Glossary

Adjuvant chemotherapy – The administration of chemotherapy after surgery or radiation treatment for cancer.  This round of chemotherapy follows on the main treatment to help take care of any remaining malignant cells.

Adjuvant therapy – More general than adjuvant chemotherapy, adjuvant therapy refers to any treatment administered following the main treatment. This might be chemotherapy, but it also might be radiation or hormone therapy, or other treatments.

ADT – Androgen Deprivation Therapy

Alkylating Agents – Chemotherapy drugs that chemically link to cellular DNA and thereby prevent mitosis.  This stops growths in the body, including malignant tumors.

Anemia – A clinical condition when the patient has insufficient red blood cells to carry oxygen that the body demands.  As a result, the patient feels tired and may have other complications.  Common side effect of chemotherapy drugs.

Angiogenesis – Growth and development of new blood vessels. Happens when an organism grows. Cancerous tumors rely on angiogenesis to grow.

Antibody conjugates – Armed antibodies or empowered antibodies.  Explained here.

Antineoplastic – Inhibiting the development of abnormal tissue growth.  Anti-cancer drugs are antineoplastic.

Anthracyclines – Class of antibiotics derived from bacteria and used to treat cancer.  Used on a wide range of cancers.  More.

Antiemetic – Anti-nausea medicine used to stop vomiting and feeling sick-to-the-stomach, which are common side effects of chemotherapy medicines.

Antifolate –Class of chemotherapy medicines that stop mitosis by inhibiting the action of folic acid in the cellular metabolism.

API – Active Pharmaceutical Ingredient- biologically active moeity of drug.  Not part of any carrier or filler.  In simple drugs, it is a unique chemical compound.  In more complex medicines, it can be a biologic substance or combination of materials.

Basket clinical trials – also called bucket clinical trial – relatively new type of clinical trial that uses different statistical techniques to get actionable data from a smaller group of patients.  Widely used in tests of targeted therapies where the limited patient pool would make traditional trials less feasible.

Biologics Medicines or medicine-like products used to treat disease, including viruses, antibodies, therapeutic proteins, and whole cells.  In contrast to small molecule drugs, biologics are typically large and complex molecules.  They cannot be taken orally because the digestive system would denature them before they are absorbed into the body.  Also called biopharmaceuticals.

Biologic response modifier – a formal name for “immune boosters”.  Medicines that are intended to make the body’s immune system more vigilant are BRMs.  These include colony- stimulating factors and interferons. Some endogenous materials that naturally occur in the body are called biologic response modifiers.

Biologics License Application (BLA) – An application to the US Food and Drug Administration to market and sell a new biologic product for human medicine.   Analagous to a NDA for drugs, the BLA is used for vaccines, blood products, cells and tissues, and gene therapy.

Calvert formula – Calculation scheme used to determine optimum dose of carboplatin.

Catheter – Tube inserted into the body. Used to administer chemotherapy.

CCNS – cell-cycle non-specific drugs – chemotherapy drugs that inhibit reproduction of cells in any phase of the cell division cycle.  Contrast with CCS drugs.

CCS – cell-cycle specific drugs – chemotherapy drugs that inhibit reproduction of cells in one phase of the cell division cycle.

Checkpoint Inhibitor – Chemicals that blocks normal proteins on cancer cells or on immune system T cells. These proteins slow that action of the immune system on cancer and by inhibiting them, scientists hope the immune system will be more active against malignant cells. More.

Chemobrain – Also called “chemo fog.” Attention span, thinking, and short-term memory problems during and after cancer treatment. Cancer patients who do not receive chemotherapy also report similar symptoms, so it is not clear that the chemotherapy agents are the cause.

Chemoprevention – Chemoprophylaxis – use of drugs to forestall or prevent disease.  Not used widely against cancer, although some have proposed programs to do so.

Chemotherapy cycles – a repeat pattern in the administration regimen.  There might be formal evaluations after a cycle. Most patients have multiple cycles.

Combination chemotherapy – Administration of more than one drug to treat cancer.  Quite common.  Page on combination chemo.

Companion Diagnostics – Required test(s) that goes along with the therapy.  Ccompanion diagnostic are included in the labeling instructions for the therapeutic product   Diagnostic tests often involve measurement of the patient’s serum levels of proteins, metabolites, and tracers..

