Cancer therapy
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- Created by: LUFCMazza
- Created on: 17-08-20 13:16
Local therapies include...
surgery and radiotherapy
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Systemic therapies
such as cytotoxic drugs, hormonal therapies, moleculalry targeted therapies
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what are some cytotoxic drugs?
antimetabolites, alkulating agnets and platinum drugs. Topoisomerase inhibitors (fluoroquinolones), anti-mitotic drugs, work ot inhibit cell proliferation and induce cell death, inhibit DNA replicaiton and RNA synthesis, DNA damaged based therapies s
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since
normal cells can deal with tehse better than cancer cells
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what's palliative chemotherapy
prolong survival and control symptoms, reduce tumour bulk, slow growth, delay devleopment of new lesions
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chemosensitiity of tumours- high?
acute lymphoblastic, small cell lung cacner
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medium
ovarian and breast cancer
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low
pancreatic, endometrial and malignant
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methotrexate
antimetabolite, inhibits DHFR needed in tetrahydrofolate synthesis, so folic acid syntehsis is inhibited, no purines and so RNA and DNA replication
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alkulating agents
chemically damaged DNA
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cyclopshophamide
irreversibel cross links formed between guanine bases, detoxicfication of aldophospahamide intermediate so sleectivity for cells ith low ALDH.a ctive in autoimmune diseas (lupus, RA)
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cisplatin
dispalcement of chloride ligands by water allowing cross-linking of DNA bases by platinum, intra strand DNA cross links= cytootoxiisty
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used in
testicular cancer
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anti-tumour antibiotic?
bidn DNA, inhibit topoisomerase
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doxorybici
DNA intercalating antrhacycline, inhibits DNA topoisomerase II and stabilises reaciton intermediate where both DNA strands are broken, most toxic in G2 phase
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vincristine
anti microtubule agent inhibits tubulin polymerisation and prevents assembly of mitotic spindle- arrests cell in metpahase
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taxanes
antimitotic drug, prevents disassembly of microtubules
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tamoxifen
-- hydroxytamoxifen = oestrogen receptor antagonist = inhibits ER dependent transcription, arrests growth of ER positive berast cancer. Oestrogenic agonsit effect endometruim. Aromatase inhibitors block peripheral oestr
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oestrogen syntehss
in post-menopausal women
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aromatase inhibitors
block extra-ovarian oestrogen syntehsis in post-menopausal women (breast cancer)
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reduce testosterone
to treat prostatic tumours (orhcidectomy, drugs to depress LH release and anti-androgens)
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trastuzumab?
therapeutic antibodies against GF receptors (breast cnacer)
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Imatinib?
inhibitor of tyorisne kinase actiivty, high response rates in early CML (chronic myeloid leukaemia.)
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Inhibits
TK in GI stromal tumours
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Mutaiton in
BCR-ABL = emergence of resistanc
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what;s alopecia?
cold caps cool scalp during therapy and limit hair loss, reduce blood circulationand redyces drug delievery to scalp
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bone marrow toxicity
neutrophil count v low, fever bacteraemia
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hand foot syndrome seen with
methrotrexate or doxorubicin, tingling, burning or peeling
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Extravasion of cytotoxic drugs?
drugs leak into local tissue at the site of infusion, due to vascular damage or fragile veins, toxicity is non-specific and causes this
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lowered risk when
PICC used which rapidly dilates drug via deliver into vena cav
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small lyng cancers use
CAV
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what's the philadelphia chromosome translocation?
it is a reciprocal translocation- drives chronic myeloid leukaemia (CML) -- generation of BCR-ABL fusion genes in CML -- deregulated TK activity
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HER2?
mutation is seen in breast and ovarian cancers
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what is overexpressed
EGFR tyrosine kinases
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whta mAB is used?
trastuzumab
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DNA damage checked for in the
S stage
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Chekc in G1 if
mitogen levels are sufficient
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Check in M phase if
chromosomes are attached to spindle
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chemotherapies work at differnet stages of cell cycle. G1...
tamoxifen, trastuzumab
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S
cyclophosphamide, cisplatin
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M
doxorubicin, vincristine
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Drug resistance?
efflux pumps, decreased drug uptake, increased metabolism, impair apototic pathway,
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Metastasis...
benign- loss of growth contorl, local growth at the site of origin, confined to initiating tissue, clear capsele, clinical signs related to local space occupying or differentiated protein production (hormones), treated with surgery
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alignant
.
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characterisitcs of cance
invasion, metastasis, progression,pkenorphic, anaplasia
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trabsformation
change from epithelial cell to fibroblast cell
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invasion
loss of integrity in basement membrane and extension of tumour into local tissue
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metastasis
loss of control of cell grwoth, loss of orgnaisation and localsiation, spread to unrelated organ
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pleomorphism
ability of tumour to vary in size and shape of cell and their nuceli
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anaplasia
complete lack of differentiation, seen in malignancy
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Other cards in this set
Card 2
Front
Systemic therapies
Back
such as cytotoxic drugs, hormonal therapies, moleculalry targeted therapies
Card 3
Front
what are some cytotoxic drugs?
Back
Card 4
Front
since
Back
Card 5
Front
what's palliative chemotherapy
Back
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