Cancer Pharmacology (part II) Flashcards
(35 cards)
What are two examples of Vinca Alkyloids?
- Vinblastine
- Vincristine
How do vinca alkaloids act?
They bind specifically to the protein tubulin preventing microtubule assembly.
At what phase of the cell cycle do vinca alkaloids work?
M phase
- No mitosis
- Blocks cell division and induces apoptosis
What are the respective toxicities of vincristine and vinblastine?
- Vincrinstine => neuropathy
- Can be used in combination therapy because it does not affect the marrow like most cancer drugs
- Vinblastine => bone marrow
What cancers are treated with vincristine?
- Lymphoma
- Sarcoma
- Breast
- Lung
- Cervix
What cancers are treated with vinblastine?
- Lymphoma
- Testicular
How are vinblastine and vincristine metabolized?
Hepatically
What is the mechanism of action of Taxol?
Taxol binds to microtubules preventing normal mitosis.
- It acts to stabilize the microtubule structure preventing depolymerization and inducing apoptosis
What cancers are treated with Taxol?
High degree of activity in:
- Breast
- Lung
- Ovarian cancers
What are examples of proteosomal inhibitors?
- Velcade
- Carfilzomib
What is the mechanism of proteosomal inhibitors?
Inhibit degradation of proteins
- Leads to the activation of unfolded protein stress response pathway and apoptosis.
What cancers are proteosomal inhibitors used for?
- Multiple myeloma
- Mantle cell lymphoma
What are examples of immunomodulatory drugs?
- Thalidomide
- Lenalidomide
- Pomalidomide
What are uses for immunomodulatory drugs?
- Leprosy
- Graft vs. Host disease
- Multiple myeloma
- Myelodysplastic syndrome (lenalidomide)
In what patients are immunomodulatory drugs CONTRA-indicated?
- Patients who are actively trying to have children should not be given immunomodulatory drugs because they are highly teratogenic in both males and females
- contraception should be used in these patients
Generally, what are major side effects of chemotherapy?
- Anemia
- Granulocytopenia
- Thrombocytopenia
What growth factors are approved to prevent hematologic symptoms of chemotherapy?
- G-CSF
- GM-CSF
- Epo
- IL-11
- Thrombopoietin
- These factors stimulate the maturation of late procurers of specific cell lineages
How are growth factors administered?
- Subcutaneously
- IV
- Intramuscularly have longer half life but slower absorption
- G and GM-CSF are given daily
What are some side effects of growth factors?
- Side effects are usually mild
- Bone pain, fever, and headache
What are the indications for giving G-CSF and GM-CSF?
- BMT
- MDS
- Neutropenia
- Life threatening infections
What are the indications for giving Epo?
- Chronic renal failure
- Anemia of chronic disease
- MDS
- AIDS
- After chemotherapy
What is the risk of erythropoiesis stimulating agents?
ESAs shortened overall survival and/or increased the risk of tumor progression or recurrence in clinical studies in patients with breast, non-small cell lung, head and neck, lymphoid and cervical cancer.
What are ESAs indicated for?
- Anemia due to the effect of concomitantly administered chemotherapy
In what patients should ESAs NOT be used fin?
Should not be used in patients receiving myelosuppressive therapy when the anticipated outcome is a cure
