DNA Damaging Agents and Antimetabolites

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Questions and Answers

What is the primary mechanism of action of Sunitinib?

  • Blocks estrogen receptor
  • Inhibits PD-1
  • Prevents immune cell activation
  • Inhibits VEGFR (correct)

What types of cancer is Tamoxifen primarily used to treat?

  • Renal cell carcinoma
  • GI stromal tumors
  • Pancreatic cancer
  • Breast cancer (correct)

How do PD-1 inhibitors function in cancer therapy?

  • They promote tumor growth
  • They stimulate estrogen receptors
  • They activate immune cells
  • They inhibit the binding of PD-1 and PD-L1 (correct)

Which of the following statements regarding Hormonal Therapies is true?

<p>Tamoxifen blocks estrogen receptor to inhibit cancer growth (C)</p> Signup and view all the answers

Which of the following drugs is NOT classified as a PD-1 inhibitor?

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

Which drug is known to block DNA repair in cancer cells?

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

What is the mechanism of action of Imatinib?

<p>Inhibits BCR and ABL (D)</p> Signup and view all the answers

Which of the following drugs is specifically used for treating breast cancer?

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

For which condition is Gefitinib primarily indicated?

<p>Non-small cell lung cancer (A)</p> Signup and view all the answers

Which of the following drug classes has a mechanism involving the insertion between base pairs and DNA cleavage?

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

What is the primary mechanism of action of PARP inhibitors?

<p>Blocking DNA repair mechanisms in cancer cells (A)</p> Signup and view all the answers

Which drug is administered as an IV infusion for its therapeutic purpose?

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

What is the recommended dose of Imatinib for Chronic Myelogenous Leukemia (CML)?

<p>400mg OD (A)</p> Signup and view all the answers

What is the primary mechanism of action for the drug 5-fluorouracil?

<p>It inhibits the conversion of cytidylic acid to 2-deoxycytidylic acid. (D)</p> Signup and view all the answers

Which class of drugs does Paclitaxel belong to?

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

What effect do Vinca Alkaloids have on microtubules?

<p>They prevent microtube polymerization, inhibiting cell division. (B)</p> Signup and view all the answers

Which of the following drugs effectively acts during the S-phase of the cell cycle?

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

What is a common use for Docetaxel?

<p>Treatment of breast and lung cancers (B)</p> Signup and view all the answers

Which type of drug is gemcitabine classified as?

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

Which mechanism describes how antimitotics, such as Paclitaxel, work?

<p>By binding to free tubulin to prevent microtubule disassembly. (D)</p> Signup and view all the answers

What is the main feature of purine or pyrimidine antimetabolites?

<p>They inhibit normal cellular metabolite biosynthesis. (D)</p> Signup and view all the answers

What is the primary mechanism through which Pertuzumab acts to inhibit cancer cell growth?

<p>It prevents the activation of HER2. (B)</p> Signup and view all the answers

Which type of cancer is specifically targeted by T-DM1 therapeutically?

<p>HER2 breast cancer (B)</p> Signup and view all the answers

What is the role of Bortezomib in cancer treatment?

<p>It inhibits the 26S proteasome to trigger stress responses in cells. (B)</p> Signup and view all the answers

Which therapeutic agent inhibits vascular endothelial growth factor (VEGF) as part of its mechanism?

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

In which scenario is T-DM1 recommended for use?

<p>For HER2 breast cancer after surgery (B)</p> Signup and view all the answers

What consequence does the inhibition of angiogenesis have on tumors?

<p>It prevents tumors from receiving necessary blood supply. (D)</p> Signup and view all the answers

What type of cancer is primarily treated with Angiogenesis inhibitors like Bevacizumab?

<p>Colon and lung cancer (C)</p> Signup and view all the answers

Which statement regarding HER2 overexpression is correct?

<p>It leads to abnormal cell growth and proliferation. (A)</p> Signup and view all the answers

Which drug class from the table primarily targets the N7 position of guanine in DNA?

<p>Alkylating Agents (A), Platinum Drugs (D)</p> Signup and view all the answers

Which of the following drugs is a nitrogen mustard?

