final exam Flashcards
(22 cards)
false positives
- You don’t have cancer
- Lacks specificity
- More procedures
False negatives
- You do have cancer
- Lacks sensitivity
main cancer screens
skin, prostate, breast, colorectal, cervical
Pap smear screening
- For cervical cancer
- 75% effective saves lives!
mammogram screening
- For Brest cancer
- Like an X-ray
- Crushed down breasts = very uncomfy
prostate cancer screening
- Digital rectal exam
- Very invasive
- PSA looks for a specific antigen
- Blood test
- 75% false positive and 20% false negative
Problems with current cancer screens
- Tests detect cancer at mid or late stages of progression
- Most tests are not specific
- Mosts tests are invasive
- Tests do not distinguish the severity of disease
- Tests do not exist for many cancer types
different types of imaging
Xray imaging
- Can be improved by collecting data on computer instead of film
3D mammograms
- Using several low-dose X-rays at different
- More sensitive
- FDA approved
- Gotta check insurance
Microwaves
- Using AI and microwaves person lying down
CT scans
- Computer-controlled X-rays
- Capable of giving 3D
- Improved imagery
PET scan
- Uses radioactive tracer molecules to pinpoint cancers
CT AND PET SCAN
- Ct shows location and pet sees activity
- This machine combines both
MRI
- Detects radio waves given off by
tissues when exposed to magnetic
field
- Similar to CT scan: 3-D image;
more sensitive in soft tissues
personalized cancer treatment
Proteomics
- The study of all expressed proteins
Genomics
- Looking at genetic mutations
Mamma print
- 70 gene profile
- Genomic test for breast cancer
- FDA approved
- Only 10 % false negative
- 27% false positive
Epigenetic
- Turning genes on and off is switching epigenetic
Bioinformatics
- Take information and make data
Three markers for breast cancer
Tamoxifen
- Blocks hormone receptor
- You’re in fake menopause
Herceptin
- Antibody against Her 2
ibrance
- Combined with letrozole
- Hormone inhibitor
Colon cancer screening
- Screen is colonoscopy
- Risks include bowel perforation
- Virtual colonoscopy
- Using a CT scan
- Virtual is less sensitive and specific than colonoscopy
Non invasive colon cancer screens
- gFOBT for hemoglobin in stool not specific for human blood
- FIT; is an antibody test against human hemoglobin
- Cologaurd; detects hemoglobin and has 9 other markers for the poop
- SEPTIN 9; blood based using cancer specific marker
Prostate cancer screens
Stockholm 3 test
- Checking for genetic differences
- Blood test
- Detects and quantifies protein and genetic markers
- AI intelligence used
4kscore test
- Blood test FDA approved
- Detects and quantifies 4 protein markers
- Total PSA free plus sound to proteins most common PSATotal PSA (Free + bound to proteins)
-The most common PSA test only measures
this
– Free PSA (lower free/total worse prognosis)
– Intact PSA (a non-active form of PSA; high
ratio of intact/free= worse prognosis)
– Human Kallikrein 2 (HK2
therapeutics
Surgery; removal of primary tumor
Radiation therapy; localized doses of ionizing radiation to destroy remaining cancer cells or kill tumor cells inaccessible to surgery.
Chemotherapy: Systemic application of drugs that kill or halt cancer cell growth
radiation therapy
- External beam: uses external device that focuses high energy photons (Gamma or xrays ) from cobalt cesium
- IMRT: monitor shape of tumor, radiation is delivered via several different beams that are further divided into beamlets, Allows 3d to conform shape of tumor
- Proton therapy: X-rays passes through the body damaging normal tissue as well as tumor cells energy from proton delivers lower doses of radiation directly to the tumor with minimal damage
- Brachytherapy: low dose therapy internal; radioactive seeds into the tumor and leave them in minimal damage, High dose: high doses of radiation delivered directory into tumor via probes, Probes removed to prevent further exposure to radiation
chemotherapy
Chemotherapy
- Kill or stop dividing cells
- advantages: Reach metastatic cells through the body, Can be combined radiation and immunotherapy
- Disadvantages: usually toxic to other diving cells, Can cause liver toxicity, Development of chemoresistant cancer cells
- Chemotherapy kills stem cells, bone marrow, red and white blood cells, platelets
Targeted chemotherapy
Herceptin
- Against her 2
- TK receptor
- Have to be injected
Iressa
- Small molecule
- TK inhibitor
- Can be ingested
- Can get in cells and stop cancer cells
- 10% of lung cancer patients
Gleevec
- Small molecule
- Against CML
ibrance
- FDA approved
- For ER+ and HER2-
- Cell cycle inhibitor
Vemura finib
- For melanoma
- BRAF
- Mutation identified one amino acid changed V600E
- Kinase inhibitor
Immunotherapy
- Use our immune system
- Adoptive cell therapy; patient’s own immune cells are removed, selected for their cancer-fighting ability, amplified, and injected back into the patient
- Prophylactic vaccines
- Provenge; against metastatic prostate cancer
- Patients T cells removed and activated by Provenge, amplified, and reinfected into patient
- Consists of protein overexpressed in prostate cancer + factors that promote growth and development of “killer” T-cells
- Checkpoints inhibitors
- Keytruda
- Our system produces killer T cells that can recognize and kill cancer cells
- Cancer cells counter by producing a checkpoint protein PD 1 which kills the T cell
Synthetic T cells
Requires antigen that the T cells recognize
- MHC protein
- Co-stimulatory molecule
- Cancer gets rid of all of these three
- Make a CAR T cell, doesnt require MHC
- Includes its own stimulatory domains
- Approved for lymphoma
Gene therapy
Uses wither viruses, naked DNA, or DNA enclosed
Problems: take animal viruses that affect human clells
Makes them less responsive
Efficiency of DNA delivery is low
Gendicine for p53 approved in china
Oncorine- Oncolytic virus
Get into cell and then spread virus to surrounding cancer cells
Only affects cells that lack p53
Oncorine approved in china
TVEC
- Oncolytic
- Modified herpes simplex
- Only replicate in cancer cells
- Direct killing- virus replicates and lyses cancer cells
- Systemic killing- lysed cancer cell releases specific tumor antigens and virus produces molecules GM-CSF that cause a strong immune response against tumor cells throughout the body
Nanotechnology
- One nano particle you can have better detection and deliver drugs more efficiently
- Infrared light is one aspect of using nanoparticles
- Magnetic nanoparticles
- Iron containing nanoparticles allows for directed targeting using external magnetic field
- Visual detection by MRI
- Killing of cancer cels by exposure to external amf
