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28 Cards in this Set
- Front
- Back
what is Induction:
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Given to induce a remission. Commonly used in the treatment of acute leukemias
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what is Adjuvant
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Used after initial surgical or radiation therapy to minimize recurrence
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what is Neoadjuvant
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Given prior to surgery or radiation to reduce tumor burden
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what is Salvage
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Used after recurrence of refractory tumor following chemo
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what is Chemosensitive
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Given concurrently with radiation to increase radiosensitivity
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what is Palliative
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Given specifically to address symptom management without expecting to significantly reduce the cancer
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to 'cure' cancer what do you need?
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need 100% cell kill
Can’t rely on host immunological defense to kill remaining cancer cells |
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what is meant by Clinically complete remission
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tumor size decreased to a size no longer detectable clinically
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antimicrobial vs anticancer drugs:
selective toxicity |
Antimicrobial: high selective tox (won't hurt human cells)
Anticancer: limited selective tox (hits human cells) |
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what is one of the major targets of cancer (a process)
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Mitotic activity
to stop cell division |
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Rapidly dividing cells are most vulnerable to chemotherapy...what normal tissues are most likely to be affected by these drugs (3)
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Bone marrow
GI tract (NVD) Hair follicles |
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a major tumor determinant is...(something that will affect the responsiveness to cancer chemo)
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Growth fraction; tumor mass doubling time
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what is the relationship between tumor growth fraction and drug susceptibility?
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larger growth fraction --> increased drug susceptibility
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what is the relationship between tumor mass doubling time and drug susceptibility?
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faster doubling time --> increased drug susceptibility
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one complication to effective tx is the fact that the tumor cells are of a _____ population
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heterogeneous population
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KNOW: Tumor Cell population is continuously changing
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Number of dividing vs resting cells change
Biochemical/biological character change Number of cells than can metastasize change |
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KNOW SLIDE:
Solid Tumors Most tumors do not grow “rapidly” like leukemias and lymphomas Growth rate decreases as neoplasm size increase Tumor outgrows ability to maintain blood supply Not all cells proliferate continuously |
Compartments
Dividing cells vs non-dividing cells(Varies. Dividing cells may be ~5% tumor volume) Dividing cells are the primary population susceptible to most anticancer drugs |
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What is the log kill hypothesis?
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Each dose kills a certain fraction (not number) of cells
The fraction killed is dose-dependent Chemotherapy is limited by the drug toxicity (dose-limiting toxicities) Repeated doses are needed and cell kill follows first order kinetics |
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starting with 1x10^12, go over log kill tx
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what does increased tumor size do to drug susceptibility?
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decreases it
Larger tumors are harder to kill more difficult for drugs to penetrate poor vascularization many cells not proliferating less sensitive to drug therapy more metastasis occurring more therapy (time) required, more toxicity |
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a clinically detectable tumor is what size?
lethal? |
clinical: 1x10^9
lethal: 1x10^12 |
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describe CCS (cell-cycle specific) cancer drugs
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Cells must be mitotically active for drug to produce its effects
Drug target is only available at a particular phase of the cell cycle |
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describe CCNS (cell-cycle non-specific) cancer drgus
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Drug effect may be enhanced but not dependent on mitotic activity
if it can see the DNA it will modify it |
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what is responsible for removing water soluble products from cells (and can act as an efflux pump)
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P-glycoprotein
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Efflux pumps are a problem for what type of cancer drugs?
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Natural product drugs
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in general, what kind of therapy should you use for cancer tx? what 3 things does this method aid in?
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COMBINATION
Maximizes cell kill by using different attack mechanisms Decreases resistance development Decreases doses and toxicities |
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doxorubicin has what unique adverse affect?
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Cardiotoxicity
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bleomycin has what unique adverse affect?
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Pulmonary fibrosis
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