Pharmaco of Endocrine Cancers Flashcards
What class of drug is tamoxifen?
Selective Estrogen Receptor Modulator
What is tamoxifen used for
Breast cancer
Which isomers display what activity for tamoxifen?
Cis-isomer displays estrogenic activity
Trans-isomer displays anti-estrogenic activity
What is tamoxifen’s MOA
Competitively blocks endogenous estrogen binding to the estrogen receptor in the target tissue (e.g. breast)
What are the side effects of tamoxifen
hot flashes, increased risk of endometrial and uterus cancer (from cis-isomer accumulating in the uterus), DVT, menstrual irregularities, vaginal bleeding and discharge, nausea and vomiting
What toxicity is associated with tamoxifen?
High doses can lead to neurotoxicity
What class of drug is pembrollizumab?
Anti-PDL1 antibody
What is pembrolizumab’s MOA
Binds to PDL1 and blocks the masking effect, allowing T cells to kill the cancerous cells
How often should pembrolizumab be given?
every 3 weeks
What is pembrolizumab used for
Cervical cancer
What are the side effects associated with pembrolizumab?
Infusion related SE like rash and itch from hypersensitivity, fatigue, diarrhea, nausea, joint pain, possible life threatening immune-related inflammation on lungs, endocrine organs, liver, kidneys and sepsis
In which patient groups is pembrolizumab contraindicated in? (2)
Patients taking corticosteroids or immunosuppressants (stop for the course of medicine and can continue after)
Avoid in pregnant women
What class of drug is leuprorelin?
GnRH analogue
What is leuprorelin’s MOA?
Leuprorelin agonises pituitary GnRH receptors (negative feedback) and decreases testosterone production and decreases the stimulatory effect on androgen-sensitive prostate cancer cells, inducing apoptosis
What can be measured for patients on leuprorelin therapy?
PSA for first few weeks
LH, FSH and testosterone after 4 weeks (stabilise)
