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: T 2 N 1 M 0 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.