Activity 3: Aptamer Game Teacher Resource
Print outs of all necessary documents are below.
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Understanding drug action game: Traditional chemotherapy vs. aptamer complex drugs.
Curriculum
Aims
This activity will enable students to develop background understanding of some important concepts behind aptamers and their potential use in nanomedicine. Students should be able to upon completion:
Student learning outcomes:
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Articulate what the lock and key concept is and how it relates to aptamers and receptors.
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Understand the implications of the target factor in chemotherapy treatment (fast dividing cells)
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Appreciate the decrease in side effects in chemotherapy cancer treatment if the treatment can be made more specific.
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Be able to analyse class results and use them to explain how chemotherapy drug treatment linked with an aptamer would make a more successful treatment.
Background Information
Cancer is the result of a faulty cell cycle with cells dividing too frequently when they shouldn’t, forming a tumour. The fast-growing tumour can turn cancerous and damage surrounding tissue as well as move to other tissues, invading and effecting other organs.
Tumours are generally not cancerous if they are localised to the initial site in tissues meaning its cells are not able to migrate to a new location to form a new tumour elsewhere. These tumours are called benign. Tumours become cancerous when the tumour has cells with the ability to move into other tissues around the body forming secondary tumours elsewhere, medically speaking the patient has cancer if this happens.
Chemotherapy drugs were discovered in the 1940’s. Since then extensive research and development has been made leaving society with the many versions available today.
Chemotherapy drugs can be quite successful at treating some cancers but can have varying success in some individual patients due to the micro-environments of the tumours with different survival outcomes depending on the type of cancer and how aggressive it is.
Chemotherapy drugs target cancer cells fast dividing nature. This has implications though when the chemotherapy drug is traveling through the body as it cannot distinguish between healthy normal fast diving cells and the cancerous cells and will target both. This is the reason why chemotherapy patients have so many side effects.
Side effects include: Hair loss as hair follicle cells replicate and divide frequently, anaemia and weakened immune system because the chemotherapy drugs also effect the fast dividing red bone marrow cells, digestive system issues as all the cells lining the digestive tract frequently divide to replace those that are frequently damaged by roughage in the GI tract and more. Even though these cells are going through normal functions because they divide frequently, and chemo drugs target fast dividing cells, these cells also get effected.
Because of all the symptoms caused by normal healthy cells being targeted unintentionally, chemotherapy drugs that are bound to aptamers have serious potential to reduce unwanted side effects (because less/ no fast dividing healthy cells are targeted). Most importantly, if a receptor is found that is only present on cancer cells (and an appropriate aptamer can be found/made that is specific to that cancer receptor) then in theory, all the cancer cells in a patient can be targeted and killed by treatment curing the patient of cancer; with a dramatic reduction in side effects.
Emphasis on the ‘lock and key’ like feature/ mechanism of aptamers with receptors should be made/ addressed with the students so that the students understand the key concept of aptamer technology potential is highly targeted cancer treatment with dramatically lower side effects.
Game Instructions
Anything written in red is to provide extra teacher content/ direction for the instructions.
Prior to the start of the game, make sure one has all the cut outs and student cell cards. Once this is attained, split up the class into three categories: healthy slow dividing cells, healthy fast dividing cells and cancerous cells. Ensure that students are divided evenly across the three categories and that the correct corresponding activity sheet is given to every student. Every student from the start of the activity will need to keep a record of each outcome for their cell with each passing round; to be compiled into a class results table at the end of the six rounds of the game.
The teacher will inform students which version of the game one will be playing.
There are two different versions of the game. One where the teacher can play rock paper scissors with the students and one where one could role a dice against the students. Both are run so that there is a higher probability that fast-dividing cells will be given the chemotherapy drug and ‘lose’.
To speed either version of the game up the teacher could have 1 or more students also play the role of the teacher and verse other class mates at rock paper scissors or rolling a die.
Less rounds could be played as well to speed up the game. However to make the best use of data analysis for interpretation, it would be best to do a minimum of three rounds through the class.
