Personalised Medicine - Curing Cancer Flashcards Preview

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Flashcards in Personalised Medicine - Curing Cancer Deck (31):

What is cancer?

A disease of population of cells that live, divide, invade and spread without regard to normal limits.


With regards to cells what normally occurs?

Normally, cells growth, death and location are tightly regulated in the body


On a molecular basis what causes cancer?

Cancer is a diseased caused by a mutation in DNA

Caused by exogenous carcinogens, DNA replication errors, inheritance


What DNA genes are mutated that results in cancer?

Oncogenes (become acitvated)
Tumour suppressor genes (inactivated)


With regards to cancer what may be suitable targets for drug therapy?

Cancer biomolecules maybe suitable as molecular targets for drug therapy


How can cancer cells be distinguished from other cells/

Cells aquire a series of key phenotypic characterisitcs


What are the key characteristics of cancer cells?

- Evading apoptosis
- Self-sufficiency in growth signals
- Insensitivity to antigrowth signals
- Sustained angiogenesis
- Limitless self replication potential
- Tissue invasion and metastasis


Whats the three key points of the pathophysiological basis of cancer?

- Growth and invasion of primary tumours
- Metastasis and distant effects of wide spread disease
- Systemic effects of paraneoplastic syndromes


How many people get cancer in NZ each year and how many die?

21050 new cases
8891 deaths


What are the five most common cancers in NZ?

1) Prostate
2) Colon, rectum and anus
3) Breast
4) Melanoma of the skin
5) Trachea, bronchus and lung


What is cancer chemotherapy?

The use of chemicals to kill cancer cells in the body


What are some examples of chemotherapeutic agents?

- Metal complexes
- DNA binding molecules
- Vitamin mimics
- Antibodies


How is cancer chemotherapy administered?

intravenously, then spreads systemically and kills cancer cells everywhere in the body


How do cancer chemotherapies not kill normal cells?

They are selective for cancerous cells.

Selective toxicity is achieved through direct, metabolic, hormonal and immune cytotoxicity mechanisms


When did cancer chemotherapy begin and describe the studies results?

1942, Goodman at yale used mustard gas derivative to treat lymph gland cancer, resulted in cancer regression

Important forerunner to modern alkylating agent i.e cyclophosphamide


When did chemotherapy first cure cancer?

1958, Hertz, showed that methotrexate cured choriocarncinoma

Showed that chemotherapy could cure cancer


When was the anticancer platinum complex discovered

1978 - Cisplatin, barnett showed that it acted on a range of solid tumors


When did targeted therapies being to be used?



What is target therapies?

Therapeutic targeting of specific molecules involved in cancer development and progression


What is targeted therapies potential?

Potential for more effective less toxic and individualised cancer therapies.


What are two major landmarks in targeted therapies?

1998 - trastuzumab approved for HER-2 positive breast cancer

2001- Imatinib approved for chronic myelogenous leukemia


What is chronic myelogenous leukaemia (CML)?

chronic myelogenous leukaemia the product of the acquisition of Philadelphia chromosome, abnormal fusino protein and self sufficiency of growth signals,


What did treatment of CML with imatinib compared to other treatments do?

Resulted in 95% survival compared to next best of 40%


What is the latest modern revelation of cancer therapy?

2011 - immune checkpoint modulation


What is immune checkpoint modulation?

The use of monoclonal antibodies binding cytotoxic T lymphocyte antigen 4 i.e ipilimumab (CTLA-4) or Programmed death one i.e nivolumab (PD-1) to modulate the immune systems response to prevent cancer growth


What do ipilimumab and nivolumab do?

- Supresses antitumour T-cell immune cytotoxicity

i.e Which decreases tumour growth


What do results of ipilimumab and nivolumab use indicate?

Durable responses in subgroups of patients with melanoma, non-small lung cell cancer

But this immune suppression can result in
- Colitis
- Dermatitis
- Endocrinopathies

i.e immune related side effects


What are some pharamcolgical anticancer treatment actions and side effects?

Anti-proliferation = Diarrhoea , alopecia
DNA mutagenesis = Cancer
Sex hormone defficiency = impotence
Blocked growth factor receptor signalling = Hypertension, clotting
Autoimmunity = colitis


Can cancers be resistant to treatment?

Only if they acquire the appropriate mutations


Whats the three summaries of this lecture?

- Targeted therapies inhibit oncoprotein drivers of cancer development and progression
- Individualisation of therapy by genetic testing to detect somatic mutations to direct patients to specified targeted therapies
- Adverse effects are often related to the main pharmacological mechanism.


What are the stages of cancer?

1-5 where 5 has metastasized.