The presentation is a short brief regarding the brain tumor and the leading molecules used in the treatment of Brain tumor as BBB is a major limiting factor for this treating brain tumors
Chemotherapy uses chemical agents or drugs to treat cancer by destroying malignant cells. Paul Ehrlich is considered the father of chemotherapy for discovering the first effective treatment for syphilis. Chemotherapy drugs work during different phases of the cell cycle to damage DNA and prevent cell reproduction. There are several types of chemotherapy drugs including alkylating agents, antimetabolites, anti-tumor antibiotics, topoisomerase inhibitors, mitotic inhibitors, and corticosteroids. Common side effects of chemotherapy include fatigue, pain, mouth sores, diarrhea, nausea, vomiting, and hair loss.
This document discusses the toxicities of targeted cancer therapies. It begins by defining targeted therapy and describing the ideal features of an anticancer target. It then outlines several common toxicities of targeted therapies including cardiovascular issues like hypertension and ventricular dysfunction, QTc prolongation, thromboembolic complications, and various skin toxicities. Specific mechanisms, risk factors, management strategies, and monitoring approaches are described for each toxicity.
Chemotherapy is an important treatment option for both primary and secondary brain tumours. For primary brain tumours, temozolomide is often used in combination with radiation therapy for glioblastoma based on results from the landmark Stupp trial showing improved survival. Other drugs commonly used include carmustine, PCV regimen, platinum agents and targeted therapies such as bevacizumab are being investigated. Ongoing clinical trials are evaluating these agents in various settings and combinations to improve outcomes for brain cancer patients.
- Chemotherapy began during WWII after observing bone marrow aplasia and lymphoid tissue dissolution in soldiers exposed to nitrogen mustard.
- Chemotherapy can be used definitively, as neoadjuvant therapy before surgery/radiation, adjuvantly after other treatments, or concurrently with radiation therapy.
- Common drugs include alkylating agents, antimetabolites, platinum compounds, taxanes, and antibiotics. They work by alkylating DNA, inhibiting DNA/RNA synthesis, or interfering with microtubule formation.
- Major toxicities include bone marrow suppression, gastrointestinal issues like mucositis, alopecia, and increased risk of infection. Careful patient monitoring is important during chemotherapy treatment.
The document discusses several new agents for the treatment of plasma cell disorders like multiple myeloma. It provides information on newer proteasome inhibitors like carfilzomib and ixazomib, immunomodulatory drugs like pomalidomide, HDAC inhibitors like panobinostat, and monoclonal antibodies like daratumumab and elotuzumab. It also mentions some investigational drugs in development and discusses the importance of combination therapies and addressing issues like cost of these new treatments.
Principles of treatment of nervous dysfunction Veterinary NeurologyAjith Y
This document discusses treatment strategies for central nervous system (CNS) diseases and injuries in animals. It covers:
1) Eliminating infections through antibiotics, though many cannot cross the blood-brain barrier;
2) Reducing intracranial pressure through mannitol or hypertonic glucose administration to decompress the brain;
3) Managing brain trauma by stabilizing the patient, controlling seizures, fever and edema;
4) Using CNS stimulants temporarily in shock or anoxia but not respiratory failure;
5) Sedating animals in convulsions with CNS depressants like anesthetics. The overall aim is preventing further damage through symptomatic support and removing infectious causes.
This document discusses various strategies for radiosensitization and radioprotection in radiation oncology. It describes how radiation directly damages DNA and how free radicals generated can be fixed by oxygen, leading to cell death. It then discusses chronic and acute hypoxia in tumors and various mechanisms and agents that can be used for radiosensitization, including hypoxic cell sensitizers like misonidazole and nimorazole, hypoxic cytotoxins like mitomycin C, and strategies like blood transfusion, hyperbaric oxygen, and carbogen inhalation. It also discusses the radioprotector amifostine and its mechanisms of action and administration. Glutamine is mentioned as a potential protector against radiation-induced
Chemotherapy uses chemical agents or drugs to treat cancer by destroying malignant cells. Paul Ehrlich is considered the father of chemotherapy for discovering the first effective treatment for syphilis. Chemotherapy drugs work during different phases of the cell cycle to damage DNA and prevent cell reproduction. There are several types of chemotherapy drugs including alkylating agents, antimetabolites, anti-tumor antibiotics, topoisomerase inhibitors, mitotic inhibitors, and corticosteroids. Common side effects of chemotherapy include fatigue, pain, mouth sores, diarrhea, nausea, vomiting, and hair loss.
This document discusses the toxicities of targeted cancer therapies. It begins by defining targeted therapy and describing the ideal features of an anticancer target. It then outlines several common toxicities of targeted therapies including cardiovascular issues like hypertension and ventricular dysfunction, QTc prolongation, thromboembolic complications, and various skin toxicities. Specific mechanisms, risk factors, management strategies, and monitoring approaches are described for each toxicity.
