Chemotherapy Drugs Quiz: Cancer Principles

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Questions and Answers

What is the primary goal of cancer chemotherapy?

To manage symptoms

To cure the disease (correct)

To improve quality of life

To reduce the risk of recurrence

What is the target of most anticancer drugs?

Specific cellular processes of normal cells

Unique features of malignant cells

DNA or RNA of normal cells

Metabolic sites essential to cell replication (correct)

Why do antitumor agents have a steep dose–response curve for both therapeutic and toxic effects?

They are highly expensive to produce

They are highly specific to cancer cells

They affect all kinds of proliferating cells, including normal cells (correct)

They are highly soluble in water

What is the mechanism of newer anticancer agents?

Blocking checkpoints to allow the immune system to attack cancer cells Signup and view all the answers

What is an example of a non-cancer disease where methotrexate is used?

Rheumatoid arthritis Signup and view all the answers

What is the role of chemotherapy in cancer treatment?

To reduce neoplastic cell burden to maintain a chronic disease Signup and view all the answers

What is a potential side effect of using the drug mentioned in the text?

Ocular toxicity Signup and view all the answers

What is the category of drugs that includes 6-mercaptopurine and fludarabine?

Purine analogs Signup and view all the answers

What is the primary use of 6-mercaptopurine in cancer treatment?

Maintenance of remission in acute lymphoblastic leukemia Signup and view all the answers

What is the mechanism of action of fludarabine in cells?

It is phosphorylated by deoxycytidine kinase Signup and view all the answers

What is the relationship between azathioprine and 6-mercaptopurine?

6-Mercaptopurine is a metabolite of azathioprine Signup and view all the answers

What is the additional benefit of 6-mercaptopurine and its analog, azathioprine?

Treatment of Crohn's disease Signup and view all the answers

What is the primary mechanism of cytotoxicity of alkylating agents?

Covalently binding to nucleophilic groups on various cell constituents Signup and view all the answers

Which type of cells are alkylating agents most toxic to?

Rapidly dividing cells Signup and view all the answers

What is a common side effect of alkylating agents?

Secondary malignancies Signup and view all the answers

What is the primary mechanism of action of antitumor antibiotics?

Disruption of DNA function Signup and view all the answers

What is the primary site of biotransformation of cyclophosphamide and ifosfamide?

Liver Signup and view all the answers

Which of the following is a cell cycle specific antitumor antibiotic?

Bleomycin Signup and view all the answers

What is the active compound formed from the metabolism of cyclophosphamide and ifosfamide?

Phosphoramide mustard Signup and view all the answers

What is the result of gemcitabine being deaminated?

It is converted to difluorodeoxyuridine, which is not cytotoxic Signup and view all the answers

What is the formulation of ifosfamide available for administration?

IV only Signup and view all the answers

What is the purpose of gemcitabine administration via IV infusion?

To allow it to be phosphorylated by deoxycytidine kinase Signup and view all the answers

Which of the following is used to treat prostate cancer?

Mitoxantrone Signup and view all the answers

What is the relationship between doxorubicin and daunorubicin?

Doxorubicin is the hydroxylated analog of daunorubicin Signup and view all the answers

What is the primary route of excretion for ifosfamide?

Renal Signup and view all the answers

Which enzyme is responsible for metabolizing ifosfamide?

CYP450 3A4 and 2B6 Signup and view all the answers

What is the main cause of bladder toxicity in patients taking cyclophosphamide?

Acrolein in the urine Signup and view all the answers

What is the effect of nitrosoureas on non-dividing cells?

They can escape death if DNA repair occurs Signup and view all the answers

What is the mechanism of action of nitrosoureas?

Alkylation of DNA and inhibition of RNA and protein synthesis Signup and view all the answers

What is the primary use of nitrosoureas in cancer treatment?

Treatment of brain tumors Signup and view all the answers

Study Notes

Principles of Cancer Chemotherapy

Cancer chemotherapy aims to cause a lethal cytotoxic event or apoptosis in cancer cells to arrest tumor progression.
The attack is generally directed toward DNA or against metabolic sites essential to cell replication.
Ideally, anticancer drugs should interfere only with cellular processes unique to malignant cells, but they often affect all kinds of proliferating cells, including normal cells.

Chemotherapeutic Agents

Chemotherapeutic agents can also be used in non-cancer diseases, such as methotrexate in rheumatoid arthritis and psoriasis, azathioprine in organ transplantation, and hydroxyurea in sickle cell anemia.
Examples of chemotherapeutic agents affecting RNA and DNA include purine analogs, alkylating agents, and antibiotics.

Treatment Strategies

Goals of treatment include reducing neoplastic cell burden to maintain a "normal" existence of the disease with the patient as a chronic disease.
Treatment strategies depend on the type and stage of cancer, with three main goals: cure, control, and palliation.

Purine Analogs

Purine analogs include guanine analogs (6-mercaptopurine, 6-thioguanine) and adenosine analogs (fludarabine, cladribine).
6-Mercaptopurine is used in the maintenance of remission in acute lymphoblastic leukemia and also beneficial in the treatment of Crohn's disease.
Adenosine analogs, such as fludarabine and cladribine, are used in leukemia and lymphomas.

Alkylating Agents

Alkylating agents exert their cytotoxic effects by covalently binding to nucleophilic groups on various cell constituents.
Alkylation of DNA is probably the crucial cytotoxic reaction that is lethal to tumor cells.
Alkylating agents do not discriminate between cycling and resting cells, and are used in combination with other agents to treat a wide variety of lymphatic and solid cancers.
Examples of alkylating agents include cyclophosphamide and ifosfamide, which are used in the treatment of non-Hodgkin lymphoma, sarcoma, and breast cancer.

Antibiotics (Antitumor)

Antitumor antibiotics owe their cytotoxic action primarily to their interactions with DNA, leading to disruption of DNA function.
They are cell cycle nonspecific, with bleomycin as an exception.
Examples of antitumor antibiotics include anthracyclines (doxorubicin, daunorubicin, idarubicin, epirubicin, and mitoxantrone), which are used in the treatment of sarcomas, carcinomas, acute lymphocytic leukemia, and lymphomas.

Nitrosoureas

Nitrosoureas, such as carmustine and lomustine, are primarily employed in the treatment of brain tumors due to their ability to penetrate the CNS.
They exert cytotoxic effects by an alkylation that inhibits replication and eventually RNA and protein synthesis.
Although they alkylate DNA in resting cells, cytotoxicity is expressed primarily in cells that are actively dividing.

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Description

This quiz covers the fundamental principles of cancer chemotherapy, including the mechanisms of action and targets of anticancer drugs. Learn how cancer chemotherapy works to arrest tumor progression and the challenges of developing effective treatments. Test your understanding of the principles of cancer chemotherapy and its applications.

Cancer Chemotherapy Principles