a daganat-terápia alapjai

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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 .

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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 Presentation

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Page 1: a daganat-terápia alapjai

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 .

Page 2: a daganat-terápia alapjai

• Staging– TMN staging: (for solid tumors)

• T: tumor size• N: node involvement• M: metastases

• Ex: T2N1M0

a daganat-terápia alapjai

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• Modalities of Treatment– Surgery– Radiation– Chemotherapy

a daganat-terápia alapjai

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• 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

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• 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

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• 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

Page 8: 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

Page 9: a daganat-terápia alapjai

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.