Chemotherapy is an important treatment option for both primary and secondary brain tumours. For primary brain tumours, temozolomide is often used in combination with radiation therapy for glioblastoma based on results from the landmark Stupp trial showing improved survival. Other drugs commonly used include carmustine, PCV regimen, platinum agents and targeted therapies such as bevacizumab are being investigated. Ongoing clinical trials are evaluating these agents in various settings and combinations to improve outcomes for brain cancer patients.
- Chemotherapy began during WWII after observing bone marrow aplasia and lymphoid tissue dissolution in soldiers exposed to nitrogen mustard.
- Chemotherapy can be used definitively, as neoadjuvant therapy before surgery/radiation, adjuvantly after other treatments, or concurrently with radiation therapy.
- Common drugs include alkylating agents, antimetabolites, platinum compounds, taxanes, and antibiotics. They work by alkylating DNA, inhibiting DNA/RNA synthesis, or interfering with microtubule formation.
- Major toxicities include bone marrow suppression, gastrointestinal issues like mucositis, alopecia, and increased risk of infection. Careful patient monitoring is important during chemotherapy treatment.
The document discusses several new agents for the treatment of plasma cell disorders like multiple myeloma. It provides information on newer proteasome inhibitors like carfilzomib and ixazomib, immunomodulatory drugs like pomalidomide, HDAC inhibitors like panobinostat, and monoclonal antibodies like daratumumab and elotuzumab. It also mentions some investigational drugs in development and discusses the importance of combination therapies and addressing issues like cost of these new treatments.
Principles of treatment of nervous dysfunction Veterinary NeurologyAjith Y
This document discusses treatment strategies for central nervous system (CNS) diseases and injuries in animals. It covers:
1) Eliminating infections through antibiotics, though many cannot cross the blood-brain barrier;
2) Reducing intracranial pressure through mannitol or hypertonic glucose administration to decompress the brain;
3) Managing brain trauma by stabilizing the patient, controlling seizures, fever and edema;
4) Using CNS stimulants temporarily in shock or anoxia but not respiratory failure;
5) Sedating animals in convulsions with CNS depressants like anesthetics. The overall aim is preventing further damage through symptomatic support and removing infectious causes.
This document discusses various strategies for radiosensitization and radioprotection in radiation oncology. It describes how radiation directly damages DNA and how free radicals generated can be fixed by oxygen, leading to cell death. It then discusses chronic and acute hypoxia in tumors and various mechanisms and agents that can be used for radiosensitization, including hypoxic cell sensitizers like misonidazole and nimorazole, hypoxic cytotoxins like mitomycin C, and strategies like blood transfusion, hyperbaric oxygen, and carbogen inhalation. It also discusses the radioprotector amifostine and its mechanisms of action and administration. Glutamine is mentioned as a potential protector against radiation-induced
The document discusses principles of cancer immunotherapy and its application to lung cancer. It covers tumor immunology, mechanisms by which tumors evade immune surveillance (such as loss of antigens or promotion of an immunosuppressive microenvironment), and immune checkpoint inhibitors such as PD-1 and PD-L1 inhibitors. For advanced non-small cell lung cancer lacking a driver mutation, immunotherapy either alone or in combination with chemotherapy is now standard first-line treatment depending on factors like PD-L1 expression level. Pembrolizumab or atezolizumab combined with chemotherapy are preferred options.
Radiosensitizers are agents that increase the lethal effects of radiation when administered with radiotherapy. They work through various mechanisms like increasing DNA damage, inhibiting repair, and modulating biological response. Common types include physical agents like hyperthermia, chemical agents like nitroimidazoles to target hypoxic cells, and biological modifiers like cetuximab. Effective radiosensitizers improve the therapeutic ratio by increasing tumor cell killing while minimizing harm to normal tissues. Combining radiosensitizers with radiotherapy can improve outcomes for many cancer types.
This document discusses anti-cancer or neoplastic drugs and is presented by Dr. Homan. It covers topics such as the definition of cancer, epidemiology, risk factors, characteristics, types, cell cycle, carcinogenesis, diagnosis, classification of anti-cancer drugs, mechanisms of action, and toxic effects. The document provides information on various classes of anti-cancer drugs including alkylating agents, antimetabolites, cytotoxic antibiotics, hormones, and their mechanisms of treating cancer by affecting DNA, RNA, or microtubules.
Chapter 27 chemotherapy side effects dr lmsNilesh Kucha
The era of modern chemotherapy began in the early 1940s when Goodman and Gilman first administered nitrogen mustard to lymphoma patients. Although nitrogen mustard was originally developed as a chemical weapon, its toxic effects on the lymphatic system led to clinical trials of its use in cancer treatment. This marked the beginning of chemotherapy as an active field of cancer research and therapy development.