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

What is the primary mechanism of action of nitrosoureas?

<p>Alkylating DNA at the O6 of guanine (B)</p> Signup and view all the answers

Which of the following drugs is NOT an alkylating agent?

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

Which of the following is a characteristic of platinum drugs?

<p>They crosslink DNA by attaching to the N7 of guanine. (D)</p> Signup and view all the answers

What is the structural feature that distinguishes nitrosoureas from other alkylating agents?

<p>The presence of a nitrosourea group (B)</p> Signup and view all the answers

Which of the following drugs is most likely to be used to treat multiple myeloma?

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

Based on the table, what is a common feature among all drugs listed?

<p>They all act by directly damaging DNA. (C)</p> Signup and view all the answers

Flashcards

Antimetabolites

Drugs that inhibit the biosynthesis of cellular metabolites, affecting DNA/RNA synthesis.

5-fluorouracil

An antimetabolite used to inhibit the conversion of cytidylic acid, affecting DNA synthesis.

Paclitaxel

A taxane that stabilizes microtubules, preventing their disassembly during cell division.

Docetaxel

A taxane that binds free tubulin to inhibit microtubule disassembly; used for various cancers.

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Microtubules

Cytoskeletal structures that play a crucial role in chromosome segregation during cell division.

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Vinca Alkaloids

A class of drugs such as Vinblastine that prevent microtubule polymerization.

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S-phase

The phase of the cell cycle where DNA is synthesized and chromosomes are duplicated.

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Cytidylic acid

A nucleotide precursor involved in RNA and DNA synthesis, targeted by 5-fluorouracil.

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Antitumor Antibiotics

Class of cancer treatment drugs including daunorubicin and doxorubicin that interfere with DNA.

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PARP Inhibitors

Block DNA repair enzymes in cancer cells to promote cell death, used in various cancers.

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Vinorelbine

A chemotherapy drug preventing proper spindle formation, affecting mitosis in cancer cells.

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Tyrosine Kinase Inhibitors

Drug class like imatinib that stops signals necessary for cancer cell growth and survival.

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Imatinib

A tyrosine kinase inhibitor indicated for chronic myelogenous leukemia (CML) and ALL.

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Gefitinib

Inhibitor of epidermal growth factor receptor (EGFR) for non-small cell lung cancer treatment.

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Trastuzumab

Monoclonal antibody used in breast cancer treatment by inhibiting HER2 receptor.

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Daunorubicin

An anthracycline antibiotic that inserts itself into DNA to disrupt cancer cell function.

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Alkylating Agents

Chemicals that add alkyl groups to DNA, damaging it and preventing replication.

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DNA Crosslinking

A process where two strands of DNA are linked together, preventing separation during replication.

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Nitrogen Mustards

A class of alkylating agents, including drugs like Cyclophosphamide and Melphalan.

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Carmustine

A nitrosourea that alkylates the O6 of guanine, causing DNA damage and crosslinks.

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Cisplatin

A platinum drug that crosslinks DNA by attaching to N7 of guanine.

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Busulfan

An alkylating agent that removes a mesylate group to alkylate guanine, causing crosslinks.

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Ifosfamide

An alkylating agent with a similar MOA to Cyclophosphamide, affecting DNA replication.

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Procarbazine

Forms ions and cations to alkylate the O6 position on guanine, causing DNA damage.

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Sunitinib

A tyrosine kinase inhibitor that targets VEGFR to inhibit tumor growth by starving it of nutrients.

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PD-1 Inhibitors

Class of drugs that inhibit PD-1, allowing T-cells to kill tumor cells by preventing tumor evasion.

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Pembrolizumab

A PD-1 inhibitor that enhances T-cell activity against tumors by blocking PD-1 receptor.

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Tamoxifen

Blocks estrogen receptors to prevent hormone-driven cancer growth, primarily used in breast cancer.

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PD-L1 Inhibitors

Drugs that inhibit PD-L1, preventing tumor cells from evading the immune response mediated by PD-1.

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HER2 overexpression

A condition where the HER2 protein is produced in excess, leading to abnormal cell growth and proliferation in cancers.