Complete blood cell count (CBC) – Common diagnostic test showing the number of red blood cells, white blood cells, and platelets in a patient’s blood.   The amount of hemoglobin (substance in the blood that carries oxygen) and the hematocrit (the amount of whole blood that is made up of red blood cells) are also measured. A CBC is used to help diagnose and monitor many conditions. Also called blood cell count, complete blood count, and full blood count.

Complete remission – describes cancer in patient who has been treated but now has no symptoms and no trace of cancer in imaging or medical tests.

Consolidation chemotherapy – also called postremission therapy or intensification therapy.  Chemotherapy administered after the cancer has gone into remission.

CTX or CTx – occasionally an abbreviation for chemotherapy.

Curative chemotherapy – Chemotherapy intended to cure or cause significant progress against the cancer, in contrast to adjuvant, neoadjuvant, or palliative chemotherapy.

Cytopathology – study of disease at the cell level.

Cytostatic – adjective describing material that slows or stops the growth of cancer, without necessarily killing cells.  Some of the newer targeted therapies fall in this category.

Cytotologystudy of cells

Cytotoxic – adjective describing material that kills cells or suppresses the growth and multiplication of cells.  Conventional chemotherapy agents are cytotoxic, which is why the side effects are so severe.

Disseminated cancer – Cancer that has metastasized.

Disease Free Survival (DFS) – Length of time patient goes after treatment without indication of cancer returning.

Dose-dense chemotherapy – Treatment regimen consisting of a series of pulses.  each with a high (maximum-tolerated dose),  the time between the pulses is small.

DPI – Drug package insert. Written instructions and cautions included with pharmaceuticals delivered at the retail level, often containing information mandated by a regulatory agency.

Drug-drug interactions – Response (negative or positive) when two drugs together produce a effect neither would produce by itself. Also refers to situations when one of the drugs is an over-the-counter medicine or an herbal supplement.

Drug activation – The conversion of a prodrug to an active medication inside the body.

Drug deactivation – Metabolism of compound so that it is no longer active against the target disease.

Drug efflux – Biochemical mechanism to remove drug from inside of cell to outside.  The efflux system evolved to protect the cell from outside contaminants.  It may work on drugs that the cell recognizes are foreign.  Drug efflux is part of the xenobiotic metabolism by which organisms deal with outside materials.

Drug indication – A particular use for the drug usually expressed in terms of illness and patient characteristics or history. FDA labels approve drugs for particular indications.

Dysplasia – When abnormal cells are in a tissue.  Indicates possible risk for development of cancer.

Epigenetics – Describes characteristics that are phenotypic (descriptive of the organism) and heritable but which are not genetic or encoded in the DNA.  Epigenetic modifications are changes in how the genes are expressed but not the genes.

First-line chemotherapy – Initial treatment for cancer when chemotherapy is intended to be the prime treatment.  As distinct from adjuvant chemotherapy (after the main treatment of surgery or radiation) and neo-adjuvant chemotherapy (which is intended to increase the efficacy of the main treatment of surgery or radiation).

Glomerular filtration rate (GFR) – rate of blood flow through the kidneys – a rough estimate of how fast the kidneys can process blood and remove foreign materials – important in pharmacokinetics.

Genotoxic – Adjective that describes an agent that destroys a cell’s genetic material (DNA, RNA). Genotoxins are mutagens; they include radiation and chemicals.

Growth Fraction – Percentage of cells in a tumor that are proliferating and reproducing at any given point in time.

Half-life – Time characteristic of how a material decays. In pharmacokinetics, the shorter the half-life, the faster the medicine concentration declines in the body.

Health-related quality of life – Metric used by medical professions in evaluation of  treatment alternatives.  More on quality of life.

Hematologic malignancies – cancer of the blood and lymph and related tissues.

Hickman catheter – Catheter placed for access to major vein.  Often used for cancer patients both to deliver chemotherapy and to remove blood samples.

Histologystudy of anatomy at small scales (microanatomy).

Histopathology – study of disease at the tissue level.

Induction chemotherapy – Initial course of chemotherapy, especially if it is planned in advance of radiation treatment.  More.