The document discusses various classes of anti-cancer drugs, including their mechanisms of action, pharmacokinetics, clinical uses, and common adverse effects. It covers alkylating agents, antimetabolites, plant alkaloids, antibiotics, hormonal agents, and other miscellaneous anti-cancer drugs. The classes of drugs discussed attack cancer cells through different mechanisms such as alkylation of DNA, inhibition of DNA synthesis, disruption of microtubule formation, and interference with hormone signaling pathways.
Tumor growth requires angiogenesis to develop new blood vessels. This process is regulated by a balance of pro-angiogenic and anti-angiogenic factors. Tumors disrupt this balance by inducing hypoxia and secreting factors like VEGF, which activate the "angiogenic switch" and promote new vessel growth. This allows tumors to recruit blood vessels to supply nutrients and remove waste. Anti-angiogenic therapies aim to block this process by targeting VEGF and its receptors. Drugs like bevacizumab and sorafenib inhibit angiogenesis to limit tumor growth and progression.
Paraneoplastic syndrome (PNS) is the term used to refer to the disorders that accompany the benign or the malignant tumors and are not caused by mass effect or invasion / metastasis.
These disorders are triggered by an immune system response to neuronal proteins expressed by the tumor(onconeural proteins).
These PNS also occur due to substances secreted by the neoplasm itself.
Cancer occurs due to genetic changes in cells that lead to uncontrolled growth. Anticancer drugs target features of cancer cells, including their DNA, to interfere with cell division and cause cell death. The main classes of anticancer drugs are alkylating agents, antimetabolites, antibiotics, and plant alkaloids. Alkylating agents like cyclophosphamide cause DNA damage. Antimetabolites like methotrexate interfere with DNA synthesis. Antibiotics such as doxorubicin intercalate DNA. Side effects depend on the drug but can include suppression of the immune system and damage to organs.
This document provides an overview of glioblastoma, including its incidence, risk factors, prognosis, biomarkers, and molecular subtypes. Some key points:
- Glioblastoma accounts for 54% of new gliomas and 45% of primary malignant brain tumors. 5-year survival rates are below 5% worldwide.
- Risk factors include age, ionizing radiation exposure, and certain genetic syndromes. Prognostic factors associated with better outcomes include younger age, methylated MGMT status, and extent of surgical resection.
- Emerging biomarkers like IDH1/2 mutations and EGFR amplification/mutations show promise in predicting prognosis, though MGMT methylation status is currently the only validated predictive biomarker.
Recent advances in inflammatory muscle diseasesNeurologyKota
This document summarizes recent advances in diagnosing and treating inflammatory muscle diseases. It discusses several conditions including dermatomyositis, polymyositis, necrotizing myopathy, and inclusion body myositis. Diagnostic techniques like muscle biopsy, MRI, ultrasound, and myositis antibody panels are described. Treatment typically begins with corticosteroids and may include immunosuppressants like methotrexate or rituximab for refractory cases. Newer areas of focus include gene therapies and monitoring disease activity with imaging modalities.
This document summarizes cancer chemotherapy and the various classes of chemotherapeutic drugs. It describes the mechanisms of action, indications, and side effects of alkylating agents, antimetabolites, plant alkaloids, antibiotics, and other classes of drugs. The principles of cancer chemotherapy are to arrest tumor progression by causing cytotoxicity or apoptosis in cancer cells, often targeting DNA or metabolic pathways essential for cell replication. Drugs are generally used in combination to achieve maximal cell killing while remaining within a tolerable toxicity range.
ANTI CANCER DRUGS[ANTI-NEOPLASTIC DRUGS] MEDICINAL CHEMISTRY BY P. RAVISANKAR.Dr. Ravi Sankar
The document discusses antineoplastic agents (anticancer drugs) and provides information on cancer and its diagnosis and treatment. It defines cancer as uncontrolled cell growth and discusses how cancer is classified. It also summarizes some common cancer types in children and adults. The document outlines several methods used to treat cancer, including surgery, radiation therapy, immunotherapy, hormonal therapy, chemotherapy and antibiotics. It provides classifications of antineoplastic drugs and examples.
Targeted drug delivery systems aim to increase the therapeutic efficacy of drugs while decreasing toxicity. This is achieved through passive targeting that relies on the enhanced permeability and retention effect, or active targeting using ligands that bind to receptors on tumor cells. The summary discusses key aspects of passive targeting including nanoparticle size, charge, and surface properties to maximize tumor accumulation. It also describes active targeting using ligands or antibodies directed against receptors overexpressed on tumor cells. The document provides examples of molecular targets for targeted therapies in cancer treatment.
Optimizing Chemotherapy For Malignant Gliomafondas vakalis
The document discusses optimizing chemotherapy for malignant glioma. Meta-analyses showed that combining temozolomide (TMZ) with radiotherapy improved survival rates compared to radiotherapy alone. A phase III trial demonstrated that concomitant and adjuvant TMZ with radiotherapy significantly improved progression-free and overall survival. Subset analyses found the benefit was consistent across patient subgroups. Methylation of the MGMT gene promoter was identified as predictive of benefit from TMZ therapy.
