Chemotherapy Flashcards Preview

Principles of Disease 16 > Chemotherapy > Flashcards

Flashcards in Chemotherapy Deck (39)
1

Describe some different methods of cancer treatment

Surgery
Chemotherapy - oral and IV
Radiotherapy
Targeted therapies e.g. immunotherapy

2

Name the different classes of anti-cancer therapeutics COME BACK

Alkylating agents

Antimetabolites

Vinca Alkaloids

Taxanes

Antimitotic Antibiotics

Immunotherapy with monoclonal antibodies

Targeted drugs

Hormonal drugs

3

Describe the mechanism of action of the alkylating agents class of chemotherapy drugs

Alkylating agents e.g. cisplatin, bisulfan
• Alkyl groups of the drugs allow covalent bonds to form between the drug and DNA
• In this case, it attaches to the guanine between DNA strands at N7 during replication, preventing it from taking place since the strands cannot separate.

4

What type of drugs are cisplatin, carboplatin and bisulfan?

Alkylating agent

5

Describe some mechanisms of resistance to alkylating agents

Mechanisms of resistance include:
o Decreased entry or increased removal of a drug by the cell
o Inactivation of the drug by the cell e.g. glutathione
o Enhanced repair of affected DNA by DNA repair enzymes

6

Describe the mechanism of action of antimetabolite drugs

Similar chemical structure to essential metabolites required by cell prior to cell division.
May be incorporated into new nuclear material or bind irreversibly with vital enzymes to inhibit cell division:
o E.g. antagonise folic acid (methotrexate),
o Antagonise purine (6-mercaptopurine, 6-thioguanine),
o Inhibit thymidylate synthase (5-fluorouracil),
o Incorporate fluoridated nucleoside in place of normal nucleoside (5FU instead of uracil in RNA)

7

What is methotrexate and what is its mechanism of action?

Antimetabolite, antagonises folic acid synthesis and therefore inhibits purine synthesis

8

What is 6-mercaptopurine and what is its mechanism of action?

Antimetabolite which inhibits purine synthesis

9

What is 5-fuorouracil and what is its mechanism of action?

Antimetabolite which inhibits thymidylate synthase and is incorporated into the place of uracil in RNA to prevent transcription

10

Name two classes of drugs that are derived from plants which act as spindle poisons

Vinca alkaloids
Taxanes

11

Describe the mechanism of action of vinca alkaloids

Vinca alkaloids - these drugs bind to tubulin and inhibit its polymerisation into microtubules, preventing spindle formation in dividing cells and causing arrest at metaphase. Their effects manifest only during mitosis. They also inhibit other cellular activities that involve the microtubules, such as leukocyte phagocytosis and chemotaxis, as well as axonal transport in neurons. E.g. vincristine

12

What is vincristine?

Vinca alkaloid

13

Describe the mechanism of action of taxanes

Taxanes - act on microtubules, stabilising them (in effect ‘freezing’ them) in the polymerised state, achieving a similar effect to that of the vinca alkaloids. E.g. Paclitaxel (IV) and docetaxel (oral)

14

Give some examples of taxmen drugs

Paclitaxel and Docetaxel

15

How is paclitaxel administered?

Oral

16

How is docitaxel administered?

IV

17

Describe the mechanism of antimitotic antibiotics and give some examples

• Anthracyclines and Non-anthracyclines

o Intercalate and inhibit DNA and RNA synthesis
o Inhibit topoisomerases to prevent transcription and replication
o Membrane binding and increase permeability to various ions
o Generate free radicals to disrupt DNA chain and prevent mitosis
o Metal ion chelation resulting in cytotoxic compounds
o Alkylation blocking DNA replication

• E.g. daunorubicin, doxorubicin

18

What type of drug is daunorubicin and doxorubicin?

Antimitotic antibiotics

19

Give some examples of antimitotic antibiotics

Daunorubicin
Doxorubucin

20

What are the principles that underly combinational chemotherapy treatment?

Combine those with:
o Different mechanism of action
• Synergistic or at least additive
• Reduce risk of developing resistance
o Dissimilar toxicity profile e.g. not both with neurotoxicity (cisplatin and taxane)

21

List some common side effects of chemotherapy treatment

Alopecia
Nausea and vomiting
Myalgia (muscle pain)
Constant fatigue
Myelosuppression

22

Which cytotoxic agents can affect fertility?

Carboplatin
Cisplatin

23

Which cytotoxic agents can cause cardiotoxicity?

Cisplatin
5-fluorouracil

24

Which cytotoxic drug can cause pulmonary fibrosis?

Methotrexate
Bisulfan

25

What is phlebitis and what can cause it?

Inflammation of a vein, usually caused by trauma, inactivity though can be caused by insertion of cannula or recurrent infusions and injections

26

Give three targets of hormonal drugs given in cancer

o Anti-oestrogen Tamoxifen, aromatase inhibitors for breast cancer
o Gonadorelin analogue e.g. Goseralin (Zoladex) for prostate and breast cancer
o Anti-androgen (CPA, flutamide) for prostate cancer

27

What is tamoxifen?

Anti-oestrogen, used in breast cancer

28

What drug is an anti-oestrogen used in breast cancer?

Tamoxifen

29

What is Goseralin (Zoladex)?

Gonadorelin analogue for breast and prostate cancer

30

Name a gonadorelin analogue used to treat certain breast and prostate cancers

Goseralin (Zoladex)

31

What is Flutamide (CPA)?

Anti-androgen used in prostate cancer

32

Name an anti-androgen drug used in some prostate cancers?

Flutamide (CPA)

33

Give some examples of targeted drugs

o Epidermal growth factor receptor (EGFR) Gefitinib (Iressa)/Erlotinib for lung cancer and some breast cancer
o Vascular endothelial receptor (VEGF) Bevacizumab (Avastin)
o Multiple targets sorafenib, sunitinib, etc

34

What drugs target EGFR and are used to treat lung cancer and some breast cancers?

Gefitinib (Iressa) and Erlotinib

35

Gefitinib (Iressa) and Erlotinib: what are they good for?

Lung cancer and some breast cancer

36

Name a CTLA-4 inhibitor?

Ipilimumab

37

What is ipilimumab?

Anti-CTLA4 monoclonal antibody

38

Nivolumab, Pembrolizumab, Atezolizumab, Durvalumab, and Avelumab are all examples of what?

PD-L1 inhibitors

39

Name some PD-L1 inhibitors

Nivolumab, Pembrolizumab, Atezolizumab, Durvalumab, and Avelumab