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23 Cards in this Set
- Front
- Back
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What is the Skipper model of cell kinetics?
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For tumors with constant growth rate, the ANP drug follows log cell-kill kinetics.
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Define log cell-kill kinetics.
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Cell kill is proportional regardless of the tumor burden.
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What are the closest human models to the Skipper model?
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Trophoblastic neoplasms, germ cell tumors, and Burkitt lymphoma.
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How do most solid human tumors grow?
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According to the Gompertzian model.
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What is the Gompertzian model of cell kinetics?
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Tumor growth fraction is not constant by decreases exponentially with time.
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According to the Gompertzian model, when does growth rate peak?
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When the tumor reaches 37% of its maximum size.
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Chemotherapy that response to Gompertzian tumors depends on what?
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Where the tumor is in its particular growth curve.
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In the Gompertzian model, __ is highest early but __ is slow.
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Growth fraction is high early but growth rate is slow.
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This model of cell-kill only applies to dividing cells.
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Skipper model.
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What are the two causes of kinetic resistance to chemotherapy?
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1. Growth of tumor > blood supply 2. Cells exit cycle into G0
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What are two therapeutic strategies that increase cell cycling in a tumor? Why use these strategies?
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1. Debulking tumor to stimulate cell proliferation 2. Priming leukemia cells with G-CSF to recruit more cells
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What makes kinetic resistance reversible?
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The cell reenters the cell cycle.
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Describe genetic resistance to chemotherapy.
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Mutations throughout generations of the cancer cells.
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Describe the Goldie-Coldman hypothesis.
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It is much less likely that cancer cells will become resistant to multiple drugs at the same time.
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Why do normal tissues never develop resistance to chemo?
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Presence of normal p53.
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This can lead to resistance against all chemo agents.
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Loss of apoptosis (increase in BAX expression, loss of p53 and Bcl2).
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What should be the dose-limiting factor for combined chemo drugs?
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Toxicity.
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Name the two kinds of cells found in a tumor.
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1. Tumor stem cells - capable of reconstituting the cancer 2. Transient amplifying cells - sensitive to chemotherapy
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Name three means of supportive care for chemo patients. These practices limited __ and allow __.
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Recombinant growth factor, blood product transfusion, and modern antibiotics. Limit chemo toxicity and allow greater dose intensity.
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Describe the effect of chemo on normal tissues.
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Cumulative.
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How are most chemo agents metabolized and excreted?
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Metabolized by the liver and excreted by the kidney.
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Define average dose per week.
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Steep dose-response curve and modest dose reduction.
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Rescue = ?
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Increased dose intensity.
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