What are treatment options for cancer?
What are the steps of the cell cycle?
G1 (gap 1, preparation for DNA replication)
R (restriction point, point in G1 where the cell becomes committed)
S (DNA replication)
G2 (preparation for mitosis)
M (mitosis, cell divsion)
What happens during G1 (gap 1)?
Preparation for DNA replication
What is R during the cell cycle?
Restriction point, where the cell become committed
What happens during S?
What happens during G2?
Preparation for mitosis
What happens during M?
Mitosis, cell division
What are things that make the cell cycle go around?
What makes the cell cycle stop?
Tumour suppresor genes
What does chemo delivery do?
Reduces the amount of cells
What happens if the interval between chemo delivery is to long?
The cells grow back
How is systematic therapy delivered?
Oral or intravenous route
Regular cycles with timing dependent on the findings from pharmacokinetics (half life, excretion)
May need to delay treatment if toxicites develop
What needs to happen to chemotherapy if toxicities develop?
It needs to be delayed
What are methods of assessing drug therapy?
What may assessing drug activity help?
Overall survival (OS)
Progression-free survival (PFS)
Improved quality of life (QoL)
What is progression free survival?
Length of time during and after treatment of a disease that a patient lives with the disease but it does not get any worse
What is overall survival?
The length of time from either the diagnosis or the start of treatment for a disease that the patient is still alive
What does an adjuvant do?
What does a neoadjuvant do?
May improve survival through increasing operability
What is adjuvant treatment?
Treatment given in addition to a primary treatment
What is neoadjuvant chemotherapy?
Medicines administered before surgery for the treatment of cancer
What are some different classes of cytotoxic agents?
What are some sites of action for cytotoxic agents?
Anti-metabolites prevent RNA synthesis by binding to DNA
Alkylating agents cross link guanine nucleobases, directly attacking DNA
Intercalating agents wedge between bases along DNA to stop polymerase and other proteins from binding (preventing DNA transcription and DNA duplication)
Spindle poisons act on tubulin, which forms the microtubules that attach to chromosomes during mitosis
What do alkylating agents do?
Attach to free guanines on seperated DNA strands, impairing DNA replication
What does the alkyl group of an alkylating agent allow?
Covalent bonds with other molecules
What is an example of an alkylating agent?
What are some mechanisms of resistance against alkylating agents?
Decreases entry or increases exit of agent in cell
Inactivation of agent in cell
Enhanced repair of DNA lesions produced by alkylation
How do antimetabolites work?
Similar structure to essential metabolites required by cell prior to cell division
Can be incorporated into new nuclear material or bind with vital enzymes
What are examples of antimetabolites?
Antagonise folic acid
What are examples of spindle poisons?