Exam 1 Table Flashcards
1
Q
5-fluorouracil (5-FU) target
A
Thymidylate synthase - blocks uracil to thymine conversion
2
Q
5-fluorouracil (5-FU) drug class
A
Anti-metabolite; uridine analog
3
Q
5-fluorouracil (5-FU) cell cycle phase
A
S
4
Q
5-fluorouracil (5-FU) dose limiting side effect
A
Myelosuppression
5
Q
5-fluorouracil (5-FU) rescue drug
A
Thymidine
6
Q
5-fluorouracil (5-FU) synergy drug
A
Leucovorate
7
Q
5-fluorouracil (5-FU) unique resistance mechanisms
A
-Downregulation of activating enzymes that convert 5-FU to fd-UMP
-Upregulation of thymidylate synthase
8
Q
5-fluorouracil (5-FU) genetic testing
A
~5% of the population has gene polymorphisms that result in a deficiency of the enzyme dihydropyrimidine dehydrogenase (DPD) which breaks down 5-FU
9
Q
Cytarabine target
A
Converted to Ara-CTP intracellularly -> competitive inhibitor of DNA polymerase alpha
10
Q
Cytarabine drug class
A
Anti-metabolite; cytosine analog
11
Q
Cytarabine cell cycle phase
A
S
12
Q
Cytarabine indication
A
-Leukemia
-Lymphoma
13
Q
Cytarabine dose limiting side effect
A
Myelosuppression
14
Q
Cytarabine synergy drug
A
Tetrahydrouridine because of inhibition of cytidine deaminase
15
Q
Cytarabine unique resistance mechanisms
A
-Downregulation of activating enzymes
-Upregulation of cytidine deaminases
-Downregulation of influx transporters
16
Q
6-mercaptopurine (6-MP) target
A
Blocks multiple enzymes in de novo purine biosynthesis
17
Q
6-mercaptopurine (6-MP) drug class
A
Antimetabolite; purine analog, thio-analog of adenine
18
Q
6-mercaptopurine (6-MP) cell cycle phase
A
S
19
Q
6-mercaptopurine (6-MP) dose limiting side effects
A
Hematologic toxicity, myelosuppression
20
Q
6-mercaptopurine (6-MP) drug interactions
A
Allopurinol increases 6-MP toxicity
21
Q
6-mercaptopurine (6-MP) unique resistance mechanisms
A
Loss of HGPRT (activating enzyme)
22
Q
6-mercaptopurine (6-MP) genetic testing
A
TPMT polymorphism loss of function - (TPMT inactivates 6-MP) - dose adjustment needed
23
Q
Methotrexate target
A
DHFR inhibitor
24
Q
Methotrexate drug class
A
Antimetabolite, antifolate
25
Methotrexate cell cycle phase
S
26
Methotrexate dose limiting side effect
myelosuppression
27
Methotrexate rescue drug
Leucovorin
28
Methotrexate unique resistance mechanisms
-Amplification of DHFR or resistant mutation of DHFR
-Decreased polyglutamation
29
Chlorambucil target
Cross-links DNA
30
Chlorambucil drug class
Alkylating agent; mechlorethamine derivative
31
Chlorambucil cell cycle phase
Non-specific
32
Chlorambucil dose limiting side effect
-Myelosuppression
-N/V
-Carcinogenic (secondary malignancies) and teratogenic (ALL alkylators)
33
Alkylating agent/platinum agent unique resistance mechanisms
-Increased expression of DNA repair enzymes
-Increased glutathione concentrations to reduce reactive intermediates
-Increased expression of cellular glutathione S-transferase (GST)
34
Cyclophosphamide target
Cross-links DNA
35
Cyclophosphamide drug class
Alkylating agent; requires hydroxylation by CYP450 (prodrug)
36
Cyclophosphamide cell cycle phase
Non-specific
37
Cyclophosphamide dose limiting side effects
-Hemorrhagic cystitis - acrolein buildup in bladder
-Mild bone marrow toxicity due to high ADH in these cells that break down metabolite
38
Drug that must be given with Cyclophosphamide
Mesna is administered with cyclophosphamide to block hemorrhagic cystitis - free thiol on mesna reacts with and inactivates acrolein metabolites in urine
39
Mitomycin C target
Bifunctional adducts on DNA (cross-links)
40
Mitomycin C drug class
alkylating agent (aziridine containing natural product)
41
Mitomycin C cell cycle phase
Non-specific
42
Mitomycin C dose limiting side effect
Myelosuppression
43
Cisplatin target
Forms intrastrand crosslinks - covalent crosslink between G and A
44
Cisplatin drug class
-Platinum drugs - covalent cross linkers
-Prodrug - requires non-enzymatic conversion to the active aqua form
