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50 Cards in this Set
- Front
- Back
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Actively dividing cells are at center of tumor
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Tumor killing by drugs follows
first order kinetics (i.e. a fixed fraction of tumor cells are killed during chemotherapy = Log-kill hypothesis) |
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4 phases of cell cycle:
1. G1: prep DNA synthesis 2. S: DNA replication 3. G2: proof read before division 4. M: cell division |
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G1 phase of cell cycle involves (3)
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1. prep for DNA synthesis
2. synthesis of substrates: ribo & deoxyribonucleotides 3. synthesis of enzymes for DNA formation |
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S phase of cell cycle involves
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DNA replication/Synthesis
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G2 phase of cell cycle involves
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1. proof reading [of new DNA]
2. correction of mismatches 3. protein synthesis |
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M phase
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is the separation of Chromatides and division into 2 cells
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G0 Phase is the
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differentiation into mature cell
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chemo agents broad classification
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1-cell cycle specific drugs
2-cell cycle non-specific drugs |
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cell cycle specific drugs
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These cancer chemotherapy drugs act in particular cell phase of cell cycle and are effective only against replicating cells
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cell cycle non-specific drugs
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These cancer chemotherapy drugs act at various phases of cell cycle and are effective on both replicating and resting cells (G0)
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3 principles of combination cancer chemotherapy
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1. achieve maximal killing
2. acceptable toxicity (without causing lethal organ damage) 3. prevent resistance |
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first principle of combination cancer therapy: achieve maximal killing
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Combining drugs known to be effective against tumor, ideally with different mechanism of action so that each kills a different fraction of tumor is the
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second principle of combination cancer therapy: acceptable toxicity without causing lethal organ damage
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Most anticancer cells kill both cancer cells and normal cells
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Acceptable toxicity of combination cancer therapy (2nd Principle) kills these normal cells (include effect)
((normal cells being affected by chemo agents )) |
1. Bone marrow: neutro- and thrombocytopenia
2. GI mucosa: mucositis & blisters 3. Hair Follicle: alopecia 4. Gonads: infertility |
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Because most anticancer drugs induce DNA damage, they are considered
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carcinogenic
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most carcinogenic chemotherapeutic agents
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procarbazine,
melphalan, cisplatin) |
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Principle 2 of combination cancer therapy is based on the idea that the toxicity of any one drug is mostly
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confined to one particular organ
(thus, drugs with different toxicity profile should be combined) |
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These 2 anticancer drugs' major toxicity is hemorrhagic cystitis
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1. Cyclophosphamide
2. Ifosfamide (reduced by MESNA) |
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MESNA
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1
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This anticancer drug's major toxicity is pulmonary fibrosis (LUNGS)
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Bleomycin
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Cisplatin major toxicity
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nephrotoxicity
deafness (KIDNEY & CNVIII) |
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what to add to cisplatin to reduce their nephrotoxicity and ototoxicity
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Amifostine
hydration |
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major side eefects of anthracyclins
1. Doxorubicin 2. Daunorubicin |
dilated cardiomayopathy
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how to reduce risk of dilated cardio in anthracyclin
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(reduce with Dexrazoxane)
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tetra D of anthracyclin
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D : Dilated cardiomyo
D : Doxurobicin D : Dounorubicin D : Dex-razoxane |
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major side effect of Vincristine
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periphral neuropathy
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These 3 anticancer drugs' major toxicity is bone marrow suppression
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1. Etoposide
2. Methotrexate 3. Vinblastine |
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how to decrease chemo toxicity on BM
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(reduce with Filgrastim (GM-CSF))
(MTX specific reduce with Leucovorin (THF)) |
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This anticancer drug's major toxicity is pancreatitis & bleeding
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L-asparagine
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A tumor cell has a mutation of dihydrofolate reductase enzyme develops
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resistance
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Multidrug resistance is mediated by
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p-glycoprotein
(efflux drug by ATP-dependent channel) |
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Hodgkin's Lymphoma regimen
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ABVD regimen
1. A = Adriamycin 2. B = Bleomycin 3. V = Vincristine 4. D = Dacarbazine |
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ABVD cell cycle effect
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Various Stages of Cell Cycle
1. Adriamycin at G0 2. Bleomycin at G2 3. Vincristine at M 4. Dacarbazine at G0 |
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ABVD regimen toxicity
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Toxicity at Various Organs
1. Adriamycin: Caridotoxicity 2. Bleomycine: Pulmonary Fibrosis 3. Vincristine: neurotoxicty 4. Dacarbazine: bone marrow |
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testicular cancer regimen
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BEP regimen
1. Bleomycin: G2 2. Etoposide: Late S & G2 3. CisPplatin: cell cycle nonspecific |
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BEP regimen toxicity
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1. Bleomycin: pulmonary fibrosis
2. Etoposide: Bone marrow toxic 3. Cisplatin: nephro & ototoxicity |
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Adjuvant Chemotherapy
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Chemotherapy that is added in addition to surgery or radiotherapy
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Neo-adjuvant chemotherapy
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Chemotherapy that is given before surgery to decrease the size of the tumor
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Induction chemotherapy
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Chemotherapy that is given to obtain complete remission from the tumor, usually blood cancers
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Maintenance chemotherapy
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Chemotherapy that is given to maintain remission from the cancer
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classification of chemotherapeutics
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Alklating agents
Antimetabolites Natural products Antitumor antibiotics Hormonal agents Miscellaneous agents signal transduction inhibitors |
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Alklating agents
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1. Cyclophosphamide
2. Cisplatin 3. Melphalan |
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Antimetabolites
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1. MTX
2. 5-FU 3. Gemcitabine |
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Natural products
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1. Etoposide
2. Paclitaxel 3. Vincristine |
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Antitumor antibiotics
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1. Bleomycin
2. Doxorubicin 3. Daunorubicin |
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Hormonal agents
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1. Glucocorticoids
2. Estrogens 3. Progestins 4. Anti-androgens |
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Miscellaneous agents
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. Arsenic trioxide
2. Hydroxyurea 3. L-asparaginase |
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signal transduction inhibitors
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1. Imantinib
2. Gefitinib |
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oral chemo for HCC
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sorafaneb
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