Infusion – Slow intravenous administration of chemotherapy medication.  Called for in some regimens to prevent too much of a spike in blood concentration of the drug.

Intra-arterial – Administration of drug into a patient’s artery.  Much less common that intravenous injection.

Intracavitary – Administration of drug into a patient’s bodily cavity such as the abdomen.

Intralesional – Injecting the drug directly into the tumor.

Intramuscular – Administration of drug into a patient’s muscle.  Sometimes used in some chemotherapy regimens.

Intrathecal – Administration of drug into a patient’s spinal fluid (cerebrospinal fluid).

Intravenous – Administration of fluids, including chemotherapy, into a patient’s vein.  Often called IV.  Most common method of administering chemotherapy.  More.

Investigational New Drug – A designation by the US Food and Drug Administration for new medicines that have not yet been approved for general use but which the sponsor is seeking data about.  The FDA typically grants a medicine IND status after some animal testing has ruled out gross toxicity, but before clinical trials in humans begin.

IV bolus – A discrete amount of drug solution that is given to a patient at one time.

Kinase – Any of a class of enzymes that facilitates the transfer a γ-phosphate group from ATP.  Important in metabolism. Many kinases play a part in cancer progression.

Kinase inhibitor – A class of drugs that block the action of kinases.  The drugs are intended to thwart the progression of cancer and possibly other diseases.

Kinome – Name for all the genes that encode for kinases in the genome.  There are 538 kinases in humans.

Maintenance chemotherapy – Low intensity course of chemotherapy given after main treatment course. If the cancer has disappeared, maintenance chemotherapy may be used to prevent recurrence. Other times the cancer is still present but the doctor wants to ease off the heavy chemotherapy for a time period, and he or she switches to a lower dose to avoid losing progress made during the main therapy round.  More.

MetastasisThe spread of cancer from the organ is started in to other parts of the body.

Micrometastasis – Spread of small tumors throughout the body – tumors that cannot be detected in a diagnostic test.

Mitotic inhibitor – General term for drugs that inhibit mitosis by disrupting microtubules that form in the M-phase of the cell cycle.

Modality – Type or category of treatment.  In cancer, surgery, radiotherapy, and chemotherapy are modalities of treatment.

Mucositis – Inflammation of mucous membranes.  Mucous membranes are involved in absorption and secretion and line many tracts and structures of the body including the eyes, lungs, and digestive tract from mouth to anus. Mouth sores, oral mucositis, and esophagitis are types of mucositis and common side effects of chemotherapy.

Multisource Drugs – Generic Drugs

Myelosuppression – Decrease in bone marrow activity and production of white blood cells (leukocytes), red blood cells (erythrocytes), and/or platelets (thrombocytes).

Myeloid Growth Factors – chemicals administered to chemotherapy patients with the intent of stimulating white blood cell formation.  Myelosuppression is a very common side effect of chemotherapy treatment and administration of colony-stimulating factors can help.

Neoadjuvant chemotherapy – The counterpart to adjuvant chemotherapy before the main cancer treatment. The main treatment may be more chemotherapy or radiation or surgery. For instance, a patient may be given neoadjuvant chemotherapy to shrink a tumor before surgery. More.

Next-generation sequencing – aka high-throughput sequencing – a variety of methods to analyze DNA and RNA and identify their base sequences. Also called massively parallel sequencing. Important in fundamental cancer research.

New Drug Applications (NDA) – an application to the US Food and Drug Administration to market and sell a new medicine. While the NDA is a document package submitted on a particular date, in practice FDA personnel and pharmaceutical companies communicate during the development process, often for several years before the NDA is filed.

New Molecular Entity (NME) – term used by the US Food and Drug Administration for chemicals that have not previously approved as medicines in the US.  Some new drugs are NMEs, and these are often the most valuable new drugs for pharmaceutical companies.

Orphan Drug – A medicine for a disease that does not afflict many people. The US government has the Orphan Drug Act (ODA) to promote development of drugs for small markets. The EU has a similar program.

Overall Survival – How long the patient lives after treatment.

Palliative chemotherapy – Palliative procedure in medicine are ones that are not intended to cure a disease or cause remission in a cancer so much as to make the patient more comfortable.