This document discusses pharmacology of antineoplastic agents. It begins by classifying antineoplastic agents into cell cycle specific agents, cell cycle non-specific agents, and miscellaneous agents like antibodies. It then discusses mechanisms of action, side effects, and drug resistance. Specific agents and their mechanisms, uses, and side effects are outlined. Alkylating agents like cyclophosphamide and mechanisms like crosslinking DNA are explained in detail.
Mitochondrial myopathy is a group of neuromuscular diseases caused by damage to the mitochondria in nerve and muscle cells. Symptoms include muscle weakness, exercise intolerance, heart problems, movement disorders, and seizures. Most cases occur in people under 20 years old and begin with exercise intolerance or muscle weakness. While prognoses vary, these are progressive diseases that can lead to death. There is no cure, but physical therapy, vitamins, and supplements may provide relief from some symptoms.
This document provides an overview of pheochromocytoma, which is a rare tumor that forms in the adrenal glands and secretes excessive amounts of catecholamines. It discusses the definition, causes, pathophysiology, clinical manifestations, diagnosis, and treatments of pheochromocytoma. Regarding treatment, it describes surgical removal of the adrenal gland, preoperative use of alpha-adrenergic and beta-adrenergic blockers, radiation therapy, chemotherapy, ablation therapy, embolization therapy, and targeted therapy as options. It also covers nursing management of patients with pheochromocytoma and potential complications.
Primary brain tumors are a diverse group of neoplasms that can arise from different cells in the central nervous system. The most common primary brain tumor in adults is brain metastasis. Meningiomas are the most common non-malignant primary brain tumor, followed by pituitary and nerve sheath tumors. Gliomas account for 75% of malignant brain tumors, over half of which are glioblastomas. Primary brain tumors are classified and graded according to the WHO system, with grade I being low proliferative potential and grade IV being most malignant. Clinical features vary depending on tumor location but often include headaches, nausea, seizures, and focal neurological deficits.
Primary brain tumours are a diverse group of neoplasm arising from different cells of the central nervous system.
It accounts for about 2% of all cancers with an overall annual incidence of 22 per 1,00,000 population.
Most common brain tumour in adults is Brain Metastasis.
The document discusses principles of cancer immunotherapy and its application to lung cancer. It covers tumor immunology, mechanisms by which tumors evade immune surveillance (such as loss of antigens or promotion of an immunosuppressive microenvironment), and immune checkpoint inhibitors such as PD-1 and PD-L1 inhibitors. For advanced non-small cell lung cancer lacking a driver mutation, immunotherapy either alone or in combination with chemotherapy is now standard first-line treatment depending on factors like PD-L1 expression level. Pembrolizumab or atezolizumab combined with chemotherapy are preferred options.
Radiosensitizers are agents that increase the lethal effects of radiation when administered with radiotherapy. They work through various mechanisms like increasing DNA damage, inhibiting repair, and modulating biological response. Common types include physical agents like hyperthermia, chemical agents like nitroimidazoles to target hypoxic cells, and biological modifiers like cetuximab. Effective radiosensitizers improve the therapeutic ratio by increasing tumor cell killing while minimizing harm to normal tissues. Combining radiosensitizers with radiotherapy can improve outcomes for many cancer types.
This document discusses anti-cancer or neoplastic drugs and is presented by Dr. Homan. It covers topics such as the definition of cancer, epidemiology, risk factors, characteristics, types, cell cycle, carcinogenesis, diagnosis, classification of anti-cancer drugs, mechanisms of action, and toxic effects. The document provides information on various classes of anti-cancer drugs including alkylating agents, antimetabolites, cytotoxic antibiotics, hormones, and their mechanisms of treating cancer by affecting DNA, RNA, or microtubules.
Chapter 27 chemotherapy side effects dr lmsNilesh Kucha
The era of modern chemotherapy began in the early 1940s when Goodman and Gilman first administered nitrogen mustard to lymphoma patients. Although nitrogen mustard was originally developed as a chemical weapon, its toxic effects on the lymphatic system led to clinical trials of its use in cancer treatment. This marked the beginning of chemotherapy as an active field of cancer research and therapy development.
The document discusses various classes of anti-cancer drugs, including their mechanisms of action, pharmacokinetics, clinical uses, and common adverse effects. It covers alkylating agents, antimetabolites, plant alkaloids, antibiotics, hormonal agents, and other miscellaneous anti-cancer drugs. The classes of drugs discussed attack cancer cells through different mechanisms such as alkylation of DNA, inhibition of DNA synthesis, disruption of microtubule formation, and interference with hormone signaling pathways.
