Chemo

Question 1

Goal of chemo

Answer 1

kill 100% cells
- if not possible, control growth and palliative

Question 2

growth fraction

Answer 2

ratio of proliferating cells to resting cells

Question 3

higher GF means…

Answer 3

higher chance of chemo working
- more malignant tumor

Question 4

lower GF means…

Answer 4

bigger tumor, dec GF and slower growing

Question 5

Barriers to chemo

Answer 5

• need 100% kill
• tox
• tumor response
• late detection
• drug resistance
• cell heterogeneity (leads to resistance)–find right combo to kill all cells

Question 6

tumor heterogeneity increases with…

Answer 6

AGE

Question 7

tumor resistance

Answer 7

Mutations become very resistance; 1 tumor can have 1 million bits

Question 8

same dose therapy

Answer 8

• need same dose for cancer every time (high dose) bc same dose kills same # of cells each time

Question 9

chemo most toxic drugs EVER

Answer 9

• often late detection, lead to mets, less responsive, worsen debilitation (may not tolerate)
• earliest detection is 1 cm tumor
• solid tumor responds worse bc dec GF and limited blood supply

Question 10

Intermittent chemo

Answer 10

• lets normal cells recover but not too long before next dose
• GI and epi recover quicker

Question 11

combo therapy

Answer 11

• multiple drug better than one
• dec resistance and normal cell injury
• don’t want to give multiple drugs with similar toxicity (ex: 2 nephrotox)

Question 12

optimal dosing therapy

Answer 12

• keep active drug present in body as long as can
• maximize result

Question 13

Regional drug therapy

Answer 13

• target tumor and not normal cells
• dec systemic tox

Question 14

Usual chemo toxicities

Answer 14

• n/v–trigger CTZ
• dec WBCs, RBCs, plts 2W post-tx (neutro, erythrocytopenia, thrombo)
• diarrhea
• fatigue
• alopecia (reversible–7-14d post-surg)
• reprod–fetus, germinal epi of testes, don’t get preg, may do sperm bank
• hyperuricemia–cell death and destroy (allopurinol)
• bone marrow supp
• stomatitis
• digestive tract injury–mouth to rectum
• extravasation
• carcinogenic organ damage to kidneys, heart, and lungs

Question 15

Anticancer agents

Answer 15

cytotoxic, hormonal, biologicals, targeted drugs
- often combined to kill cancer and dec SE

Question 16

Cell cycle specific drugs

Answer 16

• worse at treating prolif cells
• treats G0 or S

Question 17

immune checkpoint inhibitors

Answer 17

lets immune cells respond strongly

Question 18

t-cell transfer therapy

Answer 18

boosts t cell activity by adding lab grown cells to the body

Question 19

monoclonal antibody therapy

Answer 19

marks cancer cells so they are seen better

Question 20

Immune system modulators

Answer 20

enhance response; slow tumor growth