Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Renal > Sweatman: Rx of Renal Cancer > Flashcards

Sweatman: Rx of Renal Cancer Flashcards

these questions are probably more detailed than need be. Also the toxicities of drugs don't include myelosuppression bc thats a no-brainer

1
Q

What is the best curative treatment in renal cancer?

A

surgical excision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are common sites of metastatic growth in renal tumors?

A 
lymph nodes (most common)
lung, liver, bone (destructive lesions)
adrenal gland
brain
opposite kidney
subcutaneous skin nodules
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most common renal tumor in children called?

A

Nephroblastoma (Wilm’s Tumor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

T or F: WIlm’s tumor is highly curable

A

T. 5 year survival rate is consistently above 90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Standard chemotherapy postnephrectomy in pts with Wilm’s tumor involves 3 different regimen options. Each one has what drug in common?

A

Vincristine

  1. Vincristine + dactinomycin (18 weeks)
  2. Vincristine + dactinomycin + doxorubicin (24 weeks)
  3. Vincristine + doxorubicin +cyclophosphamide + etopside (24 weeks)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Treatment for recurrent disease in Wilm’s tumor patients involves alternating courses of what two tx regimens?

A
  1. Vincristine, doxorubicin, cyclophosphamide

2. etopside and cyclophosphamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

T or F: treatment of clear cell sarcoma is similar to the treatment of nephroblastoma (wilm’s tumor)

A

T. treatment options involves 2 standard regimens used in the treatment of Wilm’s tumor PLUS RADIATION THERAPY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Patients with recurrent clear cell sarcoma involving the brain have benefited from what tx?

A

ICE (ifosfamide, carboplatin, etopside) coupled with local control (surgical resection and/or radiation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In the tx of childhood tumors, all of the drugs have a similar ROA…?

A

IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Carboplatin toxicities

A

infection susceptibility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

cyclophosphamide and ifosfamide toxicities

A

hemorrhagic cystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what can you use to treat the toxicity of cyclophosphamide and ifosfamide?

A

MESNA to treat hemorrhagic cystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

doxorubicin toxicities

A

acute and chronic cardiotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

dactinomycin toxicities

A

hepatic dysfunction

infection susceptibility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

etopside toxicities

A

hematologic toxicity

BP instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

vincristine toxicities

A

bilateral sensory “stocking-glove” pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are examples of rapamycins?

A

temsirolimus

everolimus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the MOA of rapamycins? net effects?

A

bind to FKBP12 and inhibit mTORC1

this inhibits cell cycle progression and angiogenesis and promotes apoptosis

19
Q

In terms of ROA and dosing regimen, how do temsirolimus and everolimus differ?

A

temsirolimus: IV weekly
everolimus: oral daily

20
Q

What metabolizes both temsirolimus and everolimus? how is temsirolimus somewhat different?

A

CYP3A4

temsirolimus is metabolized to sirolimus, likely a more important agent

21
Q

What are prominent side effects of temsirolimus and everolimus?

A

maculopapular rash
mucositis
anemia
fatigue

22
Q

What are less frequent side effect of temsirolimus and everolimus seen with progressive drug cycles?

A

reversible leukopenia

thrombocytopenia

23
Q

How can temsirolimus and everolimus affect the pulmonary system? Tx for this?

A

pulmonary infiltrates
can lead to cough, SOB

stop drug (duh)
prednisone
24
Q

What are the TKIs used in the tx of adult renal tumors?

A

sunitinib
sorafenib
pazopanib

25
Q

What do all 3 TKIs inhibit?

A

VEGF-receptor 2 and other tyrosine kinases

there is a long list of other tyr kinases for each drug. you should probably look at them.

26
Q

ROA for the 3 TKIs? Metabolism?

A

oral

CYP3A4

27
Q

Response to which TKI is better (31%) and longer lasting than for other antiangiogenic drugs?

A

sunitinib

28
Q

What are common vascular toxicities observed with antiangiogenic drugs (i.e. TKIs)?

A

bleeding
HTN
arterial thrombotic events

29
Q

What are specific side effects of sunitinib?

A

fatigue
hypothyroidism
CHF (often with HTN)
hand foot syndrome

30
Q

What is the BBW for pazopanib? What does this call for?

A

hepatic disease: severe and fatal hepatotoxicity has been reported

liver function tests before tx, at least once weekly during first 4 months of tx, and periodically after

31
Q

What are some other side effects of pazopanib?

A

hyperbilirubinemia, especially in Gilbert’s syndrome which involves glucuronidation deficiency and reduced excretion of bilirubin)??

32
Q

T or F: interferon-alpha alone is more effective in tx of metastatic renal cell carcinoma when compared to inf-alpha + bevacizumab

A

F. adding bevacizumab to interferon alfa results in significant imporvement in progression-free survival, when comapred to inf-alfa alone

33
Q

what is the MOA of bevacizumab?

A

VEGF inhibitor

34
Q

What are the main safety concerns associated with bevacizumab?

A 
HTN
arterial thromboembolic events (stroke, angina, MI)
wound healing complications
GI perforations
proteinuria
35
Q

What is aldesleukin?

A

recombinant IL-2

36
Q

Aldesleukin was designated as a ____ drug for renal cell carcinoma

A

orphan

(an orphan drug is one that was developed specifically to tx a rare condition. often pharmaceutical companies are given incentives to develop orphan drugs)

37
Q

What is the MOA of aldesleukin?

A
  • binds IL-2 receptor on cells of the immune system
  • stimulates a cytokine cascade
  • may stimulate cytotoxic lymphocytes
38
Q

How does T sweat describe aldesleukin?

A

“VERY nasty stuff!”

39
Q

There are over 120 adverse events listed for aldesleukin. Name them all. actually, just name the 2 T sweat listed.

A
  1. capillary leak syndrome–>loss of vascular tone (THIS IS RESPONSIBLE FOR MANY OF THE ADVERSE EFFECTS)
  2. decreased mean arterial pression (MAP)–>decreased organ perfusion
40
Q

What is the MOA of interferon-alpha?

A

direct antiproliferative effect on the tumor cell by

  1. enhance or inhibit protein synthesis
  2. modify cell surface antigen expression
  3. modulate immune system
41
Q

What are the net effects of interferon-alpha?

A

immunomodulatory effects: it induces a host response to the tumor which slows the rate of cell proliferation

42
Q

What are some side effects of interferon alpha?

A 
neuropsychiatric:
suicide
homicidal and suicidal ideation
depression
relapse of drug addiction
aggressive behavior
43
Q

T or F: interferon alfa provides a modest survival benefit compared to other commonly used treatments and should be considered for the control arm of future studies of systemic agents

A

Fact (so, true, not false)

Renal (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions