Drugs for Lung Cancer

Question 1

When is bevacizumab not recommended?

Answer 1

squamous cell carcinomas because it can lead to severe bleeding and increased cavitation.
Also when there is hemoptysis or brain metastases

Question 2

What mutations can render erlotinib inneffective?

Answer 2

KRAS mutations because the proliferative pathway remains active downstream of the drug blockade

Question 3

Which mutations are more common in non-smokers?

Answer 3

EGFR, EML4-ALK, and hMSH2

Question 4

What is treatment for SCLC?

Answer 4

etoposide and cisplatin or carboplatin. Surgery is typically not an option because of early metastisis

Question 5

What is treatment for NSCLC?

Answer 5

cisplatin AND paclitaxel, gemcitabine, docetaxel.

If EGFR positive use erlotinb. Bevacizumab for those with non-squamous histo or hemoptysis.

Question 6

What is MOA of carboplatin?

Answer 6

forms DNA intrastrand crosslinks and adducts

Question 7

What is MOA of cisplatin?

Answer 7

forms DNA intrastrand crosslinks and adducts

Question 8

What is MOA of cyclophosphamide?

Answer 8

pro-drug of active alkylating moiety

Question 9

What is MOA of doxorubicin?

Answer 9

intercalator, free radical generator, topo II inhibitor

Question 10

What is MOA of etoposide?

Answer 10

DNA topo II complex stabilizer

Question 11

What is MOA of gemcitabine?

Answer 11

DNA polymerase inhibitor via incorporation of triphosphate form during DNA synthesis

Question 12

What is MOA of ifosfamide?

Answer 12

intra and inter-strand cross linker

Question 13

What is MOA of irnotecan?

Answer 13

DNA-topo I complex stabilizer

Question 14

What is MOA of paclitaxel?

Answer 14

microtubule stabilizer inhibition depolymerization

Question 15

What is MOA of pemetrexed?

Answer 15

DHFR inhbitor

Question 16

What is MOA of topotecan?

Answer 16

DNA topo I complex stabilizer

Question 17

What is MOA of vincristine?

Answer 17

microtubule inhibitor, tubules disintegrate int spiral aggregates/ protofilaments.

Question 18

What is MOA of vinorelbine?

Answer 18

microtubule inhibitor, tubules disintegrate int spiral aggregates/ protofilaments.

Question 19

What are main adverse effects of carboplatin?

Answer 19

platinum allergies, myelosuppression, anemia, increased hepatic enzymes, BUN and creatinine.

Question 20

What are main adverse effects of cisplatin?

Answer 20

platinum allergies, nephrotoxicity, myelosuppression and ototoxicity

Question 21

What are main adverse effects of cyclophosphamide?

Answer 21

anemia, renal compromise, hemorrhagic cstitis, pulmonary fibrosis

Question 22

What are main adverse effects of doxorubicin?

Answer 22

myelosuppression, CHF, hepatic disease

Question 23

What are main adverse effects of etoposide?

Answer 23

myelosuppression, hematologic toxicity, alopecia

Question 24

What are main adverse effects of gemcitabine?

Answer 24

arthralgia, fatigue, peripheral neuropathy

Question 25

What are main adverse effects of ifosfamide?

Answer 25

alopecia, neurotoxicity, hematuria renal failure

Question 26

What are main adverse effects of irinotecan?

Answer 26

myelosuppression, diarrhea, asthenia

Question 27

What are main adverse effects of paclitaxel?

Answer 27

taxane hypersensitivity, myalgia and arthalgia

Question 28

What are main adverse effects of pemetrexed?

Answer 28

GI toxicity. Elevated LFTs and creatinine. Can't combine with cisplatin because of GI toxicity

Question 29

What are main adverse effects of topotecan?

Answer 29

GI toxicity, hyperbilirubinemia

Question 30

What are main adverse effects of vinblastine?

Answer 30

neuropathic toxicity, neutropenia

Question 31

What are main adverse effects of vinorelbine?

Answer 31

myelosuppression, neuropathic toxicity, neutropenia.

Question 32

What is MOA of erlotinib?

Answer 32

reversible inhibitor selective for EGFR

Question 33

What are main adverse effects of erlotinib?

Answer 33

liver and kidney problems, corneal perforations and rash