introduction to cancer therapy 1

Question 1

what are the traditional treatments for cancer

Answer 1

surgery, radiation, chemotherapy

Question 2

what are examples of precision medicine

Answer 2

targeted therapy and immunotherapy

Question 3

what is cancer chemotherapy

Answer 3

therapy that involves administration of chemical agents to destroy cancer cells

Question 4

what was the first cancer drug developed from

Answer 4

mustard gas

Question 5

mustard gas is a type of what agent

Answer 5

alkylating agent

Question 6

how did they discover the first cancer drug

Answer 6

from mustard gas accident during WW2, the men exposed had a lower white count

Question 7

why can cancer change their genomes rapidly

Answer 7

due to a lack of DNA repair machinery and they are very plastic

Question 8

cancer don’t have DNA repair machinery this allows them to quickly develop

Answer 8

resistance

Question 9

neoadjuvant chemotherapy is what?

Answer 9

administrated prior to surgery to facilitate resection and prevent metastasis

Question 10

adjuvant chemotherapy is what

Answer 10

after surgery, reduce risk of distant relapse and increase disease-free survival

Question 11

palliative chemotherapy is

Answer 11

improve patients quality of life by controlling symptoms in a patient where a cure in unlikely

Question 12

salvage chemotherapy is

Answer 12

potentially curative, high-dose regimen given to a patient who has failed/reccurred in prior regimen

Question 13

what are the four types of chemotherapy

Answer 13

1. neoadjuvant
2. adjuvant
3. palliative
4. salvage

Question 14

what are cytotoxic drugs

Answer 14

these kill dividing cells, as a consequence these kill healthy cells which makes the patient immunosuppressed

Question 15

what are the 5 functions of chemo drugs

Answer 15

1. antimetabolites
2. topoisomerase enzymes
3. structural damage
4. disturbed function of the mitotic spindle
5. hormonal agents

Question 16

what are antimetabolites

Answer 16

limit the synthesis of nucleic acid precursors, and structural analogues. S phase specific

Question 17

what is the function of topoisomerase enzymes

Answer 17

participate in the winding and unwinding of DNA are inhibited

Question 18

what are structural damage drugs

Answer 18

structural damage to mature DNA

Question 19

what are example of a drug that affects the mitotic spindle

Answer 19

vinca alkaloids

Question 20

what is the function of hormonal agents drugs

Answer 20

block proliferation of hormone-response cells

Question 21

what is the mechanism of alkylating agents

Answer 21

target DNA, produce alkylation through formation of intermediate. the drug enters through a chloride transporter and inside the cell they are hydrolysed. the hydrolysis results in an active species which binds to DNA in a way that can’t be repaired.

Question 22

which type of chemotherapy drug is not cell cycle phase specific

Answer 22

alkylating agents

Question 23

what are intermediates

Answer 23

block damaged DNA

Question 24

what is the mechanism of antimetabolites

Answer 24

interfere with DNA synthesis

Question 25

which type of drug is S-phase specific

Answer 25

antimetabolites

Question 26

what are mitotic spindle agents mechanism of action

Answer 26

bind to microtubular proteins inhibiting microtubule assembly thereby interrupting the mitosis phase of cell division

Question 27

what are topoisomerase inhibitors mechanism of action

Answer 27

DNA topoisomerase I and II are essential for transcription and replication and mitosis. Regulates structure and winding of DNA

Question 28

what are the 5 principles of combination chemotherapy?

