MbShea@PWP@English@UMCP

Abstract: This medical school seminar paper will focus on a specific class of chemotherapy drugs called nitrogen mustards. To start, chemotherapy refers to any drug or combination of drugs that is used to treat cancer. One of the most common types of chemotherapy drugs are alkylating agents, non-hormonal drugs that are non-specific, meaning they target cancer cells across the entirety of the cell cycle. Nitrogen mustards are the most common type of alkylating agent, characterized by their bis(chloroethyl) group. During WWI and WWII, they originally served as chemical warfare agents in a gaseous form. When scientists discovered the ability of such toxic agents to decrease lymphocyte counts in soldiers, clinical trials were started at Yale University. Studies aimed to test the effectiveness of nitrogen mustard compounds on lymphoma, while also maintaining a minimal level of toxicity to patients. Through decades of human clinical trials and alterations of the drug to find a form most effective in treating cancers, nitrogen mustards have become one of the most common drugs used in chemotherapy today. Currently, the most commonly used nitrogen mustards include cyclophosphamide, chlorambucil, and mechlorethamine. They function through an SN1 mechanism to create an alkylated nitrogen mustard that inserts itself into the N-7 center of a guanine base on a DNA molecule. These insertions produce inter-strand crosslinks that indicate to tumor suppressor gene p53 that there is an error in the DNA helix. Therefore, the targeted cancer cells undergo apoptosis, making the drug useful across various types of cancers. (WC = 248)

Reader's profile: Medical student interested in oncology but confused about current applications of nitrogen mustards

Reader’s response: I found your paper to be very thought provoking, especially since I have a strong interest in medical oncology and its current applications. Your explanation of the discovery of nitrogen mustards and their mechanism of action was very thorough and fascinating to learn about. However, I am still confused about one aspect of your report. As a medical student, a major part of learning about common drugs is to learn their current applications in clinical settings. Your paper focused mostly on the discovery of the drug and subsequent clinical trials in the 20th century. However, in order to advance my learning on nitrogen mustards, I would like to know about current drugs used in chemotherapy today, and what makes them more preferable over other common treatments in use today.

Revised Thesis: Rather than focus on the discovery and subsequent clinical trials of nitrogen mustards, the main argument will shift focus towards current clinical applications of the drug. In addition, emphasis will be put on the use of nitrogen mustards in combination with other cancer treatment methods such as surgery and radiation therapy. Also, the mechanism of action that makes nitrogen mustards unique and more effective than other commonly used chemo drugs will be discussed.

Voice: Third person

Citations: APA throughout

Good plan, T. especially with the revised thesis to address that audience. You can also note that your paper has a secondary organizing idea: medical humanities, here, that the history of a chemotherapy agent helps a practitioner note the complexity and surprised that is part of drug discovery.

Now, you have a good topic for the medical school interview if they ask you an open-ended question.