Peripherally inserted central catheter (PICC) – Device used for long-term chemotherapy regimens, these catheters can stay in the patient’s body for week. A flexible tube goes into an arm vein and up the the superior vena cava in the chest.

Pharmacogenomics – Field that tries to understand and predict how a patient will respond to a drug.  Takes into account the patient’s genetics. Potentially an important part of precision medicine.

Pharmacovigilance – the practice of identifying the hazards caused medicines as they are being used by patients.  Most people who practice this focus on adverse drug reactions or lack of drug efficacy.

Phenotypic effect – expression of a trait as influenced by genes and the environment.  Both intended and side effects are phenotypic responses of the human to drug treatment.

Port – A catheter device surgically inserted under the patient’s skin. Makes it easy to administer chemotherapy and may be used if the regimen is expected to involve many incidences of administration.  The exposed surface is typically 2.5 to 4 cm in diameter.

Precision oncology – medical treatment whereby tumors are analyzed to see what type of chemotherapy is optimal.  Usually the analysis involved sequencing the tumor genome.

Primary chemotherapyNeo-adjuvant chemotherapy.

PRO – patient-related outcome. Refers to paradigm for evaluating medical interventions.

prodrug – substance that may not be an active medicine, but is converted inside the body to a metabolically active drug

Progression-free survival (PFS) – time treated patient experiences without cancer getting worse (by whatever measure is being used to measure worsening.)  A metric often used in trials of treatments.

PPE – Personal protective equipment.  Clothing and other paraphernalia designed to shield workers from hazards.

QALY – Quality-adjusted life year. – an artificial metric used in assessment of medical interventions.    Recognizes that desirable outcomes are a combination of length of life and quality of life.

QOD – Quality of life near death. The quality of life in a patient’s final weeks.

QOL – Quality of life. Somewhat amorphous but important measure of subjective experience of patient well-being from the patient perspective. Increasingly used in evaluation of medical interventions.

Radical chemotherapy – This is an imprecise term not used in formal scientific writing. Informally, it is used in an inconsistent manner. Radical therapy in medicine often means therapy with an intent to cure, not to slow the disease or control symptoms. But radical therapy in cancer treatment often means a major deviation from norms, including leaving out one or more treatments.

Relapse – The return of a disease after a period of improvement.

Regimen – The entire course of the chemotherapy administration, including schedule, methods of administration, types and dosages of agents, order of agents in the case of combination chemotherapy, and any adjunct medicines given to the patient at the time.

Relapse – The entire course of the chemotherapy administration, including schedule, methods of administration, types and dosages of agents, order of agents in the case of combination chemotherapy, and any adjunct medicines given to the patient at the time.

Remission – Clinical state where the tumor or scope of the cancer is less than it was in the past. Partial remission refers to a decline in disease or decrease in number of cancer cells; full or complete remission is when the cancer can no longer be detected. Goal of cancer therapy.

Resistance – Decrease in effectiveness of chemotherapy in a patient when the surviving tumor cells become hardened and less likely to respond to the medicine.an no longer be detected. Goal of cancer therapy.

Salvage Chemotherapy – Chemotherapy given to a patient after other treatments (including other chemo regimens) have been tried and failed.  There is no official definition for what counts as salvage chemotherapy, but researchers often use the term.  More.

Second-line chemotherapy – Chemotherapy regimen given when the first-line of treatment (chemo, radiation, and/or surgery) doesn’t work.

Signal transduction – Transmission of information through a cell by a series of chemical reactions.  Enzymes called protein kinases are often key parts of the transmission chain.  Many cellular processes rely on signal transduction, including tissue growth in both healthy tissue and tumors.

Signal transduction inhibitor – Chemical that stops or slows biochemical pathways that are “signals”.   Within the context of oncology, the signals being blocked are related to cell reproduction.

Small molecule drugs – Medicines with a molecular weight under 1000 or so, made by chemical synthesis or conventional fermentation.  Contrast to biologics in recent drug development.

Stomatitis – Sores on the lining of the mouth. Oral inflammation and ulcers. Common side effect of chemotherapy.

