Mer Scott
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PHCY320 (Oncology) Quiz sobre ON5 Cytotoxic resistance and endocrine therapy, criado por Mer Scott em 06-10-2019.

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Mer Scott
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ON5 Cytotoxic resistance and endocrine therapy

Questão 1 de 13

1

Primary resistance: No to administration
Acquired resistance: Initial –> tumour reappears –> patient
Caused by
- Alterations in drug
- Modifications to

Arraste e solte para completar o texto.

    response
    regression
    relapses
    metabolism
    drug target

Explicação

Questão 2 de 13

1

Resistance mechanisms:
1. Reduced drug
E.g. MTX uptake via reduced folate carrier
2. Alteration of drug targets
e.g. Production of DNA TopII with resistance to
3. Decreased drug concentration ( prodrug activation)
e.g. high GST levels inactivate
4. Increased of drug
e.g. P glycoprotein and multidrug resistance-related protein with

Arraste e solte para completar o texto.

    uptake
    intracellular
    anthracyclines
    decreased
    cisplatin, alkylating agents
    removal
    vincas, taxanes, anthracylines

Explicação

Questão 3 de 13

1

Where do resistant cells come from?

Theory 1: Only cells survive therapy, and repopulate tumour.
Theory 2: Mutations present post-therapy are for.
Combined model: Escape from growth control, present, over time we see structural/biochemical
, cytotoxic therapy then causes resistance.

Sensitive drugs with shorter lifespans are therefore prone to resistance.

Arraste e solte para completar o texto.

    resistant
    naturally selected
    normal
    mutations
    abnormalities
    less

Explicação

Questão 4 de 13

1

Apparent resistance: Tumour can be sensitive but not show a clinical response due to incorrect . The interval is too . Cell-cycle specific agents with short needed.
Anatomical also causes apparent resistance; ALL (acute lymphoblastic leukemia) relapse in children due to failure to penetrate .

Arraste e solte para completar o texto.

    scheduling
    long
    t1/2
    isolation
    BBB

Explicação

Questão 5 de 13

1

Chemo principles:
Principle 1: Treat . with chemo as an adjuvant successfully only in breast cancer and in children.
Principle 2: Treat with a . Use drugs with different . Will have different unwanted effects - though note there is additive not . Alternating regimens toxicity.

Arraste e solte para completar o texto.

    rapidly
    Primary radiation/surgery
    combination
    targets
    efficacy
    toxicity
    decreases

Explicação

Questão 6 de 13

1

Endocrine Therapy Principles:
Cellular proliferation is influenced by hormones.
– female breast, endometrial carcinoma
– prostate
There is tumour regression following .

Arraste e solte para completar o texto.

    Oestrogen
    Androgen
    ovariectomy

Explicação

Questão 7 de 13

1

Hormonal sensitivity in breast cancer depends on genes, estrogen receptors and growth factor receptors.
• ER+ means there will be to therapy
• ER+ AND PgR+ increases your chance of
Also carry growth factor receptors (GFRs).

Inverse correlation:
High ER content = few
High GFR content = few

Arraste e solte para completar o texto.

    response
    remission
    GFRs
    ERs

Explicação

Questão 8 de 13

1

Choose the incorrect statement.

Selecione uma das seguintes:

  • High estrogen favours growth factor synthesis.

  • Hormone therapy goal is to prevent formation of growth factors.

  • Growth factors lead to mitosis and a reduction in estrogen receptors.

Explicação

Questão 9 de 13

1

Oestrogen receptor antagonists e.g. Tamoxifen, clomiphene citrate, nafoxidine
- estrogen receptor modulators (SERM)
- binds to oestrogen receptors
• Oestrogenic effects (inhibit resorption, stimulates synthesis)
• Anti-oestrogenic effects (breast tissue, inhibits synthesis of )

Example: Tamoxifen, for breast cancer. Is an adjuvant/. Metabolised by CYP2D6, 3A4, metabolites have t1/2. Unwanted Effects: flushes, nausea, amenorrhoea, bleeding

Arraste e solte para completar o texto.

    Selective
    Competitively
    bone
    PgR
    GF
    recurrent metastatic
    prevention
    long
    hot
    vaginal

Explicação

Questão 10 de 13

1

Aromatase inhibitors e.g. Anastrozole, Letrozole, Exemestane (steroid)
Aromatase converts androgens to ; this is the primary mechanism of BC in menopausal women, so we can inhibit it. For breast cancer. No value if patient is . SEs: Stiffness, pain, loss of bone mineral (osteoporosis, bone fractures).

Arraste e solte para completar o texto.

    oestrogen
    post
    advanced
    premenopausal
    joint
    density

Explicação

Questão 11 de 13

1

Carcinoma of the prostate:
Androgens modulate by:
• Growth of prostatic
• Production of prostatic
prostate cancers arise from epithelium

3 main approaches:
1. Remove source
2. Block hormone (*5 alpha-reductase)
3. Androgen R

Arraste e solte para completar o texto.

    epithelium
    fluid
    Most
    primary
    synthesis
    antagonists

Explicação

Questão 12 de 13

1

Lowering androgen levels
1. (orchidectomy)
2. Chemically using synthetic releasing hormones - analogues e.g. goserelin, leuprorelin. Causes initial (high ) = Downregulation of GnRH , loss of sensitivity, suppress formation. Unwanted effects: sexual , hot , growth of tissue

Arraste e solte para completar o texto.

    Surgically
    gonadotrophin
    GnRH and LHRH
    flare
    LH and FSH
    receptors
    androgen
    dysfunction
    flushes
    breast

Explicação

Questão 13 de 13

1

Antiandrogens e.g. Flutamide can flare.
antagonist
• Prevents binding to androgen receptors in
Have no effect on function and so fewer side effects.

Arraste e solte para completar o texto.

    inhibit
    Selective
    testosterone
    nuclear
    prostate
    pituitary

Explicação