08.26 - Pharmacology of Lung Cancer (Sweatman) - Questions Flashcards Preview

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Flashcards in 08.26 - Pharmacology of Lung Cancer (Sweatman) - Questions Deck (58):
1

Drug used for non-squamous NSCLC only

Bevacizumab

2

Which subtype harbors EGFR mutation

Adenocarcinoma

3

Why no Bevacizumab in Squamous Cell

High risk of bleeding

4

KRAS mutation can render __ drugs ineffective

Anti-EGFR

5

In what subtype is EML4-ALK more prevalent

2-7% of NSCLC, more in adeno

6

What type of patients are likely to have EML4-ALK

Nonsmokers, Light Smoking, Adeno

7

EML4-ALK produces activation of

MEK/ERK Pathway

8

Inhibitor of EML4-ALK

Crizotinib

9

Problem in TKI administration

Orally administered - Must be absorbed

10

Mutations (4) more common in Non-smokers

EGFR, EML4-ALK, HER2, hMSH2

11

What percent of patients have actionable mutations

60%

12

Top 3 mutations, in order, in adenocarcinomas

KRAS, EGFR, ALK

13

Which subtype of tumor should have mutation testing

Adenocarcinoma

14

Test for EGFR

DNA seq

15

Test for EML4-ALK

FISH

16

Treatment rationale for SCLC

Met occurs early so chemo/radiation is only option

17

Treatment rationale for NSLC

Surgical recision if early stage, Genetic testing if adeno

18

Standard treatment for SCLC

Etoposide + Cisplatin or Carboplatin

19

Standard treatment for NSCLC

Cisplatin + Taxel or other; Maintenance w/ Pemetrexed; Targeted; Bevacizumab if non-squamous

20

General MOA of Pemetrexed

DHFR inhibitor

21

General MOA of -platins

Form DNA intrastrand crosslinks and adducts

22

General MOA of Cyclophosphamide

Alkylating

23

General MOA of - Taxels

Microtubule stabilizer inhibiting de-polymerization

24

General MOA of Doxorubicin

Intercalator, Free Radicals, Topo 2 inhibition

25

General MOA of Etoposide

DNA Topo 2 stabilizer

26

General MOA of Gemcitabine

DNA polymerase inhibitor

27

General MOA of Isfosfamide

Cross linker

28

General MOA of -Tecans

DNA Topo 1 stabilizer

29

General MOA of Vinca Alkyloids

Microtubule inhibitor

30

Toxicity of Carboplatin

Blood chemistry dyscrasia

31

Toxicity of Cisplatin

Nephro- and Oto-toxicity

32

Toxicity of Cyclophosphamide

Hemorrhagic Cystitis (Mesna is protective), Pulmonary Fibrosis

33

Toxicity of Docataxel

Sensory neuropathy

34

Toxicity of Doxorubicin

CHF - Cardiotoxicity

35

Toxicity of Etoposide

Infection, Alopecia

36

Toxicity of Gemcitabine

Arthralgia

37

Toxicity of Ifosfamide

Neurotoxicity, Renal failure (<10%)

38

Toxicity of Irinotecan

Typical

39

Toxicity of Paclitaxel

Myalgia and Arthralgia

40

Toxicity of Pemetrexed

Elevated LFTs and Creatinine

41

Toxicity of Topotecan

Hyperbilirubinemia

42

Toxicity of Vinblastine

Neuropathic; Never give intrathecal

43

Toxicity of Vinorelbine

Neutropenia; Never give intrathecal

44

2 notable toxicities of Erlotinib

Rash; Interstitial lung-disease-type events

45

General MOA of Afatinib

Covalent inhibitor of EGRF, HER2, and HER4

46

2 most notable toxicities of Afatinib

Diarrhea, Rash

47

Covalent inhibitor of EGRF, HER2, and HER4

Afatinib

48

Advantage of Afatinib

Less toxic than Erlotinib

49

Mutation that confers resistance of EGFR to TKI's

T790M

50

T790M mutation restores

ATP affinity of EGFR to WT levels

51

2 notable toxicites of Crizotinib

GI, Visual Disorders

52

General MOA of Crizotinib

Multi-kinase inhibitor, including ALK

53

Sims and Diffs in toxicities of Erlotinib and Crizotinib

Both liver and eye; erlotinib rash, much less rash in crizotinib

54

TKI's that are CYP substrates

Crizotinib, Erlotinib

55

Mutation that confers resistance to Crizotinib

G2032R ROS1

56

MOA of Bevacizumab

Receptor of VEGFR fused to Fc fragment of an antibody - Prevents VEGF from binding its endogenous receptor sites

57

2 notable toxicities of Bevacizumab

HTN/Thromboembolism; Fistula

58

What subtype has highest adverse effects with Bevacizumab

Squamous - don’t use