Cancer and Cell Cycle Kinetics

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Questions and Answers

What is the main effect of methotrexate on nucleotide and amino acid synthesis?

  • It has no effect on their synthesis.
  • It decreases their synthesis. (correct)
  • It converts them into non-functional forms.
  • It increases their synthesis significantly.

Which of the following cancers is not effectively treated with methotrexate?

  • Choriocarcinoma
  • Breast cancer
  • Wilms' tumor (correct)
  • Acute lymphocytic leukemia

What is a significant adverse effect associated with long-term use of methotrexate?

  • Hemolytic anemia
  • Pulmonary infiltrates and fibrosis (correct)
  • Severe myelosuppression
  • Neurotoxicity

What is the primary mechanism of action for vincristine?

<p>Blocks mitotic spindle formation (D)</p> Signup and view all the answers

Which of the following is an adverse effect of vincristine?

<p>Areflexia (A)</p> Signup and view all the answers

How does bleomycin primarily damage DNA?

<p>Through oxidative scission (C)</p> Signup and view all the answers

In which phase of the cell cycle does bleomycin act?

<p>G2 phase (A)</p> Signup and view all the answers

What potential benefit does leucovorin provide during methotrexate treatment?

<p>Reduces toxic effects on normal cells (C)</p> Signup and view all the answers

Which phase of the cell cycle do chemotherapeutic agents like 5-Fluorouracil primarily target?

<p>S phase (B)</p> Signup and view all the answers

What is the primary mechanism of action for 5-Fluorouracil?

<p>Inhibits thymidylate synthase (B)</p> Signup and view all the answers

For which type of cancer is 5-Fluorouracil most widely used?

<p>Colorectal cancer (D)</p> Signup and view all the answers

Which of the following is NOT a common adverse effect of 5-Fluorouracil?

<p>Weight gain (C)</p> Signup and view all the answers

Methotrexate primarily inhibits which enzyme?

<p>Dihydrofolate reductase (C)</p> Signup and view all the answers

What category does Methotrexate fall under in cancer treatment?

<p>Antimetabolites (D)</p> Signup and view all the answers

Which of the following is a characteristic of cell cycle-specific (CCS) drugs?

<p>They only act during a specific phase of the cell cycle. (C)</p> Signup and view all the answers

Which drug is primarily used for the treatment of lymphomas?

<p>Bleomycin (B)</p> Signup and view all the answers

Which of the following drugs is a pyrimidine analogue used in cancer treatment?

<p>5-Fluorouracil (B)</p> Signup and view all the answers

What is a common adverse effect associated with Bleomycin?

<p>Pulmonary dysfunction (B)</p> Signup and view all the answers

Which mechanism describes how 5-Fluorouracil exerts its effects?

<p>Inhibits thymidylate synthase (C)</p> Signup and view all the answers

Which drug is classified as an alkylating agent?

<p>Cyclophosphamide (A)</p> Signup and view all the answers

What adverse effect is specifically linked to Cyclophosphamide?

<p>Hemorrhagic cystitis (D)</p> Signup and view all the answers

Which of the following is true about Imatinib?

<p>It functions as a tyrosine kinase inhibitor. (B)</p> Signup and view all the answers

Which cancer is NOT a clinical use for Methotrexate?

<p>Testicular carcinoma (D)</p> Signup and view all the answers

Which statement best describes the action of Vincristine?

<p>It interferes with microtubule assembly. (D)</p> Signup and view all the answers

Which mechanism best explains the resistance to fluorouracil in recurrent colon cancer?

<p>Decreased activity of thymidylate synthase (C)</p> Signup and view all the answers

Which drug should be administered to counteract the toxicity of high-dose methotrexate in a patient?

<p>Leucovorin (D)</p> Signup and view all the answers

What is the primary molecular action that mediates the therapeutic effect of doxorubicin?

<p>It intercalates between DNA strands and inhibits topoisomerase II (B)</p> Signup and view all the answers

Which of the following is NOT a common side effect associated with fluorouracil chemotherapy?

<p>Flu-like symptoms (B)</p> Signup and view all the answers

In what scenario is decreased activity of the cell efflux pump primarily relevant?

<p>Doxorubicin resistance (D)</p> Signup and view all the answers

What is the primary clinical use of trastuzumab?

<p>To manage HER2-overexpressed metastatic breast cancer (A)</p> Signup and view all the answers

Which of the following is a severe side effect of trastuzumab?

<p>Cardiac dysfunction (D)</p> Signup and view all the answers

What mechanism of action does doxorubicin employ to exert its effects?

<p>Binds to DNA and creates free radicals (C)</p> Signup and view all the answers

Tamoxifen is primarily used to treat which condition?

<p>Breast cancer that has metastasized (C)</p> Signup and view all the answers

Which of the following side effects is commonly associated with doxorubicin?

