T2 - Neoplasia - Pharm - Naturals/misc/antibodies

Front 1

What anti cancer drug types are considered "natural?" list them.

Back 1

antibiotics and plant products
these include antibiotics:
actinomycin D (dactinomycin), bleomycin, Daunorubicin, Doxorubicin

plants:
Camptothecin analogues, Docetaxel, Etoposide, Paclitaxel Vinblastine, Vincristine.

Front 2

Go through the antibiotics and cover the underlined facts:

Back 2

Actinomycin D (dactomycin) = HIGHLY TOXIC (underlined), limited use. DNA-intercolator (GC pairs).
underlined - used for WILM's TUMOR, and as an alternative to methotrexate for choriocarcinoma.

Bleomycin - this binds to DNA and to Fe, results in free radical release and double-strand DNA breaks. Arrests in G2 phase = cell cycle specific.
Underlined: used for Hodgkin's, Non Hodgkin's, Testicular Carcinoma. Also - NOT MYELOSUPPRESSIVE (rare trait for anti-cancer drug)
causes LUNG TOXICITY.

Anthracyclines = Daunorubicin/Doxorubicin, same mechanism. Both have CARDIOTOXICITY and MYELOSUPPRESSION.

Daunorubicin - [works by intercolation and by inhibiting topoisomerase II.]
[ONLY FOR AML (acute myelocytic leukemia)] Some cardiac toxicity.

Doxorubicin - same mechanism. [Myelosuppression and cardiotoxicity]. [CHF, related to the CUMULATIVE DOSE taken over time. Doxirubin is BROAD SPECTRUM, in contrast to danurubicin.

Front 3

What are our camptothecin analogues? Details?

Back 3

Irinotecan and Topotecan. Both work by same method - they are [PRODRUGS] which are activated by the liver into [TOPOISOMERASE INHIBITORS] - this is similar to our anthracyclines.

Irinotecan - [first line for met colorectal cancer, when used with 5-FU/Leucovorin combination]

Topotecan - [OVARIAN CANCER and SMALL CELL LUNG CANCER second lines]

Front 4

What are Etoposide and Paclitaxel?

Back 4

Etoposide is another tomoisomerase-messer, here it's a [1st line drug for testicular and small cell lung tumors]

paclitaxel - weird action! it [enhance tubulin polymerization] - so it messes with spindle fibers and arrests in M.
Used for lots of cancers (wide spectrum) - [breast, ovarian, bladder, had/neck, small/non small cell lung cancer]. NOTE - DOCETAXEL is derivative used for 2nd line therapies.

Front 5

What are the vinca alkaloids? details?

Back 5

Vinblastine and Vincristine - same mechanism, [binds microtubules and promotes DEpolymerization]. This is kinda opposite to paclitaxel. [ also results in metaphase arrest]

vinblastine: [used for KS]

vincristine: [larger spectrum of effectiveness from vinblastine. [Good for blood cancers, especially Acute Lymphoblastic Leukemia (ALL) in children]
[Allopecia and peripheral neuropathy are side effects of vincristine]

Front 6

What are our miscellaneous agents?

Back 6

Cisplatin and arboplatin,

imatinib/dasitinab

Gefitinib/Sunitib

Procarbazine

Front 7

what are cisplatin and carboplatin?

Back 7

[makes crosslinks like a lot of alkylators]
used in [testicular, ovarian, breast, bladder] cancers. NOTE - these have OTOtoxicity and NEPHROtoxicity - just like AMINOGLYCOSIDES - so don't combine with them!

Front 8

what's imatinib?

Back 8

AKA gleevac.

this is our custom made BCR/ABL fusion tyrosine kinase fighter, used to treat [CML]. [Inhibits its tyrosine kinase]. [don't forget that CML is caused by a translocation 9:22].
side effects: [hepatotoxicity and edma]


NOTE - DASITINAB is a similar drug that can be used in CML's that are resistant to imatinib.

Front 9

what's gefitinib?

Back 9

another designer drug - it's about [opposing the TK that's activated by EGFR (epidermal growth factor).]

used with [NON-small cell carcinoma that failed one previous drug regiment.]

NOTE - related to SUNITINIB - also a TK inhibitor of a lot of growth factors

Front 10

Procarbazine?

Back 10

not a designer - simple [DNA synthesis inhibitor] via alkylation, don't know how.

[TREAT HODGKIN's disease] - part of the MOPP regiment - nitrogen mustard, vincristine, procarbazine, prendisone.

Front 11

Asparginase?

Back 11

one of our miscellaneous, without a glossary entry. Eats up L-asparagine, cancer cells have trouble making more - so stop protein synthesis in tumors more than in healthy cells.

Front 12

what are our monoclonal antibodies?

Back 12

bevacizumab, cetuximab, rituximab, trastuzubmab

Front 13

bevacizumab?

Back 13

VEGF = vascular endothelial growth factor. [Bevacizumab binds up available circulating VEGF to stop cancer formation.]

[this can be a first line therapy, along with something like 5-FU, for metastatic colorectal cancer!]

bad side effects -messing with VEGF causes blood problems like [increase clot throwing = more TIA's, strokes, heart attacks and GI perforations.]

Front 14

Cetuximab?

Back 14

tries to mess with EGFR - cetuximab is [an antibody against the extracellular domain of the epithelial growth factor receptor]. Kinda like Gefinitib, 'cept that was against EGFR's tyrosine kinase.

used for [squamous cell of the head/neck. also for EGFR-expressing metastatic colorectal cancer]

Front 15

Rituximab?

Back 15

This is an antibody against Cd20 - which is on a lot of NORMAL and MALIGNANT B-cells.

so, it [acts synergistically as a part of an ANTI-LYMPHOMA] regiment.

Front 16

Trastuzumab?

Back 16

This is HERCEPTIN - the Her2 receptor antagonist.

Remember that Her2 is an EGFR variant [expressed in 25-30% of primary breast cancers].

[Herceptin inhibits breast cancer cells that express Her2.] Note that it's only used with patients whose tumors are known to overexpress this.