Introductory Lecture Flashcards

Question

Cytotoxic drugs affects all cells, but primarily affects...

Answer 1

Rapidly dividing cells - cancer cells among the most affected

Answer 2

DNA abnormalities are detected

Answer 3

Cell cycle specificity - important for dosing + scheduling

Answer 4

In process of division: most effective in tumors with high growth fraction There are phase specific agents - most effective in multiple repeated doses Non-specific agents - "dose-dependent" drugs

Answer 5

Large tumors with low growth fraction "Dose-dependent"

Answer 6

To cure - elimination of all known tumor cells To improve survival - achieve tumor control, and delay time to recurrence Palliation - reduce tumor related symptoms, achieve some tumor control, and improve overall quality of life

Answer 7

Response rate (has tumor shrunk) Survival (overall survival = gold standard) Quality of life Safety ## Footnote Surrogate endpoints for overall survival include progression-free, disease-free, relapse-free survival

Answer 8

Usage of chemotherapy as the primary treatment ## Footnote Usually applied in hematologic malignancy

Answer 9

Drug treatment given AFTER primary tumor is controlled by definitive local treatment (surgery or radiation)

Answer 10

High risk for relapse - goal is to cure and destory clinically undetectable cancer cells ## Footnote Use of aggressive treamtents are often used - smaller population of cancer cells may be more susceptible (better vascular supply, higher growth fraction, less genetically diverse)

Answer 11

Inability to assess response Short + long-term risk of aggressive chemo

Answer 12

holds the same principles as adjuvant therapy - tx of subclinical, residual disease Term often applied in treatment of hematologic malignancy therapy after induction therapy has produced complete remission

Answer 13

Use of systemic drug therapy prior to local treatment (surgery, radiation)

Answer 14

Increase effectiveness of local treatment by reducing tumor burden + destroying undetectable cancer cells susceptible to chemotherapy, that may have metastasized early ## Footnote Curative intent - hopefully improve cure rate

Answer 15

Evaluate response to the chosen chemotherapy drugs

Answer 16

Longer term therapy, usually lower dose, used to decrease recurrence rate/progression rate

Answer 17

Usage in both curative + non-curative settings

Answer 18

Treatment of relapsed (recurrent after previous control) or refractory (unresponsive to tx) disease

Answer 19

Deliver chemotherapy to relatively inaccessible sites Provide high local concentrations Avoid systemic toxicity

Answer 20

High doses of cytotoxic drug is lethal to bone marrow - rescue with stem cell transplant + WBC growth factor can help reconsitute immune system

Answer 21

Reduce number of existing lymphocytes in the patient's body, to create space for infused CAR-T cells to effectively expand + fight cancer cells

Answer 22

Bone marrow suppression - neutropenia, anemia, thrombocytopenia Mucositis, stomatitis Alopecia N/V, fatigue

Answer 23

Higher cell kill Different MOA's - considering heterogeneity of tumor, may not be sensitive to one drug Prevent/slow development of tumor resistance

Answer 24

Multiple toxicities May have to dose reduce in combination - potentially reduce efficacy More complicated to administer

Answer 25

Balance efficacy with tolerable toxicity

Answer 26

Show clinical activity against tumor alone Have different MOA's with minimally overlapping toxicities No cross resistance between drugs Combination is synergistic

Answer 27

Driven from clinical trials (based on BSA for chemotherapy, monoclonal antibodies = mab's) Attempt to deliver maximum dose for maximum efficacy, but may be modified based on curability, tolerability, renal/liver function, and prior therapies

Answer 28

Toxicity/tolerability concerns

Answer 29

Recovery of host tissue toxicity How fast the tumor is growing MOA of drug - cell cycle specificity

Answer 30

With a prescribed # of cycles + duration

Answer 31

Until evidence of disease progression, or as long as the toxicity can be managed

Answer 32

Toxicity to normal cells (dose limiting) Patient co-morbidities First order kinetics of cell kill (constant % of cells kills, not constant #) Failure to detect tumor in early stage (metastasizes, low growth fraction, patient id compromised) Limited drug access to tumor site

Answer 33

Drug resistance Inherent (ex: abnormal p53 suppressor gene) or acquired (cells develop mechanisms, such as inactivating enzymes, other dominant molecular pathways, or methods of repair)

Answer 34

Spontaneous genetic mutations occuring in tumor cell populations, even without exposure to drugs ## Footnote Large tumor massses = more mutations + signalling pathways, higher probability of drug-resistant cell lines

Answer 35

Hormone receptor or hormone deprivation ## Footnote Useful for hormone-sensitive cancers (prostate, breast, endometrial)

Answer 36

Targeting speciifc molecules/signaling pathways involved in the growth + spread of cancer cells Highly selective + molecularly targeted treatments

Answer 37

Improve efficacy + avoid severe toxicities to normal cells from traditional cytotoxic chemotherapy

Answer 38

Growth signaling pathways Antibody-drug conjugates Tyrosine kinase inhibitors

Introductory Lecture Flashcards

(62 cards)