Antimetabolites

Question 1

What is the MOA of antimetabolites, what part of the cell cycle do they arrest, and what type of cell is most susceptible to these?

Answer 1

Mimic or reduce normal cell comments necessary for DNA, RNA and protein synthesis
S phase
Rapidly dividing

Question 2

3 mechanisms of resistance to antimetabolites?

Answer 2

Don’t let these guys metabolize to active forms
Stop transporting
Lower FPGS

Question 3

1 unique adverse effect of antimetabolites?

Answer 3

Hand foot syndrome, painful swelling of hands and feet.

Question 4

2 cancers we use methotrexate for?

Answer 4

Breast and NHL

Question 5

2 cancers to treat with pemetrexed?

Answer 5

Mesothelioma

NSCLC

Question 6

What cancer do we treat with pralatrexate?

Answer 6

T cell lymphoma

Question 7

What drug is the most widely used chemo drug against colorectal cancer? What else does this drug work well against as far as cancers?

Answer 7

5 fu

Variety of solid tumors

Question 8

What is capecitabine metabolized into, what are two cancers it is used for, and what is the regimen it is part of with what drug to treat what cancer?

Answer 8

5FU
Metastatic breast and colorectal
XELOX where it is combined with oxaliplatin as first line treatment for colorectal metastatic cancer

Question 9

What cancer do we use TAS 102 for?

Answer 9

Colorectal

Question 10

What cancers do we use cytarabine for and what cancers does it have no activity for?

Answer 10

Blood cancers like AML and NHL

No activity against solid tumors

Question 11

What can we use gemcitabine for?

Answer 11

Solid and hematologists cancers

Question 12

The thiopurines are metabolized by what enzyme and loss of this enzyme leads to what?

Answer 12

TPMT
If we don’t have this those drugs are hanging around causing their adverse effects stronger and longer. Myelosuppression and GI

Question 13

What do we use 6 mercaptopurine for, what cancer?

Answer 13

Childhood AL

Question 14

What cancer do we treat with 6 thioguanine?

Answer 14

Adult acute leukemia

Question 15

Big time adverse effect of fludrarabine and what do we need to do about it?

Answer 15

Potent immunosuppressant. Increased risk of opportunistic infection. Pneumocystis jiroveci pneumonia. Need to give TMP/SMX

Question 16

2 cancers we treat with fludrarabine?

Answer 16

NHL and CLL

Question 17

Big time adverse effect of cladribine and what 3 cancers does it treat?

Answer 17

Low cd4 and CD8, so immunosuppressant

Hair cell, NHL, CLL