Flashcards in Chemotherapy V Deck (40):
Tyrosine Kinase Inhibitors
Small molecule (2)
Monoclonal Antibodies (3)
Small molecule: Imatinib, Erlotinib
Monoclonal Ab: Trastuzumab, cetuximab, bevacizumab
Binds and blocks BCR-ABL
Where is Imatinib metabolized
LIVER- avoid coadministration with inducers/inhibitors of CYP3A4
What should you monitor in patients taking Imatinib?
(Increases clearance of thyroid hormone)
GI stromal tumors
Other drugs like Imatinib?
Monoclonal antibody to EGFR (transmembrane TK)
Sensitizes cell to chemo and radiation
Metastatic lung, colon cancer
Head, neck cancers (+radiation)
What must you treat patients taking Cetuximab with?
IV therapy for hypomagnesemia
What type of mutational analysis should you perform on a patient with COLORECTAL cancer to determine if they will respond to Cetuximab?
Wildtype: respond to Cetuximab
Mutated: no response
Small molecule inhibitor of the TK associated with EGFR
How is erlotinib metabolized?
Rash, nausea, anorexia, fatigue, paronchia (nailbed pain)
Perform mutational analysis on non-small cell lung cancers for ____ activating mutations
Monoclonal Ab, binds to VEGF, prevents signaling for new blood vessel formation
Metastatic colorectal cancer
Metastatic lung cancer
*significant prolongation or survival!
HTN, proteinuria, arterial clots, colon perf, bleeding, reversible posterior leukoencephalopathy syndrome, infusion reactions
Small molecule VEGF receptor TK inhibitors
Sorafenib, Pazopanib, Sunitinib
Small molecule VEGF receptor TK inhibitors metabolism
Small molecule VEGF receptor TK inhibitors SE
Similar to bevacizumab +
Hand foot syndrome
Congestive heart failure
Small molecule VEGF receptor TK inhibitors Indication
All 3 - renal cell cancer (clear cell)
Sunitnib- pancreatic neuroendocrine cancer, GI stromal tumor
Sorafenib- unresectable hepatocellular cancer
Monoclonal Ab to extracellular domain of EGFR receptor, HER-2 Neu
fever, n/v/d, cough, HA, SOB, back pain, rash, myalgia
The greatest risk of cardiac toxicity is in patients taking Trastuzumab and this other drug
What should you monitor in a patient taking Trastuzumab?
Cardiac ejection fraction
Breast cancer (Her2/neu+)
Stomach and gastroesophageal junction cancer (Her2/neu+)
When should you use trastuzumab?
when Her2/neu is overexpressed
Pts with ALK-anaplastic lympoma kinase rearrangements in adenocarcinoma of lung
Melanoma with V600E mutation in BRAF (activating mutation)
Depletes asparagine pools rapidly
Leukemia cells lack asparagine synthetase and cannot synthesize asparagine
decrease in protein synthesis
CLOTTING (decreased antithrombin 3)
Acute lymphoblastic leukemia
Inhibits DNA synthesis by inhibiting ribonucleotide reductase
Acute myelogenous leukemia
All-trans retinoic acid MOA
Induces terminal differentiation of leukemic cells
All-trans retinoic acid Indication
Acute promyelocytic leukemia (APL)
Arsenic Trioxide Indication
Treatment of relapsed APL