Cancer Chemotherapy Flashcards
(46 cards)
1
Q
which stage of cancer has quick doubling times, high growth fraction
A
early stage cancer
2
Q
late phase cancer has
A
long doubling times, low growth fraction
3
Q
describe the cell cycle
A
- Mitosis
- G0 resting stage comes off mitosis before G1
- G1
- enzyme production
- growth and metabolism
- S phase (synthesis)
- DNA replication
- G2
- growth and preparation fo cell division
- RNA synthesis spindle forms
4
Q
the growth fraction is
A
the percent of cells not in G0
5
Q
what do cell cycle specific anti-cancer agents need to take into consideration
A
- doubling time and target therapy course and scheduling
- growth fraction
- type of cancner and stage
- resistance
6
Q
what are 3 objectives of cancer chemotherapy
A
- curative
- induce complete remission
- palliative
- allieviate symptoms
- adjunct
- improve chances for cure or prevent growth of new cancerous tissue
- e.g. chemo after breast resection
7
Q
what are the goals of therapy (5 things)
A
- removal or destruction of cancerous cells while minimizing toxic effects
- minimize resistance by use of more than one drug at a time maximizing kill
- developign a dosage regimen that is often based as much upon pt tolerability as tumor response to therapy
- administer locally to produce high concentration in limited area
- used in combination with surgery or radiotherapy
8
Q
what are some characteristics of cancer cells
A
- divide rapidly, uncontrolled growth
9
Q
a carcinoma is
A
- solid tissue
- epithelial cells
10
Q
sarcoma
A
cancer of connective or mesenchymal tissue
11
Q
leukemia/lymphoma is
A
- cancer of hematopoetic system
12
Q
when you have rapidly dividing cells you should use
A
antineoplastic agents
13
Q
slow growing cells
A
cell cycle specific agents
14
Q
what are issues with cancer drugs
A
- very toxic
- kill both cancerous and rapidly dividing non-cancerous cells
- better at killing cells that are progressing through cell cycle than at resting phase
*
15
Q
what are rapidly dividing cells in the body often impacted by chemo
A
- hair follicles
- bone marrow
- intestinal epitheilium
16
Q
what are some things to consider in drug selection (5)
A
- use drugs that show activity or efficacy against the type of cancer being treated
- should not be x-resistant
- there should be minimal or no overlapping toxicity between drugs
- decrease AEs
- side effects not centered around same organ
- dosing shechule should be optimal and at consistent times
- use doubling time to plan dosing
- allow time for recovery of sensitive cells (bone marrow) b/t treatments
- should use drug compbinations with synergistic effects
- optimizing therapeutic benefit
- decrease risk and severity of AEs
- use drugs with different mechanism of action or that effect tumor at different stages of cell cycle
- more kill each cycle
17
Q
cytotoxic drugs include these classes (8)
A
- alkylating agents
- microtubule inhibitors
- enzyme inhibitors
- antimetabolites
- protein kinase inhibitors
- monoclonal antibodies
- hormonal therapy
- immunomodulators
18
Q
damage or disrupt DNA synthesis
A
alkylating agents
19
Q
what is the mechanism of action of alkylating agents
A
- cross link or form covalent bonds between amino acids
- prevent separation of the strands of DNA during cell division
- prevent DNA synthesis
20
Q
what are some commonly used alkylating agents and examples in each category
A
- Nitrogen mustards
- cyclophosphamide
- Non-nitrogen mustards
- alkyl-alkane sulfonate
- Busulfan
- Notrosourea
- Carmustine
- Misc alkylating agents
- thiotepa, temozolomide
- alkyl-alkane sulfonate
- platinum coordination complexes
- cisplating, carboplatin
- antibiotics
- bleomycin
- mytomycin C
- Actinomycin
- Anthracycline
- daunurubicin
- bleomycin
21
Q
which chemotherapeutic agents are cell cycle specific
A
- Microtubule inhibitors (G2/M)
- bleomycin antibiotics (G2)
- enzyme inhibitors (G2)
- antimetabolites (S)
22
Q
what class of chemotherapeutic agent: cyclophosphamide and busulfan
A
alkylating agents
23
Q
class of chemo agent: carmustine, lomustrine
A
nitrosoureas
24
Q
class of chemo agent: taxanes & vinca alkaloids
A
microtubule inhibitors
25
platinum coordination complexes egs
cisplating, carboplatin
26
antibiotics
* bleomycin
* mitomycin C
* actinomycin
* anthracycline
* doxorubicin
* daunorubicin
27
enzyme inhibitors
* topoisomerase I Inhibitors
* irinotecan
* toptecan
* Topoisomerase II inhibitors
* Epipodophyllotoxins
* etoposide
* teniposide
* Antibiotics
* daunorubicin, doxorubicin
28
antimetabolites include
* antifolates
* methotrexate
* purine antagonists
* mercaptopurine, thioguanine
* purine analogues
* 6-mercaptopurine
* pyrimidine analogs
* flurouracil, gemcitabine
29
imitinib, everolimus, temsirolimus are examples of this type of chemo agent
protein kinase inhibitors
30
some monoclonals for cancer include
bevacizumab, herceptin,
31
hormonal cancer therapy includes
* antiestrogens
* tamoxifen
* antiandrogens
* flutamide
* gonadotrophin releasing hormone analogue
* buserelin
32
immunomodulators used to treat cancer include
alpha interferon
rituximab
interleukin 2
33
what is the mechanism of action of antimetabolites
* mimic structures or normal metabolic constituents
* inhibit enzymes necessry for folic acid regeneration and purine/pyrimidine activation
34
how do cytotoxic antibodies work
* damage or disrupt intercalation b/t bases in DNA causing
* poisoning of topoisomerases
* generating free radicals which inhibit enzymes
* distrupting plant membranes
35
how do vinca alkaloids work
* bind tubulin and block polymerization during M stage of the cell cycle
36
what is an example of a vinca alkaloid
vincristine, vinblastine
37
what is the mech of action of taxanes
* e.g. paclitaxel
* binds tubulin, prevents depolarization at end of mytosis
38
epipodophyllotoxins are _______ \_\_\_\_\_\_\_\_\_\_ and work via this mech action
* plant alkaolids
* inhibit topoisomerase II enzyme activity
39
topotecan or irinotecan are examples of this class of chemo agents and have this mech of action
* topoisomerase I inhibitors
* inhibit topoisomerase 1 causing single strand DNA breaks resulting in cell death
40
everolimus and temisirolimus are examples of this class and have this Mech action
* protein kinase inhibitors
* prevent phosphorylation by blocking protein kinase action
41
what is the mechanism of action of immunomodulators
* harness immune response to destroy tumors by
* lymphocyctes
* cytokines
* proteins and antibodies
* natural killer cells, t cells
42
what are conjugated antibodies and naked mabs
* conjugated: mab attached to a chemotherapeutic agent or radio therapeutic agent
* naked: targets antigen on cancer cell
43
what are two types of protein kinase inhibitors
tyrosine and serine kinases
44
describe how protein kinase inhibitors can be used in Her2 or EGFR cancers
* Her2 = human epidermal growth factor receptor
* EGFR = epidermal growth factor receptor
* in some cancers Her2 and EGFR are continuously activated causing cell multiplication and growth
* protein kinase inhibitors block the protein kinase action and decrease cancers cause by overactive kinases
45
reversibly cuts one strand of DNA, reducing stress from coiling
topoisomerase I
46
cuts both strands of dNA
topoisomerase II