<p>Alopecia (A)</p> Signup and view all the answers

What is the mechanism of action of trastuzumab?

<p>Targets the HER2 receptor, inducing downregulation (D)</p> Signup and view all the answers

What type of cancer is NOT primarily treated with doxorubicin?

<p>Prostate cancer (B)</p> Signup and view all the answers

What are common side effects associated with tamoxifen?

<p>Menopause-like symptoms (C)</p> Signup and view all the answers

Flashcards

Cancer

Uncontrolled cell growth and division, invading surrounding tissues and potentially spreading to other parts of the body

Cell Cycle-Specific (CCS) Drugs

Anticancer drugs that target cells actively dividing in a specific stage of the cell cycle.

Cell Cycle-Nonspecific (CCNS) Drugs

Anticancer drugs that target both dividing and resting tumor cells.

Antimetabolites (Antineoplastic Agents)

A class of anticancer drugs that interfere with the synthesis of essential molecules required for DNA replication and metabolic function within cells.

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5-Fluorouracil (5-FU)

An antimetabolite drug that inhibits thymidylate synthase, blocking DNA synthesis, primarily acting in S phase.

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Methotrexate

An antifolate drug that inhibits dihydrofolate reductase, an enzyme crucial for DNA synthesis.

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S phase of cell cycle

The part of the cell cycle where DNA replication occurs.

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Clinical Use of 5-FU

Commonly used in treating colorectal, GI, breast, and neck cancers.

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Methotrexate clinical indication

Effective against some cancers like acute lymphocytic leukemia, choriocarcinoma, breast cancer, and head and neck carcinomas, and certain inflammatory diseases like psoriasis and rheumatoid arthritis. Also abortive in ectopic pregnancy.

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Methotrexate adverse effects

Common side effects include bone marrow suppression and toxic effects on skin and gastrointestinal mucosa (mucositis). Long-term use may cause hepatotoxicity and pulmonary problems.

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Vinca Alkaloids

Plant-derived cancer chemotherapy drugs targeting specific phases of the cell cycle.

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Vincristine mode of action

Blocks mitotic spindle formation by halting tubulin dimer assembly into microtubules, disrupting mitosis, leading to cell death.

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Vincristine clinical uses

Used in acute lymphocytic leukemia, Hodgkin's and non-Hodgkin's lymphoma, Wilms' tumor, and neuroblastoma.

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Vincristine adverse effects

Usually does not cause severe bone marrow suppression, but can lead to neurotoxicity, potentially causing areflexia, peripheral neuritis, and paralytic ileus.

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Bleomycin mode of action

Causes DNA scission through oxidative processes; a DNA-bleomycin-iron complex undergoes oxidation, leading to DNA damage.

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Bleomycin clinical uses

Part of treatment regimens for Hodgkin's lymphoma and testicular cancer.

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Fluorouracil resistance mechanism

Cancer cells may be resistant to fluorouracil because they have a decreased ability to phosphorylate pyrimidines, leading to reduced drug effectiveness.

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Methotrexate antidote

Leucovorin is given to counteract methotrexate toxicity by providing a substitute for the folate needed.

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Doxorubicin's mechanism of action

Doxorubicin intercalates between DNA strands, hindering topoisomerase II, thus disrupting DNA function, and causing cell death.

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Recurrent colon cancer

Colon cancer that returns after treatment. It might be due to resistance to fluorouracil.

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Acute lymphoblastic leukemia

A type of blood cancer, where abnormal white blood cells grow uncontrollably.

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Bleomycin's use

Bleomycin is used to treat lymphomas and squamous cell carcinomas.

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Bleomycin adverse effects

Bleomycin can cause pulmonary problems (pneumonitis, fibrosis), hypersensitivity reactions (chills, fever), and mucocutaneous reactions (hair loss, blisters).

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Cell cycle-specific drugs (CCS)

Drugs that target cells actively dividing (cycling).

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Cell cycle-nonspecific drugs (CCNS)

Drugs targeting both dividing and resting cells.

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5-Fluorouracil mechanism

5-Fluorouracil blocks thymidylate synthase, affecting DNA and RNA synthesis.

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Methotrexate mechanism

Methotrexate stops the creation of purine nucleotides by inhibiting DHFR.

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Vincristine mechanism

Vincristine disrupts microtubule formation, hindering cell division.

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Antimetabolite example

Methotrexate is an example of an antimetabolite drug.

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Trastuzumab's target

Trastuzumab targets the extracellular domain of HER2, a protein involved in cell growth.

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Trastuzumab's action

Trastuzumab triggers an immune response to internalize and reduce HER2, slowing cell growth.

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Doxorubicin's MOA

Doxorubicin creates oxygen free radicals that damage DNA, inhibiting an enzyme (topoisomerase 2).

