Intro to Chemo
Terms
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- four stages of carcinogenesis
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initiation (irrev)- due to viral, bacterial, radiatin, chem
promotion(rev)- selective clonal growth and expansion depends on environment
conversion/transformation- further genetic change
progression- clinical CANCER - role of oncogenes
- regulate cellular function including signal for division and growth, oncogenes produce excessive amounts of normal gene product or abnormal gene product leading to dysregulation of normal cell growth
- roleof tumor supressor genes
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inhibit regulate inappropriate cell growth
gene/alteration/loss/mutation/inactivation results in loss of control of cell grwoth ex are p53, BrCA1-2 - What is benign
- non cancerous growths, often encapsulated localized, they resemble cells they originate from - oma
- what is malignant
- genetically unstable, cancerous growth, invade and destroy local tissye, unencapsulated, often metastasize
- how does metastic dz develop
- tumor cells are shedding neoplastic cells, angiogenesis occurs that is development of new blood vessels and then the cells survive in circulation and attach to endothelium
- describe the cell kill hypothesis
- only a certain % of cells are killed there is never 0 cells shrink tumor to 10^4 cells and host factors can possibly eliminate
- Describe the cell cycle
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G0- resting phase, variable time
G1- first gap phase, enzyme manufactuing, prep for DNA syn
S- Synthesis of DNA, tumors that are growing quickly have a large % of cells in this phase
G2- second gap phase, prep for mitosis, movement of cellular components
M- mitosis, cell division occurs, breakdown of tubulin, mitotic spindle - what is the type of chemo. induction
- used in advanced diseases, usually when radiation or surgery would have been ineffective
- what is the type of chemo consolidation
- aggressive chemo given after initial induction regimen, goal for eradicating resistant disease,
- what is the type of chemo adjuvant
- systematic chemo given or along with surgery or radiation ther. goal is to destroy micromestatic disease
- what is the type of chemo neoadjuvant
- systemic therapy given before localized ther. goal is to destroy micromestatic disease and to make the localized disease easier to manage
- what is salvage type of chemo
- given after initial fails,
- what is complete response
- complete disappearnace of all cancer witn no evidense of disease for one month
- what is partial response
- 50% or greather decrease in tumor size; no evidence on new disease for at least one month
- what is overall response
- complete response plus partial response
- what is stable disease
- tumor does not grow by 25% or more, or shrinks by less than 50%
- what is progressive disease
- tumor growth of 25% or new disease detected
- disease free survival means
- time from complete response to relapse/death
- overall survival means
- the time from treatment to death