Answer 28

- use drugs as a single agent - use drugs with different mechanisms of resistance - use drugs with different side effects - be aware of drug to drug interactions - use drugs with different mechanisms of action

Question 29

what types of cancer can be found in category 1 responsiveness to efficacy

Answer 29

germ cell, lymphomas, leukemias

Question 30

what types of cancer can be found in category 2 responsiveness to efficacy

Answer 30

breast, colorectal, ovarian

Question 31

what types of cancer can be found in category 3 responsiveness to efficacy

Answer 31

lung, bladder, prostate, stomach, cervical

Question 32

what types of cancer can be found in category 4 responsiveness to efficacy

Answer 32

head and neck

Question 33

what types of cancer can be found in category 5 responsiveness to efficacy

Answer 33

liver, melanoma, brain, thyroid and renal

Question 34

what types of cancer have a high response and a high cure rate

Answer 34

childhood cancer, testicular, choriocarcinoma, Hodgkin Disease

Question 35

what types of cancer have a high response and low cure rate

Answer 35

breast, ovarian, small cell lung cancer, sarcoma, myeloma

Question 36

what types of cancer have a low response and a low cure rate

Answer 36

colon, stomach, prostate, pancreatic, glioblastic, non-small cell lung cancer

Question 37

what are the survival parameters

Answer 37

1. disease-free survival | 2. overall survival

Question 38

what is disease- free survival

Answer 38

from the time of treatment to first recurrence

Question 39

what is overall survival

Answer 39

from time of diagnosis to death

Question 40

how can chemo be delivered

Answer 40

intravenous or orally

Question 41

why can chemotherapy make someone immunosuppressed?

Answer 41

because chemo targets the bone marrow

Question 42

what factors can boost the immune system

Answer 42

G-CSF

Question 43

what can prevent a cancer patient from becoming immunosuppressed

Answer 43

blood fusion

Question 44

what type of drug induces sickness symptoms

Answer 44

platinum anthracylines alkylatings

Question 45

what is cardiotoxicity and who is most affected

Answer 45

when the heart muscle is injured, children

Question 46

what is pulmonary toxicity and how can you treat it

Answer 46

damaged to the lungs, treat with corticosteroids

Question 47

what is nephrotoxicity, how can you treat it

Answer 47

rapid deterioration of the kidney, treat by making sure the patient receives adequate hydration

Question 48

what is gondal damage, what should you do?

Answer 48

damage to the gonads, preserve the stem cells

Question 49

what should you do with secondary malignancies

Answer 49

avoid the responsible drug

Question 50

what is oral mucositis

Answer 50

a common complication of cancer where the mucosal lining of the mouth begins to atrophy and breakdown forming ulcers and sores.

Question 51

symptoms of mucositis

Answer 51

burning, oral pain, difficulty eating, drinking and talking and difficulty with mouth care

Question 52

how do you treat mucositis

Answer 52

protect lips with moisturiser, avoid acidic foods and regular mouthwash

Question 53

how can you become resistant to chemotherapy

Answer 53

1. tumours can acquire resistance 2. cytotoxic drugs revoke drug resistance 3. effects drugs of similar structure

Question 54

resistance in chemotherapy is often due too

Answer 54

mutation or altered gene expression of genes which: 1. transport drug in our out of the cell 2. metabolism and intracellular concentration of the drug 3. structure of the target protein which binds causing toxicity 4. protection from apoptosis

Question 55

What are the characteristics of cancer stem cells

Answer 55

quiescent, increased expression of anti-apoptotic proteins and increased activity of pro-survival pathways

Question 56

what gene is a multi-drug resistance gene

Answer 56

MDR1

Question 57

what happens to MDR1 during cancer

Answer 57

it can be upregulated meaning it Can actively pump some drugs out of the cell, reducing intracellular concentration and meaning the drug can't become cytotoxic

Question 58

what are the two types of resistance

Answer 58

intrinsic or acquired

Question 59

epigenetic are very resistant to what

Answer 59

very toxic platinum alkylating

Question 60

drug resistance is influenced by what parts of the microbiome

Answer 60

1. vascular abnormality 2. hypoxia and acidity 3. fibroblasts 4. immune cells 5. extracellular matrix 6. exosomes

Question 61

therapies to overcome resistance to alkylating agents

Answer 61

1. increased delivery of platinum to the tumour 2. combination of platinum drugs with molecularly targeted agents 3. novel platinum drugs targeting resistance mechanism 4. platinum resistance modulators