhibitors that block signaling of the T cell immune checkpoint (PD-1)
keytruda
opdivo
tecentriq
imfinzi
77
which 2 checkpoint inhibitors can be used for melanoma and lung cancer?
keytruda
opdivo
78
besides melanoma and lung cancer, what can keytruda be used for? (2)
head/neck
high mutational burden
79
besides melanoma and lung cancer, what can opdivo be used for? (2)
renal
lymphoma
80
2 uses for tecentriq and imfinzi?
urothelial (bladder)
lung
81
CTLA-4 inhibitor - (CTLA-4 usually regulates antitumor immune response initiation)
yervoy
82
what is the use for yervoy?
melanoma
83
what are the ADR for checkpoint inhibitors (PD-1 inhibitors and CTLA-4 inhibitors)?
autoimmune effects months after treatment