Tumor growth requires angiogenesis to develop new blood vessels. This process is regulated by a balance of pro-angiogenic and anti-angiogenic factors. Tumors disrupt this balance by inducing hypoxia and secreting factors like VEGF, which activate the "angiogenic switch" and promote new vessel growth. This allows tumors to recruit blood vessels to supply nutrients and remove waste. Anti-angiogenic therapies aim to block this process by targeting VEGF and its receptors. Drugs like bevacizumab and sorafenib inhibit angiogenesis to limit tumor growth and progression.
Paraneoplastic syndrome (PNS) is the term used to refer to the disorders that accompany the benign or the malignant tumors and are not caused by mass effect or invasion / metastasis.
These disorders are triggered by an immune system response to neuronal proteins expressed by the tumor(onconeural proteins).
These PNS also occur due to substances secreted by the neoplasm itself.
Cancer occurs due to genetic changes in cells that lead to uncontrolled growth. Anticancer drugs target features of cancer cells, including their DNA, to interfere with cell division and cause cell death. The main classes of anticancer drugs are alkylating agents, antimetabolites, antibiotics, and plant alkaloids. Alkylating agents like cyclophosphamide cause DNA damage. Antimetabolites like methotrexate interfere with DNA synthesis. Antibiotics such as doxorubicin intercalate DNA. Side effects depend on the drug but can include suppression of the immune system and damage to organs.
This document provides an overview of glioblastoma, including its incidence, risk factors, prognosis, biomarkers, and molecular subtypes. Some key points:
- Glioblastoma accounts for 54% of new gliomas and 45% of primary malignant brain tumors. 5-year survival rates are below 5% worldwide.
- Risk factors include age, ionizing radiation exposure, and certain genetic syndromes. Prognostic factors associated with better outcomes include younger age, methylated MGMT status, and extent of surgical resection.
- Emerging biomarkers like IDH1/2 mutations and EGFR amplification/mutations show promise in predicting prognosis, though MGMT methylation status is currently the only validated predictive biomarker.
Recent advances in inflammatory muscle diseasesNeurologyKota
This document summarizes recent advances in diagnosing and treating inflammatory muscle diseases. It discusses several conditions including dermatomyositis, polymyositis, necrotizing myopathy, and inclusion body myositis. Diagnostic techniques like muscle biopsy, MRI, ultrasound, and myositis antibody panels are described. Treatment typically begins with corticosteroids and may include immunosuppressants like methotrexate or rituximab for refractory cases. Newer areas of focus include gene therapies and monitoring disease activity with imaging modalities.
This document summarizes cancer chemotherapy and the various classes of chemotherapeutic drugs. It describes the mechanisms of action, indications, and side effects of alkylating agents, antimetabolites, plant alkaloids, antibiotics, and other classes of drugs. The principles of cancer chemotherapy are to arrest tumor progression by causing cytotoxicity or apoptosis in cancer cells, often targeting DNA or metabolic pathways essential for cell replication. Drugs are generally used in combination to achieve maximal cell killing while remaining within a tolerable toxicity range.
ANTI CANCER DRUGS[ANTI-NEOPLASTIC DRUGS] MEDICINAL CHEMISTRY BY P. RAVISANKAR.Dr. Ravi Sankar
The document discusses antineoplastic agents (anticancer drugs) and provides information on cancer and its diagnosis and treatment. It defines cancer as uncontrolled cell growth and discusses how cancer is classified. It also summarizes some common cancer types in children and adults. The document outlines several methods used to treat cancer, including surgery, radiation therapy, immunotherapy, hormonal therapy, chemotherapy and antibiotics. It provides classifications of antineoplastic drugs and examples.
Targeted drug delivery systems aim to increase the therapeutic efficacy of drugs while decreasing toxicity. This is achieved through passive targeting that relies on the enhanced permeability and retention effect, or active targeting using ligands that bind to receptors on tumor cells. The summary discusses key aspects of passive targeting including nanoparticle size, charge, and surface properties to maximize tumor accumulation. It also describes active targeting using ligands or antibodies directed against receptors overexpressed on tumor cells. The document provides examples of molecular targets for targeted therapies in cancer treatment.
Optimizing Chemotherapy For Malignant Gliomafondas vakalis
The document discusses optimizing chemotherapy for malignant glioma. Meta-analyses showed that combining temozolomide (TMZ) with radiotherapy improved survival rates compared to radiotherapy alone. A phase III trial demonstrated that concomitant and adjuvant TMZ with radiotherapy significantly improved progression-free and overall survival. Subset analyses found the benefit was consistent across patient subgroups. Methylation of the MGMT gene promoter was identified as predictive of benefit from TMZ therapy.
This document discusses pharmacology of antineoplastic agents. It begins by classifying antineoplastic agents into cell cycle specific agents, cell cycle non-specific agents, and miscellaneous agents like antibodies. It then discusses mechanisms of action, side effects, and drug resistance. Specific agents and their mechanisms, uses, and side effects are outlined. Alkylating agents like cyclophosphamide and mechanisms like crosslinking DNA are explained in detail.