Game Rules
Rock Paper Scissor Version:
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For the first section of this game, every student will be challenged to a game of rock paper scissors by their teacher. The aim is to win the best of three rounds of rock paper scissors per student, per round. If the student wins, they do not receive the chemotherapy drug card. But, if the student loses to the teacher, they do receive the drug card. The students will tally their outcomes on their cell record sheet throughout the duration of the activity.
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In the chemotherapy rounds, if students are a healthy fast dividing cell or a cancerous cell, they will automatically have a loss against them; in their attempt to win best of three rock paper scissors against the teacher.
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In rounds the chemotherapy rounds, if students are a healthy slow dividing cell, they will have no wins or losses to start with; in their attempt to win the best of three rock paper scissor battles with the teacher.
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The last round is the experimental treatment round. The teacher will come around to all with a chemotherapy drug card that are bound to an aptamer. They will see if their aptamer-chemotherapy drug card will fit any of the locks to the students’ cell receptors.
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If the aptamer key fits the receptor lock to a student’s cell type, then their cell loses, and they get given a chemotherapy drug card.
Dice Version:
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For, the chemotherapy rounds, every student will have to roll a dice to determine whether they have to take a chemotherapy drug card from their teacher. However, the student’s allocated cell type will determine what numbers rolled count as a win and not receiving a chemotherapy drug card.
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A student who is a healthy slow dividing cell will win against the teacher if they roll a 1, 2, 3 or 4 and lose, receiving a drug card if they roll a 5 or a 6.
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A student who is a healthy fast dividing cell will win if they roll a 1 or 2 but will lose, receiving a drug card from the teacher if they roll a 3, 4, 5 or 6.
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A student who is a cancerous cell will win against the teacher if they roll a 1 or 2 and lose, receiving a drug card if they roll a 3, 4, 5 or 6.
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The last round is the experimental treatment round involving an aptamer joined to the chemotherapy drug. The teacher will come around to all with a chemotherapy drug cards that are bound to an aptamer. They will see if their aptamer-chemotherapy drug card will fit any of the locks to the students’ cell.
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If the aptamer key fits the receptor lock to a student’s cell type, then the student cell loses, and they get given a chemotherapy drug card.
At the end of the game all the student’s results will need to be compiled onto the white board/ smart board, so they can be analysed as a class and then interpreted individually by the class. A copy of the table below is in the teacher resource document.
Student Activity Answers
The students have been directed to use a combination of their results and its interpretation and their own resource, using a computer or tablet to answer the following questions.
Suggested student answers are in blue. Red is teacher background/ direction.
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Question 1: Were there any differences between the cell results and the class average for that cell? If there were suggest an explanation as to why.
The student needs to look at their own results from the activity and compare them against the class average for their cell type. If there is any significant difference in the students average and class average for that cell type, they are meant to identify that this could be due to chance as the game simulates a lose probability of whether that cell type would get affected by the chemotherapy treatment.
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Question 2: Was there any major difference in the average percentage of cells receiving the chemotherapy drug between the healthy cells group and cancerous cells group in the chemotherapy round? What about in the aptamer treatment round?
The game should produce a pattern of results where the percentage of average amount of cells that received the chemotherapy drug for the healthy fast dividing cells and cancerous cells in conventional treatment round should be close in number. Whereas the slow dividing cells should have a lower average percentage of cells that received the chemotherapy drug. Students should have analysed their results and filled in the table of percentages which they should draw on to answer this question.
In theory their answer should be something like this:
Yes there was a difference in the percentages of cells that received chemotherapy drugs between the 3 groups in the conventional chemotherapy round. The fast dividing healthy cells and cancerous cells had similar percentages of …….% And ……..% whereas the slow dividing healthy cells had …..% of cells receiving the chemotherapy drug. This changed in the aptamer chemotherapy treatment round where the fast dividing and slow dividing cells had 0% receiving the chemotherapy drug and the cancerous cells had 100% of the cancerous cells receiving the drug.
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Question 3: Explain from the class results what is thought about what the chemo drug is targeting and why? Did the game rules replicate this bias of the chemo drug? Explain how?
From the class results and the students answer from question 2, the student should identify that in the conventional chemo rounds the fast dividing healthy cells and fast dividing cancerous cells both had similar % of cells receiving chemo drugs which is because chemotherapy drugs target fast dividing cells. The second part of the question is to get them to identify that the game rules were structured so that fast dividing cells would more likely/ more often receive the chemo drug instead of the healthy slow dividing cells.
