a daganat-terápia alapjai
DESCRIPTION
a daganat-terápia alapjai. Diagnosis Histopathology Tumor markers Cell surface markers (CD20, CD34…) Genetic markers (BRCA-1,Philadelphia chromosome) Tumor markers in the blood α-FP (testis, HCC), β-HCG (testis, trophoblastic neoplasia PSA CEA (colorectal, breast, lung), - PowerPoint PPT PresentationTRANSCRIPT
a daganat-terápia alapjai
• Diagnosis– Histopathology– Tumor markers
• Cell surface markers (CD20, CD34…)• Genetic markers (BRCA-1,Philadelphia chromosome)• Tumor markers in the blood
– α-FP (testis, HCC),– β-HCG (testis, trophoblastic neoplasia– PSA – CEA (colorectal, breast, lung), – CEA125(ovary), – CA199(pancreas),– thyroglobulin (thyroid)– Lactic dehydrogenase, LDH .
• Staging– TMN staging: (for solid tumors)
• T: tumor size• N: node involvement• M: metastases
• Ex: T2N1M0
a daganat-terápia alapjai
• Modalities of Treatment– Surgery– Radiation– Chemotherapy
a daganat-terápia alapjai
• Immunotherapy (melanoma, Bladder cancer, renal cell carcinoma)
• BCG Vsaccine (local regional bladder cancer)
• Monoclonal antibody – Trastuzumab– rituximab
• Hormonal therapy (breast cancer, prostate cancer)• Drugs inducing differentiation
– all-tans retinoic acid (ATRA)
• Hematopoietic stem cell transplantation
a daganat-terápia alapjai
• Criteria for Response– Cure: patient is entirely free of disease and has the same life
expectancy.– Complete response (CR): complete disappearance of all
cancer and no evidence of new disease for at least 1 month. – Partial response (PR) : 50% or greater decrease in the
tumor size or other disease markers, and no evidence or any new disease for at least 1 month.
– Stable disease: tumor size neither grows nor shrinks significantly.
– Progression of disease: 25% increase in the tumor size or the development of and new lesions while receiving treatment.
a daganat-terápia alapjai
• Management of treatment-related toxicity– Infections– Hematological reactions– Nausea and vomiting– Oral complications– Pulmonary complications– Cardiac toxicities– Gonadal dysfunction– Second cancers– Neurotoxicity– Nephrotoxicity– Hepatotoxiity
a daganat-terápia alapjai
Paraneoplastic syndrome
• Chronic adrenocortical insufficiency– Adrenal, lymphoma
• Dermatomyositis and polymyositis– Lung, stomach, ovary
• Hypercalcemia: – Lung, breast, prostate
• DIC : Acute promyelocytic leukemia• SIADH: Lung, esp. SCLC • Thrombophlebitis:
– lung, breast, ovary, Prostate
Summary
• Cancer is not a single disease entity.
• Cancer biology is the most important aspect in treating or preventing cancers
• Chemotherapy pharmacy service or oncology pharmacy service
• Know the general concepts of cancers, focus on the drug-related problems.