Mitochondrial myopathy is a group of neuromuscular diseases caused by damage to the mitochondria in nerve and muscle cells. Symptoms include muscle weakness, exercise intolerance, heart problems, movement disorders, and seizures. Most cases occur in people under 20 years old and begin with exercise intolerance or muscle weakness. While prognoses vary, these are progressive diseases that can lead to death. There is no cure, but physical therapy, vitamins, and supplements may provide relief from some symptoms.
This document provides an overview of pheochromocytoma, which is a rare tumor that forms in the adrenal glands and secretes excessive amounts of catecholamines. It discusses the definition, causes, pathophysiology, clinical manifestations, diagnosis, and treatments of pheochromocytoma. Regarding treatment, it describes surgical removal of the adrenal gland, preoperative use of alpha-adrenergic and beta-adrenergic blockers, radiation therapy, chemotherapy, ablation therapy, embolization therapy, and targeted therapy as options. It also covers nursing management of patients with pheochromocytoma and potential complications.
Primary brain tumors are a diverse group of neoplasms that can arise from different cells in the central nervous system. The most common primary brain tumor in adults is brain metastasis. Meningiomas are the most common non-malignant primary brain tumor, followed by pituitary and nerve sheath tumors. Gliomas account for 75% of malignant brain tumors, over half of which are glioblastomas. Primary brain tumors are classified and graded according to the WHO system, with grade I being low proliferative potential and grade IV being most malignant. Clinical features vary depending on tumor location but often include headaches, nausea, seizures, and focal neurological deficits.
Primary brain tumours are a diverse group of neoplasm arising from different cells of the central nervous system.
It accounts for about 2% of all cancers with an overall annual incidence of 22 per 1,00,000 population.
Most common brain tumour in adults is Brain Metastasis.
This document discusses primary central nervous system lymphoma (PCNSL). Some key points:
- PCNSL is a rare type of non-Hodgkin lymphoma confined to the brain, eyes, or spinal cord. It most commonly presents with neurocognitive symptoms in immunocompetent patients in their 50s-60s.
- Diagnosis involves brain imaging, biopsy, and ruling out systemic involvement. The standard treatment was whole brain radiation but this resulted in poor survival and neurotoxicity.
- Newer regimens combining high-dose methotrexate with other chemotherapy agents and reduced whole brain radiation have improved outcomes with median survival around 3 years and less neurotoxicity. Ongo
Primary central nervous system lymphoma (PCNSL) is a rare form of non-Hodgkin's lymphoma confined to the brain and spinal cord. It represents around 1% of all brain tumors. The standard treatment is high-dose methotrexate-based chemotherapy with or without whole brain radiotherapy. While chemotherapy alone may avoid radiation-related neurotoxicity risks, the addition of radiotherapy may improve survival outcomes. Ongoing clinical trials are further evaluating the optimal treatment approaches for managing this aggressive cancer.
The document discusses principles of chemotherapy, including common agents and their mechanisms of action, side effects, and clinical considerations. It covers conventional chemotherapy drugs like alkylating agents, antimetabolites, and antitumor antibiotics, as well as their uses in treating cancers and managing side effects. The goal of chemotherapy is to cure cancer through eliminating all cancer cells, achieving long-term disease control, or palliating cancer symptoms.
Brain tumors are the most common primary tumors in the central nervous system. The two most common primary brain tumors are meningiomas and glioblastomas. Brain metastases occur in around 15% of cancer patients, most commonly from lung and breast cancers. Primary brain tumors are graded on a scale of I to IV based on factors like growth rate and malignancy. Glioblastoma is a grade IV tumor and is the most aggressive type of astrocytoma. Standard treatment for glioblastoma involves maximal surgical resection followed by radiation therapy with concurrent temozolomide chemotherapy and then adjuvant temozolomide for 6 months. Temozolomide is an oral chemotherapy that can cross the blood-brain barrier and has
Principles of cancer chemotherapy and its clinical evaluationjyotimannath
Dr. Jyotiman Nath presented on the history and development of cancer chemotherapy. Some key points include:
- Chemotherapy originated in the early 20th century with Paul Ehrlich's work on "magic bullets" to treat infections. Sidney Farber is considered the father of modern chemotherapy.
- During World Wars I and II, exposure of soldiers to mustard gas led to the observation that alkylating agents suppressed bone marrow, laying the foundations for using similar agents to treat cancers.
- In the 1940s and 50s, drugs like methotrexate and combinations of drugs were used successfully to treat various cancers, representing major advances in the field.
- Current chemotherapy typically involves combinations of
The document provides information about brain metastasis including:
- Brain metastasis are cancer cells that have spread to the brain from primary tumors elsewhere in the body. Lung cancer, breast cancer, melanoma, and renal cancer are common sources.
