systemic anti-cancer treatment

Question 1

what are the clinical settings associated with chemotherapy ?

Answer 1

neoadjuvant
adjuvant
primary

Question 2

what is neoadjuvant therapy ?

Answer 2

chemo first followed by local treatment
thee am is to reduce the size of thee disease locally along with early treatment of micrometastasis

Question 3

what is adjuvant therapy ?

Answer 3

local treatment followed by chemotherapy
aim is to allow early treatment of local disease before it becomes inoperable and then to treat micrometastasis

Question 4

what are the types of dose limiting toxicities ?

Answer 4

1.haematological malignancies
2.non hematological systemic toxicity
3.cardiac toxicity

Question 5

what are the stages of the cell cycle ?

Answer 5

G1- organelle replication
S - DNA replication
G2 - Cell prepares for M
M - Mitosis

Question 6

what are antimetabolites ?

Answer 6

inhibit key synthetic enzymes by mimicking a natural substance or cofactor

Question 7

what are the types of anti metabolites ?

Answer 7

pyrimidines
antifolates
Purine

Question 8

what are examples of pyrimidine antifolates ?

Answer 8

5 FU
capecitabine ( oral 5-FU)
gemcitabine
Cytosine arabinoside

Question 9

what are examples of antifolates ?

Answer 9

methotrexate
Pemetrexed

Question 10

what are examples of purines ?

Answer 10

6-mercaptopurine
Cladribine
Fludarabine

Question 11

what are the characteristic features of antimetabolites ?

Answer 11

cell cycle dependency
saturable effects

Question 12

what is the mechanism of action of 5-FU ?

Answer 12

formation of 5FdUmp
formation of 5FTmp and hence the inhibition of the thymidylate synthase enzyme
( inhibition of TS)

Question 13

what is the oral form of 5FU called ?

Answer 13

Capecitabine

Question 14

what is the mechanism of methotrexate ?

Answer 14

by the inhibition of dihydrofolate reductase

Question 15

what is the mechanism of action of pemetrexed ?

Answer 15

multitargeted antifolate
inhibits TS
inhibits DHFR and GARFT which is involved in purine biosynthesis

Question 16

what must be given along with pemetrexed ?

Answer 16

b12 supplementation and folate

Question 17

what type of cancers use pemetrexed ?

Answer 17

activee in mesothelioma
non small cell lung carcinoma

Question 18

what type of chemotheerapeutic agnt is used in ALL ?

Answer 18

purines / anti metabolite
6-MP

Question 19

what typee of chemotheerapeutiic agent is used in CLL ?

Answer 19

Anti-metabolite
Fludarabine

Question 20

what type of chemotherapeutic agent is used in hairy cell leukemia ?

Answer 20

anti-metabolite
Cladribine

Question 21

what are the types of anticancer antibiotics ?

Answer 21

Mitomycin
Mitoxantrone
Actinomycin
Anthracyclines
Bleomycin

Question 22

what are examples of anthracycline antibiotics ?

Answer 22

doxorubicin

Question 23

what is the mechanism of action of anticancer antibiotics ?

Answer 23

1.inhibition of topoisomerase II
2. formation of oxygen free radicals
3.inhibition of helicase

Question 24

what are the toxicities of anthracyclines ?

Answer 24

-myelosuppression
-alopecia
-mucositis
-radiosensitizer
-radiation recall phenomenon
-cardiotoxicity
- extravasation - soft tissue necrosis

Question 25

what is radiation recall phenomenon ?

Answer 25

an acute inflammatory reaction confined to an area that had been previously irradiated and is triggered after the administration of chemotherapeutic agents

Question 26

what is the cumulative dose that significantly increases the incidence of toxicity of anthracyclines ?

Answer 26

after cumulative dose of 500mg/m

Question 27

what are the types of alkylating agents ?

Answer 27

-classic alkylating agents -non classical alkylating agents

Question 28

what are the types of classic alkylating agents ?

Answer 28

nitrogen mustards aziridines alkyl alkane sulfonates Nitrosourea

Question 29

what are the types of non-classical alkylating agents ?

Answer 29

platinums triazines imdazotetrazines

Question 30

what are the type of platinum alkylating agents ?

Answer 30

cisplatin carboplatin oxaliplatin

Question 31

what are the general toxicities of alkylating agents ?

Answer 31

myelosuppression alopecia nausea and vomiting

Question 32

what are other toxicities of alkylating agents ?

Answer 32

mutagenesis carcinogens Veno-occlusive disease infertility pulmonary fibrosis

Question 33

what is the function of topoisomerase ?

Answer 33

enzymes that catalyze the formation of transient single or double stranded DNA

Question 34

what is the difference in function of topoisomerase I and II ?