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Tamoxifen's Mechanism

Tamoxifen blocks estrogen from binding to receptors in breast cells, thus preventing growth.

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Growth Factor Receptor Inhibitors

Drugs targeting growth factor receptors on cells, for example, EGFR or VEGFR.

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Doxorubicin's Clinical Uses

Doxorubicin treats various cancers (lymphomas, myelomas, breast, lung, ovarian, thyroid), and some leukemias.

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Tamoxifen's Clinical Uses

Tamoxifen treats breast cancers, particularly those that have spread or early-stage cancers.

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CML Treatment Types

Chronic myelogenous leukemia (CML) treatments are targeted at different stages of the disease.

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Study Notes

Cancer Overview

  • Cancer involves uncontrolled cell growth and division, invading adjacent tissues and potentially spreading to distant sites.

Cell Cycle Phases

  • The cell cycle has distinct phases: G1, S, G2, and M.
  • G1: Cell growth and preparation for DNA replication.
  • S: DNA synthesis (replication).
  • G2: Cell growth and preparation for mitosis.
  • M: Mitosis (cell division).
  • The specific percentages of each phase are variable (G₁: 40%, S: 39%, G₂: 19%, M: 2%).
  • Go phase is a quiescent state.

Learning Objectives

  • Understand cancer cell cycle kinetics.
  • Classify cell cycle-specific and -nonspecific anticancer drugs.
  • Explain the mechanism of action of specific anticancer drugs (5-fluorouracil, methotrexate, vincristine, bleomycin).
  • Identify clinical uses of these drugs.
  • Understand adverse effects of these drugs.

Cancer Cell Cycle Kinetics

  • Cell cycle-specific (CCS) drugs selectively target cells in specific phases of the cell cycle.
  • Cell cycle-nonspecific (CCNS) drugs target cells in both cycling and resting phases.

Cell Cycle-Specific Drugs (CCS): Examples

  • Antimetabolites (S phase): 5-Fluorouracil (5-FU), Capecitabine, Cytarabine (ara-C), Gemcitabine

  • Taxanes (M phase): Paclitaxel, Albumin-bound paclitaxel, Cabazitaxel

  • Vinca Alkaloids (M phase): Vinblastine, Vincristine, Vinorelbine

  • Epipodophyllotoxins (G₁-S phase): Etoposide

  • Antitumor antibiotics (G₂-M phase): Bleomycin

Antimetabolites (detailed)

  • Pyrimidine Analogues: 5-Fluorouracil (5-FU), Capecitabine, Cytarabine (ara-C).
  • Purine Analogues: Mercaptopurine (6-MP), Thioguanine (6-TG), Azathioprine
  • Anti-folates: Methotrexate, Pralatrexate.

5-Fluorouracil (5-FU)

  • An antimetabolite that acts primarily during the S phase.
  • It inhibits thymidylate synthase, interfering with DNA synthesis.
  • Common clinical uses include colorectal cancer.
  • Common adverse effects include myelosuppression, diarrhea, nausea, vomiting, and neurotoxicity.

Methotrexate

  • Inhibits dihydrofolate reductase (DHFR), reducing purine nucleotide synthesis.
  • Effective against acute lymphocytic leukemia, choriocarcinoma, breast cancer, and head and neck cancers.
  • Common adverse effects include Bone marrow suppression, skin and gastrointestinal mucosa toxicity (mucositis).
  • Leucovorin rescue can be used to reduce toxicity.

Vinca Alkaloids (Vincristine)

  • Disrupts microtubule assembly during mitosis.
  • Used for acute lymphocytic leukemia, Hodgkin's and non-Hodgkin's lymphoma, Wilms' tumor, and neuroblastoma.
  • Adverse effects include neurotoxicity (areflexia, peripheral neuritis, paralytic ileus), lack of myelosuppression.

Bleomycin

  • A cell-cycle specific (G2) anti-tumor antibiotic.
  • Causes DNA damage via oxidative process.
  • Used in Hodgkin's lymphoma and testicular cancer.
  • Adverse effects include pulmonary dysfunction, hypersensitivity reactions, and mucocutaneous reactions.

Other Drugs and Classes

  • Cyclophosphamide (CCNS): Alkylating agent used for various cancers.
  • Doxorubicin: Anthracycline antibiotic, damages DNA via oxygen free radicals and inhibits topoisomerase.
  • Imatinib: Tyrosine kinase inhibitor, used for chronic myelogenous leukemia (CML).
  • Trastuzumab: Humanized monoclonal antibody that targets HER2, used in breast cancer.

Additional Information

  • Drug classifications based on cell cycle specificity and mechanism of action.
  • Specific examples of cancers typically treated with each drug.
  • Potential adverse effects of each anticancer drug.

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