- Symptoms depend on the location of metastases and can include headaches, nausea, focal weakness, seizures, and alterations in consciousness. Diagnosis is typically made through MRI or CT imaging.
- Treatment involves steroids, anticonvulsants, surgery to remove solitary metastases, stereotactic radiosurgery for a small number of lesions, whole brain radiation, and occasionally chemotherapy. The prognosis is generally poor with a median survival of 4-5 months.
This document discusses several types of childhood solid tumors, including central nervous system (CNS) tumors and neuroblastoma. It provides information on:
1) CNS tumors are the second most common malignancy in childhood, with astrocytomas making up 40% of cases. The most common astrocytoma is juvenile pilocytic astrocytoma.
2) Neuroblastoma is the most common extracranial solid tumor in childhood, arising from the sympathetic nervous system. It typically presents before 5 years of age and stages range from localized to widespread metastasis.
3) Treatment approaches for neuroblastoma and CNS tumors involve multimodal therapy including surgery, chemotherapy, and sometimes radiation
Brainstem gliomas account for about 10% of childhood brain and spinal tumors. They are challenging to treat due to their critical location. Radiation therapy plays a key role in management as surgery has limited effectiveness. Diffuse pontine gliomas, the most common type, have a terrible prognosis with over 90% of children dying within 2 years despite treatment. New immunotherapies and targeted therapies are being investigated as potential treatments to improve outcomes for these difficult to treat tumors.
This document summarizes primary nervous system tumors in adults. It discusses that primary brain tumors arise from different central nervous system cells and account for about 2% of cancers. Meningiomas are the most common non-malignant tumors, while gliomas account for 75% of malignant brain tumors, over half being glioblastomas. Symptoms, diagnostic imaging techniques, treatment options including surgery, radiation therapy, chemotherapy are described. The management of primary brain tumors in adults and children of different age groups is summarized.
Primary CNS lymphoma (PCNSL) is a rare form of non-Hodgkin's lymphoma confined to the brain and spinal cord. It most commonly affects immunocompetent elderly patients and presents with neurological symptoms. Diagnosis requires biopsy and imaging shows contrast-enhancing lesions. Standard treatment is high-dose methotrexate-based chemotherapy with consolidation radiotherapy, though radiotherapy is being used less due to neurotoxicity risks, especially in older patients. The prognosis remains poor with median survival around 2 years despite treatment.
This document discusses cancer chemotherapy and its goals, approaches, and challenges. It covers:
1. The goals of cancer treatment include being curative, palliative, or adjuvant. Major treatment modalities include surgery, radiotherapy, chemotherapy, and others.
2. Chemotherapy works by targeting the cell cycle and killing a constant fraction of cancer cells per dose. It is more effective against cancers with high growth fractions.
3. Challenges include drug resistance, toxic side effects that impact rapidly dividing normal cells, and managing those toxicities. Combination chemotherapy aims to overcome these challenges.
Chemotherapy drugs work by damaging DNA or inhibiting DNA synthesis in rapidly dividing cancer cells. While chemotherapy has improved survival for some cancers, resistance often develops and toxic side effects limit doses. Combination regimens using different drug classes aim to overcome resistance, but incremental improvements have plateaued. Recent focus is on molecularly targeted agents addressing specific cancer pathways to potentially achieve greater effects with less toxicity.
The document discusses the use of radiotherapy in treating benign diseases. It provides examples of benign diseases like Graves' ophthalmopathy and pituitary adenomas that can cause debilitating symptoms if left untreated. Radiotherapy is an effective treatment for many benign conditions and is safer and more precise with modern techniques. The document outlines indications for radiotherapy in specific benign diseases like meningiomas and pituitary adenomas. It discusses factors like tumor size, location and pathology that influence radiotherapy approaches and outcomes.
1) Brain metastases are most commonly from lung cancer and breast cancer and occur when cancer cells spread to the brain from a primary tumor in another organ.
2) Patients typically present with new neurological symptoms and MRI is the standard imaging method to detect metastatic brain tumors.
3) Treatment options include corticosteroids to reduce edema, surgical resection for select cases, whole-brain radiotherapy, and radiosurgery as a boost to the tumor site. Adjuvant whole-brain radiotherapy after surgery or radiosurgery can help prevent future brain metastases.
Brain metastases are common brain tumors in adults. The most common primary sites are lung, breast, melanoma, and colon cancers. Symptoms depend on the location of metastases and include headache, weakness, cognitive changes, seizures, and sensory or speech problems. MRI with contrast is the preferred imaging method and can detect multiple lesions, circumscribed margins, and edema. Treatment depends on prognosis and may include surgery, whole brain radiation, stereotactic radiosurgery, chemotherapy, or supportive care. Outcomes are classified by the recursive partitioning analysis which considers performance status, extracranial disease burden, age, and primary diagnosis.