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Pertuzumab

A drug that binds to HER2 subdomain II to inhibit dimerization, preventing cancer cell signaling.

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Dimerization

The process where two receptor proteins join together, which can activate cancer signaling pathways.

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T-DM1

A cytotoxic agent that targets HER2 breast cancer cells, triggering apoptosis after being cleaved.

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Apoptosis Inducing Agents

Drugs that trigger programmed cell death in cancer cells.

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Bortezomib

A drug that inhibits the 26S proteasome, leading to protein build-up and stress responses to kill cancer cells.

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Angiogenesis inhibitors

Drugs that block the formation of new blood vessels, starving tumors of nutrients.

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Bevacizumab

A monoclonal antibody that inhibits VEGF to prevent blood vessel formation in tumors.

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Study Notes

DNA Damaging Agents

  • Alkylating Agents: Alkylate DNA, creating cyclic structures and attaching to guanine's N7. Can also cause crosslinking of DNA.
    • Nitrogen Mustards: Melphalan, cyclophosphamide, ifosfamide, chlorambucil, estramustine, carmustine, lomustine, nimustine, streptozocin.
    • Nitrosoureas: Carmustine, Lomustine, Nimustine
    • Platinum Drugs: Carboplatin, cisplatin, oxaliplatin. Alkylate the O6 of guanine, causing crosslinking and DNA damage. Crosslinks DNA by attaching to guanine's N7.
    • Miscellaneous: Busulfan, procarbazine. Busulfan removes a mesylate group to form R-CH2, alkylates N7 of guanine, and causes DNA crosslinking. Procarbazine forms an ion, cation, and alkylates at the O6, potentially inhibiting protein, RNA, and DNA synthesis.

Antimetabolites

  • Pyrimidine or Purine Antimetabolites: Interfere with normal cellular metabolites by inhibiting the conversion of cytidylic acid to 2-deoxycytidylic acid, which is effective during S-phase.
    • 5-fluorouracil, capecitabine, gemcitabine, cytarabine, azacitidine

Antimitotics

  • Taxanes: Bind to free tubulin to form stable microtubules, stopping microtubule disassembly, essential for cell division.
    • Paclitaxel, Docetaxel

Targeted Therapy Agents

  • Tyrosine Kinase Inhibitors: Inhibit BCR, ABL, used for cancer cell proliferation, movement, and apoptosis avoidance. Inhibit EPFR for DNA synthesis, proliferation, migration, and survival.
    • Imatinib, Gefitinib
  • Monoclonal Antibodies: Inhibits HER2 to prevent abnormal cell growth, survival, and proliferation, impacting its dimerization.
    • Trastuzumab, Pertuzumab

Antitumor Antibiotics

  • Vinca Alkaloids: Bind to tubulin preventing microtubule formation thus preventing cell division.
    • Vinblastine, vincristine, vindesine, vinorelbine
  • Anthracyclines: Insert themselves between base pairs of DNA.
    • Daunorubicin, doxorubicin, epirubicin, idarubicin, mitoxantrone

DNA Repair Enzyme Inhibitors

  • Inhibit DNA repair in cancer cells to cause cancer cell death.
    • Olaparib, rucaparib, niraparib, iniparib, talazoparib

Apoptosis-Inducing Agents

  • Induce apoptosis (programmed cell death).
    • Bortezomib

Angiogenesis Inhibitors

  • Inhibit angiogenesis (formation of blood vessels), depriving tumors of essential nutrients.
    • Bevacizumab

Multiple Targeted Tyrosine Kinase Inhibitors

  • Inhibit various tyrosine kinases, impacting numerous pathways.
    • Sunitinib

Immunotherapies

  • PD-1 Inhibitors: Inhibit PD-1, reducing the ability of the tumor cell to evade killing.
    • Pembrolizumab, Nivolumab, Cemiplimab, Atezolizumab
  • PD-L1 Inhibitors: Inhibit PD-L1 and the ability of the tumor cells to avoid killing.
    • Avelumab, Durvalumab

Hormonal Therapies

  • Tamoxifen: Blocks estrogen receptor (ER), preventing hormone binding and cancer growth.

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