Synthetic lethality – Death of an organism or cell caused by genetic interaction of two genes induced from outside.  Also occurs from interaction between medicines and genes which “can be used to elucidate the mechanism of action of drugs. This area has recently attracted attention because of the prospect of a new generation of anti-cancer drugs”.  More.

Subcutaneous (SC) – Applied under the skin.

Tachyphylaxis – Tendency of a drug’s effectiveness to decline over time as the body or tumor develops resistance to it.

Theranostics – Type of paired therapy and diagnostic test.  The combination is intended to reduce delays in treatment by eliminating steps.  More.

Therapeutic index (TI) – Number pharmacologists use to estimate the “safety factor” in a drug. It is the ratio of the concentration (in the blood serum) at which the drug is shows activity against the disease. Drugs with low TIs are more apt to result in dangerous overdoses. All other things being equal, the higher the TI, the safer the medicine is.

Tissue – bigger than cells, smaller than organs – groups of cells near each other that do the same thing – types include connective, muscle, nervous, and epithelial

Topical – Method of administering chemotherapy by placing it on the skin.

Toxicity – A drug’s potential to cause harm to a patient.

Tumor burden – mass of tumor tissue or size of tumors carried by a patient with a malignancy.

Unresectable – Adjective used to describe cancer that cannot be removed by surgery.

Vesicant – Material that causes the skin to blister.  Some chemo agents are vesicants which is why ports are used to administer them.

Vinca Alkaloids – A class of chemotherapy agents derived from the Madagascar Periwinkle – genus Catharanthus.

List of Acronyms

AHFS -American Hospital Formulary Service

Alk – Anaplastic lymphoma kinase

ASCO – American Society of Clinical Oncology

ASHP – American Society of Health-System Pharmacists (formerly, American Society of Hospital Pharmacy)

CSTD –  Closed system drug-transfer device

FDA – Food and Drug Administration

HIPEC – Heated intraperitoneal chemotherapy

IARC – International Agency for Research on Cancer

MAP4K5 – Mitogen-activated protein kinase

NIOSH – National Institute for Occupational Safety and Health

OEL – Occupational exposure limit

ONS – Oncology Nursing Society

OSHA – Occupational Safety and Health Administration

USP – United States Pharmacopeial Convention

Medicinal Chemistry Acronyms

ALK – Anaplastic lymphoma kinase

BRAF – BRAF Proto-oncogene – Gene that encode for protein B-Raf

BRK – Breast tumor kinase

BTK – Bruton agammaglobulinemia tyrosine kinase

CDK – Cyclin-dependent kinase

CHK1 – Checkpoint kinase 1

CSF-1R –  Colony stimulating factor 1 receptor

CTK – Cytoplasmic tyrosine kinase

EGFR – epidermal growth factor receptor or epithelial growth factor receptor

EPHR –  ephrin receptor – subfamily of tyrosine kinase inhibitors

FGF – fibroblast growth factor

FGFR – fibroblast growth factor receptor

FLT3 – fms-like tyrosine kinase

HER – human epidermal growth factor receptor

HER-2 – Human epidermal growth factor receptor-2

Jak – Janus-family tyrosine kinase

JAK2 – Janus kinase 2

Lck – lymphocyte-specific protein tyrosine kinase

MAPK – Mitogen-activated protein kinases

MAP4K5 – mitogen-activated protein kinase

MEK – mitogen-activated extracellular regulated kinase

mTOR – mammalian target of rapamycin

PI3K – Phosphatidylinositol-3-kinase

PDGFR – platelet derived growth factor receptor

PDGFR-α – platelet-derived growth factor receptor α

PDGFR-β – platelet-derived growth factor receptor β

PLKs – Polo-like kinases

RET – rearranged during transfection

SRC – rous sarcoma oncogene cellular – proto-oncogene tyrosine-protein kinase c

STK11/LKB1 – serine/threonine kinase 11 or liver kinase B1

Trkb – tropomyosin-related kinase B

RTK – receptor tyrosine kinase

S/T Kinase – serine/threonine kinase

SRMS – src-related kinase

TRKB – tyrosine-related kinase B

VEGFR-2 – Vascular endothelial growth factor receptor 2

VEGFR – Vascular endothelial growth factor receptor

Yes – Yamaguchi sarcoma virus oncogene.