Medical treatment for lung cancer may involve surgery, chemotherapy, radiation therapy, or combinations of these. The appropriate treatment depends on the location and size of the tumor as well as the patient's health. Surgery is the primary treatment for early-stage non-small cell lung cancer when possible but radiation and chemotherapy are also used. Chemotherapy drugs kill cancer cells but also damage healthy cells, causing side effects. New targeted therapies and procedures like laser surgery, stents and cryotherapy help treat tumors and relieve symptoms.
Similar to Leading substances for brain cancer (20)
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The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
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share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
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• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
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DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
4. Definition of Brain tumor
A brain tumor is a localized intracranial lesion which
occupies space with the skull and tends to cause a rise
in intracranial pressure.
5. Causes of Brain Cancer
DNA Damage
Radiation
Genetics
NF-1 (acoustic neuromas)
Li Fraumeni syndrome
Tuberous sclerosis (astrocytomas)
Multiple endocrine neoplasia type-1(Pituitary
macroadenoma)
Infection
HIV
11. Timing of Chemotherapy
Adjuvant
After surgery or radiation
Defined number of cycles
Aim
Prolong time of recurrence
Recurrence
Number of cycles limited by side effects
Aim
Improve symptoms, quality of life and slow progression
12. A BIT of HISTORY….
• Surgery & radiation mainstays of treatment (and still are)
• Chemotherapy options
• PCV standard of care for many years
• Procarbazine
• Carmustine
• Vincristine
• Single agent nitrosurea (Lomustine/carmustine) are equivalent
13. Rationale For The Use Of
Chemotherapy in Neuro-Oncology
1 gram of tumor = one billion cells
GTR = removal of 99% (990,000,000 cells)
Still have 10,000,000 tumor cells
Radiation may remove 99% (9,900,000 cells),
leaving 100,000 cells
14. Barriers to Use of Chemotherapy
Uncommon (2% of all malignancies)
Blood-brain barrier
Interaction of chemotherapeutic agents with EIAC
15. Solutions to Barriers to Use of
Chemotherapy
Lipophilic molecules (Nitrosureas)
Small molecules (Gefitinib)
Osmotic Blood Brain Barrier Disruption
Design drugs that do not interfere with EIAC
medications
Make chemotherapy drugs very expensive
16. How to overcome BBB ??
Newer delivery method includes:
Interstitial chemotherapy uses disc-shaped polymer wafers (known as Gliadel
wafers) soaked with carmustine, the standard chemotherapeutic drug for brain
cancer.
Intrathecal chemotherapy delivers chemotherapeutic drugs directly into the
spinal fluid
Intra-arterial chemotherapy delivers high-dose chemotherapy into arteries in
the brain using tiny catheters.
Convection-enhanced delivery (CED) involves placing catheters into the brain
tumor or nearby brain tissue to deliver slowly and continuously a cancer drug
over several days.
18. Carmustine and Lomustine
Highly lipophilic nitrosureas
Hydrolysis in vivo to form reactive metabolites
Metabolites cause alkylation and cross-linking of DNA
CSF equilibrates within one hour to > 50% of plasma levels
Metabolism = hepatic microsomal enzyme
Excretion = predominantly renal
19. Nitrosurea Toxicities
Dose limiting toxicity is myelosuppression
Nadir 25-60 days, recovery 35-85 days
Nausea and vomiting
Dizziness, ataxia, lethargy, disorientation
Pulmonary fibrosis (dose dependent)
Infertility and mutagenesis
Carmustine is a vesicant
20. Procarbazine
Multiple sites of action (inhibits DNA, RNA and
protein synthesis)
Rapid equilibration with CSF
Metabolism = microsomal enzymes
Excretion = predominately renal
22. Standard ones include:
Temozolomide
Taken oral
First approved in 1999 for adult patients with anaplastic astrocytoma that did
not respond to other treatments.
In 2005, it was approved for use during and after radiation therapy for
patients newly diagnosed with glioblastoma multiforme.
Adverse effects: Relatively minor, but may include constipation, nausea and
vomiting, fatigue, and headache..
23. Temozolomide
Classification = alkylating agent
Rapid conversion at physiologic pH to MTIC, CSF concentration is
30% of serum
MTIC cytotoxicity due to methylation of DNA at the O6 position of
guanine
Antitumor activity is schedule dependent
Cytotoxicity influenced by levels of MGMT
Levels not infuenced by cytochrome p450
Renal and hepatic clearance minor
26. Gefitinib
Potent and selective inhibitor of EGFR tyrosine kinase
EGFR expression and over-expression in GBM other brain
cancers
Over-expression correlated with poor prognosis in many
cancers
Once-daily, oral dosing
Lipophilic compound but CNS levels are low
27. THANK YOU
For any queries, please contact me at: shivanichauhan232@gmail.com