New And Future Treatments For Blood Cancers

Question 1

What is the principle of action of chemo and radiotherapy?

Answer 1

Damages cell DNA.

Cell recognises damage -> apoptosis.

Question 2

Why do you get side effects in chemo and radiotherapy?

Answer 2

Normal cells also get their DNA damaged -> apoptosis

Question 3

Some immediate side effects of chemo?

Answer 3

Hair loss
Nausea and vomiting
Neutropenic infection
Tiredness

Question 4

Some long term side effects of chemo and radiotherapy?

Answer 4

Heart and lung damage

Other cancers

Question 5

What supportive therapies can be given when using chemo or radiotherapy?

Answer 5

Prompt treatment of neutropenic fever/ infection 
Broad spectrum antibiotics 
Red cell and platelet transfusion 
Growth factors (GCSF)
Prophylactic antibiotics and antifungals

Question 6

What is emergency treatment of standard risk neutropenic sepsis?

Answer 6

Piperacillin / tazobactam

Question 7

What is the emergency treatment of high risk neutropenic sepsis?

Answer 7

Piperacillin / tazobactam + gentamicin

Question 8

A PET scan can be used in what cancer to help monitor chemo?

Answer 8

Hodgkin’s lymphoma

Question 9

Benefit of monoclonal antibodies?

Answer 9

Only affect cells which possess target proteins so avoid side effects

Question 10

Examples of monoclonal antibodies?

Answer 10

rituximab
Ofatumunab
Obinutumab
Brentuximab vedotin

Question 11

Are biological treatments just targeted to malignant cells?

Answer 11

No so will get side effects

Question 12

Examples of biological treatments?

Answer 12

Proteosome inhibitors

IMIDs (immunomodulatory imide drugs)

Question 13

Action of proteosome inhibitors?

Answer 13

Proteosome has lots of old proteins in cell and breaks them down to amino acids for recycling.
Blocking this -> accumulation of toxic proteins in cell -> apoptosis

Question 14

Example of a proteosome inhibitor?

Answer 14

Bortezomib

Question 15

An example of an IMID?

Answer 15

Lenalidomide ( derivative of thalidomide)

Question 16

What do IMIDs do?

Answer 16

Can produce remission when no more response to chemo

Question 17

Tyrosine kinase inhibitors?

Answer 17

Imatinib
Nilotinib
Dasatinib
Ibnutinib

Question 18

Are tyrosine kinase inhibitors well tolerated?

Answer 18

Yes - very few side effects

• diarrhoea
• fluid in lungs
• neutropenia

Question 19

What is nivolumab?

Answer 19

A checkpoint inhibitor

Question 20

What is an allogenic bone marrow transplant?

Answer 20

Cells from donor to cause immune attack on cancer.

But can also attack normal cells - graft versus host disease (GVHD)

Question 21

What is adoptive immunotherapy?

Answer 21

Make the patients own immune cells recognise the cancer as foreign and attack it.

Question 22

Advantages of adoptive immunotherapy?

Answer 22

Avoids toxicity and GVHD