Chemotherapy Flashcards
(49 cards)
What percentage of breast cancer patients get chemo as their primary treatment?
34% of patients with breast cancer have chemotherapy as part of primary cancer treatment
What is consolidated?
Chemical drug induction of remission – prolonged freedom from the disease.
What is adjuvant?
Chemo CTX given for eradication of the disease.used after primary surgery
What is neoadjuvant?
Before surgery – reduces invasive surgery – Locally advanced tumour,Infalmmatory tumours,For larger tumours or those with large amounts of nodal involvement or inflammatory component,neoadjuvant chemotherapy may be used to shrink the tumour before surgey to improve the outcome and preserve remnant breast tissue
What is maintenance?
Prolonged low dose chemical chemo issued to an out patient to extend duration of remission
What is salvage?
CTX/RTX treatment are given after failure of others – control disease progression
What is combination?
More than one chemical agent maximises tumour cell kill
Which drugs work on the M phase
Taxanes,Vinca alkaloids,etposide
Which drugs work on the s phase?
Anti metabolites and topoisomerase inhibitors-
Vinca alkaloids, 5 Fluorouracil,methotrexate,hydroxyurea,doxyrubcin,cytarabine,gemcitabine,etoposide
Which drugs work on the g2 phase?
bleomycin
Which drugs are cell cylcle independent?
platinating agents,alkylating
agents,anthracyclines
What can the risk of recurrence of cancer be reduced by?
using adjuvant
chemotherapy
What is adjuvant?
After primary surgery
What is neoadjuvant?
Before surgery
How many ppls chemo fails and due to what exactly?
50% due to intrinsic and
acquired multiple drug resistance.
What are the risk factors associated with the onset of a resistant phenotype?
genetic predisposition such as mutation in a and b tubulins, and BRCA1/2; induction of expression of multi drug resistance MDR, alteration in spindle assembley checkpoints,cell cycle proteins and apoptosis.
What are mitotic inhibitors and which stage do they affect?
Disrupt the M phase of the cell cycle – leading to cell arrest.
Give an example of a mitotic inhibitor
Taxanes – paclitaxel,doxcetaxel,cabzitaxel. – Extracted from the Pacific yew- t.brevifola bark. 12- slow gorowing trees required for 1 patient.
What is paclitaxel and example of and what does it do?
Taxane . Microtubule stabiliser – cats during the telophase of the M phase – bind to subunit of tubulin – the building block of microtubules.The resulting microtubule/paclitaxel complex does not have ability to disassemble – blocking progression into mitosis and causing prolonged activation of the mitotic checkpoint.This triggeres apoptosis or reversion to the g0 phase of the cell cycle without cell division taking place
What is its Mr
RMM is so bad, 15-h bond acceptors.
What is its class and what does that then mean
it is class 5 so poorly permeable and
poorly soluable of the biopharmaceutical classification, not ideal for oral delivery
What are other taxanes?
Doxetaxel, cabzitaxel
What are the 3 points for the formulation and delivery of paclitaxel?
- Given via IV route
- Fromulation with cremophor(polyoxyl castor oil)improves its water solubility –
but cremaphor has the tendency to cause severe allergic reactions so, pre- administration of steroids and anti histamines is recommended. Cremaphor can form micelles in plasma,trapping paclitaxel and preventing distribution to cancer cells. - New approach for paclitaxel formulation sees it complexed with albumin to create nanoparticle colloidal systems.This solubalises paclitaxel which accumulates in tumour beds.No cremaphor needed so avoid sensitivity issues.
What are the side effects of taxanes specifically?
May cause peripheral neuropathy -numbness,tingling,paraesthesia and a burning pain in a stocking glove distribution. This is related to the effects on microtubule function in the nerve cells and other healthy tissue. Stress hormones were shown to arrest cells in the G0/G1 phase,which would serve to substanciate the decrease in paclitaxel efficacy – which taregts sphase.