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29 Cards in this Set
- Front
- Back
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What was the first effective chemotherapy agent found to benefit patients with advanced-stage-lymphoma?
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Mechlorethamine (Nitrogen Mustard)
1940s |
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Other than rare exceptions, how were most chemotherapeutic agents identified?
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Empirical observations
(rather than scientific efforts) |
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As of 2007, what is the overall cure rate for childhood cancer?
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75%
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What are 2 of the important discoveries made in the 1940s in the field of cancer chemotherapy?
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1. Anti-tumor antibodies
2. Use of folic-acid antagonists to treat leukemia |
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Who discovered the first folic-acid antagonist and is noted to have induced the first remission ever in childhood leukemia?
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Dr. Sydney Farber, 1947
- using Aminopterin (a predecessor to methotrexate) |
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What significant progress was made in the 1950s in regards to chemotherapy?
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The development of new chemotherapeutic drugs. Such as:
- Fluorouracil (5-FU) - 6-thioguanine (6-TG) - mercaptopurine (Purinethol) - Dactinomycin (actinomycin-D) - Methotrexate (Mexate) - Cyclophosphamide (Cytoxan) - Melphalan (Alkeran) - Busulfan (Myleran) |
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What 2 important study groups were formed in 1954?
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1. Cancer & Leukemia Group B
2. Children's Cancer Group |
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In what year did the first randomized clinical trials begin?
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1955
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Since 1955 how were all chemotherapy-related research efforts funded in the U.S.?
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Government funding
- for National chemotherapy program |
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What significant advancement was made in the 1960s in regards to combination chemotherapy?
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Initiation of combination of:
Vincristine, Doxorubicin, Methotrexate, and prednisone for acute leukemia. |
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Why was the discovery of the combination chemo for leukemia so significant in the 1960s?
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For first time, a combination of 4 drugs, each w/different mechanisms of action, were given as intensive intermittent therapy.
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What did the design of a 4-drug chemotherapy administration allow?
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- dosing that produced maximum effectiveness
- time for recovery of normal cells after each course |
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What agents were also discovered and used for first time in the 1960s & 70s?
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- Platinum agents
- MOPP (mechlorethamine, vincristine, prednisone, procarbazine) for Hodgkins |
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T or F: Phase 1 trials for adriamycin began in the 1970s
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True
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What other discovery was noted in the 1970s that was based on sanctuary theory that leukemic blasts could survive in the CSF and seed the BM?
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Intrathecal methotrexate injections to control spread of leukemia to meninges
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What was added to all leukemia protocols, by St. Jude's Childrens Research Hospital in early 1970s?
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CNS prophylaxis
- dramatically improved cure rates |
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What did the belief that cancer tumor first developed locally, then spread to regional nodes, then metastasized, lead to?
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The use of adjuvant chemotherapy following less radical surgery & systemic chemo for metastases?
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What cooperative pediatric groups evolved from Acute Leukemia & Cancer Cooperative Groups A & B, between 1969 & 1980?
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1. Children's Cancer Study Group, 1974
2. Pediatric Oncology Group (POG), 1980 3. National Wilms Tumor Study Group, 1969 4. Intergroup Rhabdomyosarcoma Study Group, 1972 |
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What did the 1980s introduce in regards to chemotherapeutic agentS?
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Topoisomerase inhibitors
- Tenoposide - Etoposide - Camptothecin analog - Irinotecan - Taxane - Paclitaxel (Taxol) |
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What chemo introduce in the 1980s was found to be effective against ovarian cancer?
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Paclitaxel (Taxol)
- NCI signed research agreement w/Bristol-Myers Squibb, resulting in 1st commercially profitable chemo |
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What was more effectively addressed in the 1990s?
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therapies that addressed side effects
- nausea/vomiting = Ondansetron - shortening postchemo BM nadirs = Neuopogen - ameliorate cardiac & bladder toxicities= dexrazoxane & mesna |
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What led to the accomplishment of being able to increase chemotherapy doses?
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Bone marrow & cord-blood transplants
Stem cell rescue Growth factors |
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What was the goal in the 1990s with chemotherapy
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- to promote continued improvement in survival rates while delivering smallest amount of drug possible
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What did giving the smallest dose possible prevent?
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Unnecessary late effects
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In 2004, what chemo was the first to be approved by the US FDA for refractory pediatric ALL WITHOUT the prior approval for an adult indication?
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Clofarabine
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What FDA rule in 1998 encouraged pharmaceutical companies to develop pediatric agents?
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'Pediatric Rule' led to the 'Best Pharmaceuticals for Children Act'
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What groups merged in 2003 to form the Children's Oncology Group?
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1. UK Children's Cancer Study Group
2. Pediatric Oncology Group 3. National Wilms Tumor Study Group 4. Intergroup Rhabdomyosarcoma Study Group |
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What led to gene testing in leukemia patients that experienced myelosuppression out of proportion for treatment with mercaptopurine & thioquanine?
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Pharmacogenetics, study of genetic variations in drug processing genes & a child's ability to process drugs
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What is expected in the future for chemotherapeutic agents & therapies?
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molecularly targeted agents, such as Gleevac for CML
- combination therapy with targeted agents & traditional cytotoxic agents |
