Targeted Cancer Therapy (REVISE)

Question 1

Outlook for Ovarian Cancer

Answer 1

Poor

Question 2

Typical Symptoms for Ovarian Cancer

Answer 2

Non-specific abdominal pain that may be misinterpreted as IBS
Pain during intercourse/vaginal bleeding
Increased urination
Other typical cancer symptoms (weight loss, fatigue, etc)

Question 3

What is targeted during targeted cancer approaches

Answer 3

Faulty genes
Faulty signalling systems
Tumour growth
Angiogenesis

Hormones responsible to promoting tumour growth (e.g. oestrogen in breast cancer)

Molecular testing of cancer cells to determine receptor expression

Question 4

Hormone-based therapy in breast cancer

Answer 4

REVISE REVISE REVISE (EASY BUT NEEDS TO BE DONE FROM LECTURE)

Question 5

Tamoxifen

Answer 5

Blocks oestrogen as a selective oestrogen-receptor modulator (SERM)
Prevents breast cancer and reduces growth of oestrogen-driven breast cancer

Used in oestrogen receptor positive breast cancer

As a receptor modulator: prevents bone loss via oestrogenic effects (prevents osteoperosis)

REVISE/SPLIT

Question 6

Mechanism of Tamoxifen

Answer 6

REVISE

Question 7

Aromatase

Answer 7

Enzymes that convert androgens (like testosterones) into oestrogen

Question 8

Aromatase Inhibitors

Answer 8

Anastrozole

Prevents peripheral conversion to oestrogens in post-menopausal women
REVISE

Question 9

HER2

Answer 9

Human Epidermal Growth Factor Receptor 2

Naturally present at low levels but over expressed in some cancers due to oncogenes (more commonly over-expressed in older patients)

Affects gene transcription & cell cycle causing over proliferation

Question 10

Trastuzumab

Answer 10

Monoclonal Antibody targeting cells that express the HER2 Receptor

Slows down/kills of metastatic breast cancer with HER2 positive tumours

Question 11

Epidermal Growth Factor (EGF receptor) kinase

Answer 11

Erlotinib

‘Small molecule’ approach

Certain lung and pancreatic cancers

Tyrosine Kinase Inhibiror

Question 12

Chronic Myeloid Leukaemia

Answer 12

Associated with a Philadelphia chromosome

Produces bcr-abl protein which has tyrosine kinase activity

**DONT NEED TO LEARN CHROMOSOME NUMBERS

REVISE

Question 13

Tyrosine Kinase Inhibitor

Answer 13

Tyrosine Kinase leads to uncontrolled cell proliferation

Imitinib inhibits TK activity

Selective inhibitor very effective for chronic nyeloid leukaemia

Question 14

PARP Inhibitors

Answer 14

Olaparib

PARP - Poly (ADP-ribose) Polymerase; repairs DNA

BRCA genes important in DNA repair at double strand breaks, PARP enzyme repairs single strand breaks

Inhibits the ability to repair itself at single strand breaks causing cell death for cancer cells

Approved for some forms of ovarian cancer

REVISE (EASY)

Question 15

Proteasome inhibitor

Answer 15

Proteosomes: Cellular structures which degrade proteins

Some proteins kill cancer cells: pro-apoptotic factors

Inhibition of intracellular proteasomes alters the regulation of intracellular proteins and prevents the breakdown of these pro-apoptotic factor

Question 16

Angiogenesis

Answer 16

Blood vessel growth to support metastasis

Question 17

Anti-VEGF

Answer 17

Vascular Endothelial Growth Factor

VEGF secreted to promote angiogenesis

Bevacizumab - mAB for advanced colonic & breast cancer

Sunitinib - Inhibits VEGF-associated receptor tyrosine kinase
- Advanced renal carcinoma