Cancer Chemotherapy Review

These flashcards review key concepts and information regarding cancer chemotherapy, including definitions, mechanisms of action, and treatment options.

What are the four characteristics that distinguish cancer cells from normal cells?

Uncontrolled proliferation, dedifferentiation and loss of function, invasiveness, and metastasis.

What is carcinogenesis?

Carcinogenesis is a multistage process that is genetically regulated, involving initiation, promotion, and progression.

What happens during the initiation stage of carcinogenesis?

Normal cells are exposed to carcinogens which produce genetic alterations; if not repaired, these alterations lead to irreversible changes and a clonal population of cancer cells.

What role does promotion play in carcinogenesis?

Carcinogens alter the environment, allowing the growth of altered cells over normal cells; this stage can be affected by chemoprevention strategies.

What is the final step of carcinogenesis called?

Progression, which involves further genetic alterations leading to increased cell proliferation and potential metastasis.

What factors influence the incidence and distribution of specific cancers?

Sex, age, race, genetic predisposition, and environmental carcinogen exposure.

Name a significant risk factor for developing certain cancers.

Exposure to ionizing radiation, which induces mutations through the formation of free radicals.

Examples of chemical carcinogens?

Tobacco smoke, azo dyes, aflatoxins, asbestos, benzene, and radon.

Which viruses are associated with specific human cancers?

Hepatitis B and C (hepatocellular cancer), HIV (Hodgkin’s and non-Hodgkin’s lymphomas), and human papillomavirus (HPV) (cervical, anal, penile cancers).

What are oncogenes?

Oncogenes develop from normal proto-oncogenes, which control cellular functions and can induce malignant changes.

What is the function of tumor suppressor genes?

They regulate and inhibit inappropriate cellular growth and proliferation, and their mutation is involved in many cancers.

What is the ultimate goal of chemotherapy?

The ultimate goal is a cure, achieving disease-free survival.

What are the three main approaches to treating established cancer?

Surgical excision, irradiation, and drug therapy (chemotherapy).

Describe the significance of combination chemotherapy.

It provides maximal cell kill within tolerated toxicity levels, offers a broader range of drug interactions, and may prevent drug resistance.

What adverse effect is commonly associated with cisplatin?

Nephrotoxicity and severe vomiting.

What type of drugs are antimetabolites?

Chemotherapy agents that resemble nucleotides and disrupt DNA and RNA replication.

What is the mechanism of action of Methotrexate?

Methotrexate binds to dihydrofolate reductase, inhibiting the synthesis of tetrahydrofolate, leading to disrupted DNA and RNA formation.

List some side effects of bleomycin.

Skin toxicity, pulmonary fibrosis, mucositis, alopecia, allergic reactions.

What effect does tamoxifen have in breast cancer treatment?

It acts as an estrogen antagonist, binding to estrogen receptors to suppress growth-promoting hormone effects.

What are some adverse effects of tamoxifen?

Hot flashes, nausea, skin rash, vaginal bleeding, increased pain in metastasized bone, and risk of endometrial cancer.

Example of cancer cytotoxic Alkylating agents

Cyclophosphamide, Ifosfamide, Dcarbazine, Mechlorethamine, Carmustine

Example of cancer cytotoxic Platinum coordination complexes

Cisplatin, Carboplatin

Example of cancer cytotoxic Microtubule damaging agents

Paclitaxel, Docetaxel, Vincristine, Vinblastine

Example of cancer cytotoxic antimetabolites, folate antagonist

Methotrexate and Pemetrexed

Example of cancer cytotoxic antimetabolites, purine anatagonist

6- mercaptopurine, azathiopurine

Example of cancer cytotoxic antimetabolites, pyrimidine antagonist

5-fluorouracil

Example of cancer cytotoxic Topoismerase-2 inhibitors

Etoposide

Example of cancer cytotoxic Topoismerase-1 inhibitors

Irinotecan, topotecan

Example of cancer cytotoxic antibiotics

Doxorubicin, bleomycin, actinomycin D, mitomycin C, daunorubicin

Example of cancer targeted Tyrosine protein kinase inhibitors

Imatinib, nilotinib,

Example of cancer targeted EGF receptor inhibitors

Erlotinib, gefitinib

Example of targeted Angiogenesis inhibitors

Bevacizumab, sunitinib

Example of targeted Proteasome inhibitors

Bortezomib

Example of targeted Unarmed monoclonal antibody

Rituximab, trastuzumab

Example of hormonal Glucocorticoids

Prednisolone

Example of hormonal Estrogens

Fosfestrol, Ethinylestradiol

Example of hormonal Selective estrogen receptor modulators

Tamoxifen

Example of hormonal Selective estrogen receptor down regulators

Fulvestrant

Example of hormonal Aromatase inhibitors

Letrozole, Anastrozole

Example of hormonal Antiandrogen

Flutamide

Example of hormonal 5-α reductase inhibitors

Finasteride

Example of hormonal GnRH analogues

 Nafarelin, leuprorelin

Example of hormonal Progestins

Hydroxyprogesterone

Platinum Coordination Complexes, Metallating agents example

cisplatin, carboplatin (2nd), oxaliplatin (3rd)

Cisplatin MOA

binds to DNA through formation of intrastrand and interstrand cross-links, disrupting DNA replication and transcription. It binds to both cytoplasmic and nuclear proteins. This alkylating action inhibits cell division and promotes apoptosis in cancer cells.

Uses of cisplatin

primarily used in the treatment of various cancers including testicular, ovarian, bladder, lung cancers, esophageal, gastric, hepatic, head and neck carcinomas.

cisplatin adverse effects

includes nephrotoxicity, ototoxicity, peripheral neuropathy, nausea, vomiting, and myelosuppression.

Antimetabolites

similar to nucleotides that make up DNA and RNA. The body often mistakes these chemotherapy agents for naturally occuring nucleotides bases and metabolizes these agents as natural nucleotides. ultimately disrupt replication and cell division by interfering with the production of nucleic acids, DNA, and RNA.

Methotrexate MOA

a folic acid analog that binds to dihydrofolate reductase (DHFR).

→ This results in inhibition of synthesis of tetrahydrofolate (THF)→ interferes with the formation of DNA, RNA, and key cellular proteins