The chemotherapy drug appears to be targeting fast dividing cells as the common factor between the healthy and slow dividing groups and the cancerous cells was that the fast dividing cells replicate quickly, like cancerous cells and in the results they both had similar % of cells that got the chemotherapy drug. The game replicated this by having a handicap in the rock paper scissor version that made a fast dividing cell more likely to lose against the teacher and by having less opportunity to roll a dice number that would give them a winning outcome against the teacher in the dice version.
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Question 4: What is an example of a chemotherapy treatment side effect? How does this relate to question 3?
A symptom of chemotherapy treatment is commonly hair loss. This relates to question 3 because hair follicle cells replicate quickly. Because hair cells replicate quickly they get targeted more by chemotherapy drugs, killing the cells. When the hair follicle cells are killed the person loses that hair strand.
The student should get this answer from a combination of some quick research, the introduction and inference by bringing together the concept learnt from question 3.
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Question 5: From your results which treatment method appears to be more effective? Using the class results create a graph to show the differences between average numbers of drugged cells for the three groups when they were using traditional chemotherapy or aptamer bound chemotherapy.
Aptamer chemotherapy drug treatment appears to be more effective as it had 100% of cancer cells receiving the chemotherapy drug unlike in the conventional chemotherapy round that had ….% of the cancer cells receiving the drug. This change in cells being effected between the conventional treatment round and the aptamer treatment round shows a decrease of healthy cells being given the treatment to none of them receiving the chemotherapy drug in the aptamer round, highlighting again that targeted cancer treatment will have no (less healthy cells effected because it has more specific targeting minimising healthy cells being effected and causing the symptoms of cancer) effect on healthy cells reducing symptoms but also target all the cancer cells and get rid of most, if not all the cancer cells. (should highlight to students that scientists researching aptamer technology has the potential to cure some cancers)
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Conclusions: Write a brief conclusion summarising the key concepts one has learned from this exercise and a point of interest one would like to learn more about after learning about aptamer technology.
Student should write a brief recount of their findings and why they have potential to be used to cure cancer/ improve cancer treatment. By getting them to reflect on what they found interesting it should get them more engaged and encourage them to do their own further research about aptamer technology outside of class if it grabs them enough.
References:
Cancer Council, 10/03/2016, ‘What is Cancer?’, retrieved 29/08/2018, https://www.cancer.org.au/about-cancer/what-is-cancer/
Canadian Cancer Society, n.p., ‘What is Cancer: Types of Tumours’, retrieved from http://www.cancer.ca/en/cancer-information/cancer-101/what-is-cancer/types-of-tumours/?region=on , viewed 21/09/2018.
The American Cancer Society medical and editorial content team, 12/06/2014, ‘ Evolution of Cancer Treatments: Chemotherapy’, retrieved 29/08/2018, https://www.cancer.org/cancer/cancer-basics/history-of-cancer/cancer-treatment-chemo.html
Xiang, D., Shigdar, S., Qiao, G., Wang, T., Kouzani, A. Z., Zhou, S.-F., Kong, L., Li, Y., Pu, C., Duan, W., 2015, ‘Nucleic Acid Aptamer-Guided Cancer Therapeutics and Diagnostics: the Next Generation of Cancer Medicine.’ Theranostics, Vol. 5, Iss. 1, pp. 23–42. http://doi.org/10.7150/thno.10202.
The American Cancer Society medical and editorial content team, 11/02/2016, ‘Chemotherapy Side Effects.’, retrieved 29/08/2018, https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/chemotherapy/chemotherapy-side-effects.html
The American Cancer Society medical and editorial content team, last reviewed 2016, ‘Chemotherapy Side Effects, What causes side effects?’, retrieved from https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/chemotherapy/chemotherapy-side-effects.html , viewed 21/09/2018.
Henri, J, Macdonald, J, Strom, M, Duan, W, & Shigdar, S 2018, ‘Aptamers As Potential Therapeutic Agents For Ovarian Cancer’, Biochimie: Elsevier, Deakin Research Online, EBSCOhost, viewed 29 August 2018.