Session 7 - Chemotherapy Flashcards Preview

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Flashcards in Session 7 - Chemotherapy Deck (26)
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1

Which types of tumour are highly sensitive to chemotherapy

Lymphomas
Germ cell tumours
Small cell lung
Neuroblastoma
Wilm’s tumour

2

Which types of tumour are moderately sensitive to chemotherapy?

Breast
Colorectal
Bladder
Ovary
Cervix

3

Which types of tumour have low sensitivity to chemotherapy?

Prostate
Renal cell
Brain tumours
Endometrial

4

What are the roles of chemotherapy?

Curative or palliative
Adjunct to surgery/radiotherapy or given in isolation
Aims to kill/prevent replication of tumour cells

5

Why is chemotherapy usually administered IV rather than orally?

Oral delivery would damage the GI tract and IV administration allows fine control/titration of dose.

6

What are the four groups of chemotherapy?

Antimetabolites
Alkylating/Platinating agents
Antibiotics
Microtubule inhibitors

7

Give examples of antimetabolites.

Capecitabine
5-Fluorouracil (5-FU)
6-Mercaptopurine

8

Give examples of alkylating/platinating agents.

Nitrogen mustards - Cyclophosphamide, Chlorambucil (alkylating)
Cisplatin (platinating)

9

Give examples of antibiotics used in chemotherapy.

Bleomycin
Epirubicin/doxarubicin

10

Give examples of microtubule inhibitors.

Vinca alkaloids - vincristine
Taxanes

11

What are the common side effects of chemotherapy?

Fatigue
Nausea and vomiting
Alopecia
Altered bowel habit
Altered taste
Mucositis
Easy bruising/bleeding - thrombocytopenia
Increased infection risk - neutropenia
Acute renal failure (drug cleared renally)

12

What is the mechanism of action of alkylating/platinating agents?

Target DNA synthesis in G1/S phase.
Form a covalent bond with DNA nucleosides disrupting structure and therefore preventing replication.

(Agents form positive ion which act as an electrophile, form covalent bond with DNA nucleosides)

13

What specific ADRs are caused by alkylating and platinating agents?

Peripheral, sensory and motor neuropathy
High frequency ototoxicity

14

What is the mechanism of action of mitotic spindle inhibitors?

Target tubules proteins in the mitotic phase
Chromosomes cant align and separate into two daughter cells correctly

(Vinca alkaloids inhibit polymerisation of tubulin so microtubules can’t form whereas Taxanes bind irreversibly to tubulin and stabilises the microtubules so it can’t separate)

15

What specific ADRs are caused by mitotic spindle inhibitors?

Neurotoxicity - glove and stocking peripheral neuropathy

16

What are the two groups of antibiotics used in chemotherapy?

Glycopeptide antibiotics - e.g. bleomycin
Anthracycline antibiotics - e.g. doxorubicin

17

What is the mechanism of action of glycopeptide antibiotics (bleomycin)?

Forms free radicals when cheated with Fe2+ ions which attack phosphodiester bonds in DNA - results in cutting of DNA strands.
Most effective in G2 stage.

18

What specific ADRs are caused by bleomycin?

Pulmonary fibrosis (10%)

19

What is the mechanism of action of anthracycline antibiotics (doxorubicin)?

Targets DNA synthesis in S phase.
Intercalate between the base pairs in DNA which interferes with transcription/replication.
Topoisomerase II inhibition.
Also generate free radicals - damage DNA

20

What specific ADR is associated with doxorubicin?

Cardiotoxic

21

What is tamoxifen?

A selective oestrogen receptor modulator (SERM)
Acts as an antagonist of the oestrogen receptor in breast tissue

22

What is the mechanism of action of tamoxifen?

Tamoxifen is metabolised in the liver to its active form, competitively binds to oestrogen receptors.
Causes cells to remain in the G0 and G1 phase of cell cycle.

23

Why can’t all breast cancers be treated using tamoxifen?

The breast cancer must be oestrogen receptor (ER) positive

24

What are the side effects of tamoxifen?

Hot flushes/sweats
Increased DVT/PE risk
Weight gain
Increased risk of endometrial cancer

25

How can chemotherapy be monitored during treatment?

Response of cancer:
- radiological imaging
- tumour marker blood tests
- bone marrow/cytogenetic

Drug levels

Checks for organ damage:
- creatinine clearance
- echocardiogram

26

What is the difference between neoadjuvant and adjuvant chemotherapy?

Neoadjuvant - given before surgery or radiotherapy in order to shrink tumour

Adjuvant - given after surgery in order to reduce risk of relapse