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What is the primary goal of anticancer drugs affecting DNA synthesis and function?
Selective toxicity—impairing or killing cancer cells while leaving healthy human cells unharmed
Do anticancer drugs that affect DNA synthesis discriminate between cancerous and healthy cells?
No, they can affect both and often have severe side effects
What are alkylating agents?
Some of the oldest and most powerful anticancer drugs that bind directly to DNA bases and form cross-links
How do alkylating agents disrupt DNA?
By forming cross-links between guanine nucleotides, preventing replication and transcription, and potentially breaking the DNA chain
Give examples of alkylating agents
Chlorambucil and cyclophosphamide
What are anti-tumor antibiotics?
Drugs that insert themselves into the DNA strand, inhibiting transcription or causing direct breaks; originally antibacterials but too toxic for infections
Give examples of anti-tumor antibiotics
Bleomycin, daunorubicin, mitomycin, streptomycin
What are platinum coordination complexes?
Drugs containing platinum that insert into DNA, blocking or breaking it to prevent replication
Give examples of platinum coordination complexes
Cisplatin, carboplatin, oxaliplatin
What are topoisomerases?
Key enzymes necessary for DNA replication that relieve tension on DNA as it splits during cell division
How do topoisomerase inhibitors work?
They prevent topoisomerases from functioning, causing DNA to break during division
Give examples of Type I topoisomerase inhibitors
Etoposide and teniposide
Give examples of Type II topoisomerase inhibitors
Irinotecan and topotecan
What are antimetabolites?
Drugs that act on DNA synthesis pathways by inhibiting enzymes or substituting for DNA building blocks
How do antimetabolites stop cell division?
By impairing the creation of new DNA, which halts cell division
Give examples of antimetabolites
Fluorouracil and methotrexate
What is the mitotic apparatus made of, and why is it important?
Microtubules, essential for a cell to divide into two new cells
How do antimicrotubule agents affect cancer cells?
They disrupt microtubules, speeding, slowing, or stopping mitosis, often causing cell self-destruction
What are vinca alkaloids and how do they work?
Drugs that inhibit the formation of microtubules
Give examples of vinca alkaloids
Vinblastine, vincristine, vinorelbine
What are taxanes and how do they work?
Drugs that freeze the mitotic apparatus partway through division, causing the cell to self-destruct
Give examples of taxanes
Docetaxel and paclitaxel
What is the goal of hormonal therapies in cancer?
To inhibit the production or block the effects of hormones accelerating tumor growth
How do hormonal therapies work for breast cancer?
Aromatase inhibitors reduce estrogen production, slowing hormone-sensitive cancer growth
How do hormonal therapies work for prostate cancer?
Androgen receptor blockers prevent androgens from accelerating cancer growth
How can hormones like prednisone affect cancer cells?
They can inhibit cell proliferation or induce cell death in certain cells, such as lymphocytes in leukemias and lymphomas
Are hormonal therapies usually curative?
No, they often delay cancer growth to allow other interventions like radiation or surgery
What is the main advantage of targeted therapies over conventional anticancer drugs?
They focus on specific traits of cancer cells, producing fewer toxic effects on healthy cells
What are monoclonal antibodies (MABs) and how do they work?
Laboratory-synthesized antibodies that bind to antigens on cancer cells, blocking division signals, initiating apoptosis, or inhibiting angiogenesis
What are tyrosine kinase inhibitors (TKIs) and how do they work?
Drugs that bind abnormal or overactive tyrosine kinase enzymes on cancer cells, preventing excessive cell division
Give examples of TKIs and their naming pattern
Erlotinib, gefitinib, imatinib; names often end in "-nib"
What are immunotherapies designed to do?
Boost or activate the immune system's ability to recognize and kill cancer cells
What are cytokines and how do they work in cancer therapy?
Small messenger proteins that can inhibit cell division, promote cell death, or encourage cytotoxic cells to attack cancer cells
Give examples of cytokines used in cancer therapy
Interferons (INF alpha 2b) and interleukins (IL-2)
How do some monoclonal antibodies help the immune system fight cancer?
They sensitize cancer cells so T lymphocytes can recognize and attack them or act as checkpoint inhibitors to prevent immune suppression
How can vaccines help prevent cancer?
By preventing infections that may lead to cancers, such as HPV and Hepatitis B vaccines
What is adoptive cell transfer?
A technique where a patient's T cells are removed, grown in a lab, and reinfused at higher concentrations
How can adoptive cell transfer be enhanced?
Genetically modifying T cells to become "serial killer cells" that more effectively find and destroy cancer cells
What does asparaginase do in cancer treatment?
Deprives tumor cells of asparagine, a necessary factor for cell division
What do histone deacetylase inhibitors do?
Affect the molecules that package DNA within the cell
What is the role of retinoids in cancer therapy?
Help undifferentiated cancer cells function more like normal cells
Why is combination chemotherapy used?
To combat cancer with a multi-pronged approach using multiple drugs
Give examples of combination chemotherapy acronyms and their associated cancers
ABVD for Hodgkin's Lymphoma
CMF for early-stage breast cancer
FOLFOX for colorectal cancer
What are common side effects of conventional chemotherapy?
Hair loss
Gastrointestinal problems
Anemia and fatigue
Neurotoxicity
Cardiotoxicity
Skin rashes
Why do conventional chemotherapy drugs cause these side effects?
They do not discriminate between healthy and cancerous cells, affecting tissues that constantly replicate
How are targeted therapies changing side effects?
They reduce severe side effects because they more selectively target cancer cells
How can physical therapists help cancer patients during treatment?
Manage pain
Promote exercise
Maintain strength
Range of motion
Cardiovascular function
What role do physical therapists play in cancer prevention?
Advise on:
Regular exercise
Quitting smoking
Low-fat and high-fiber diet
Sunscreen use
UV avoidance
Early detection through screenings and self-exams
What are some future perspectives in oncology?
More effective targeted therapies
More infection-preventing vaccines
Drugs that protect healthy cells from chemotherapy
Personalized oncology based on patient and cancer genetics