45
Cisplatin cell cycle phase
Non-specific
46
Cisplatin dose limiting side effect
-Nephrotoxicity in proximal tube
-Minimal bone marrow toxicity (good in combination with other drugs)
-Severe N/V
-Peripheral neuropathy
-Ototoxicity
-Carboplatin: cutaneous rash, vomiting, hypotension
47
Irinotecan target
Topo I inhibitor (water soluble) - binds and forms a ternary drug-enzyme-DNA complex -> blocks DNA religation
48
Irinotecan drug class
-Topo I inhibitor: camptothecins
-Prodrug into SN-38 via carboxylesterases
49
Irinotecan cell cycle phase
S
50
Irinotecan unique resistance mechanisms
-P-glycoprotein (PGP) overexpression
-Multidrug resistant protein (MRP) overexpression
-Glutathione S-transferase overexpression
-Topoisomerase downregulation
-Mutation to prevent inhibitor binding
51
Irinotecan genetic testing
~10% of the population has polymorphisms predicting low expression of UGT1A1, leading to increased toxicity of irinotecan
52
Doxorubicin target
Topo II inhibitor - intercalates and inhibits double strand religation
53
Doxorubicin drug class
Topo 2 inhibitor; anthracyclines
54
Doxorubicin cell cycle
-Non-specific
-A little G2/M
55
Doxorubicin dose limiting side effects
Cardiotoxicity due to free radical damage, severe local tissue damage if extravasated
56
Doxorubicin synergetic drugs
Dexrazoxane protects against anthracycline-induced cardiotoxicity by binding to iron
57
Doxorubicin unique resistance mechanisms
Glutathione S-transferase (GST) overexpression - the only topo 2 to have this resistance
58
Etoposide target
Topo II inhibitor - inhibits double strand religation
59
Etoposide drug class
Topo 2 inhibitor; epipodophyllotoxin glucose analog (does not intercalate)
60
Etoposide cell cycle
G2
61
Resistance mechanisms for all topo 2 inhibitors
-PGP overexpression
-Topoisomerase II downregulation or mutation
-Increased DNA damage repair enzyme
62
Bleomycin target
Intercalates into DNA - forms DNA free radical - leads to DNA single and double strand breaks
63
Bleomycin drug class
Glycopeptide antibiotic - imidazole free radical, thiazole intercalator
64
Bleomycin cell cycle
-G2
-M
65
Bleomycin dose limiting side effects
Pulmonary toxicity and rash because of lack of bleomycin aminohydrolase
66
Bleomycin resistance mechanisms
Increased levels of bleomycin aminohydrolase
67
Vincristine target
Tubulin -> inhibition of microtubule assembly (tubulin polymerization) and microtubule shortening
68
Vincristine drug class
Vinca alkaloids - microtubule destabilizer
69
Vincristine cell cycle
M
70
Vincristine dose limiting side effects
-Neurotoxicity
-Peripheral neuropathy
-Myelosuppression is mild and rarely clinically significant
71
Vincristine resistance mechanisms
PGP substrate
72
Eribulin target
Microtubule end - inhibition of microtubule assembly/elongation (polymerization)
73
Eribulin drug class
Microtubule destabilizer - halichondrin B analog
74
Eribulin cell cycle phase
M
75
Eribulin dose limiting side effects
Lower rate of neurotoxicity than vinca
76
Paclitaxel target
Tubulin inhibition of microtubule disassembly (depolymerization)
77
Paclitaxel drug class
Taxanes - microtubule stabilizer
78
Paclitaxel cell cycle phase
M
79
Paclitaxel dose limiting side effects
-Myelosuppression
-Neurotoxicity - sensory neuropathy common but reversible
80
Paclitaxel drug interactions
Cross-resistant with other large molecule antitumor agents
81
Paclitaxel resistance mechanisms
-PGP substrate (except for cabazitaxel)
-Tubulin mutations
82
Ixabepilone target
Tubulin inhibition of microtubule disassembly (depolymerization)
83
Ixabepilone drug class
Microtubule stabilizer - epothilone B analog
84
Ixabepilone cell cycle phase
M
85
Ixabepilone dose limiting side effects
-Myelosuppression
-Neurotoxicity - sensory neuropathy common but reversible
86
Ixabepilone drug interactions
NOT cross-resistant to taxanes
87
Ixabepilone resistance mechanisms
Poor PGP substrate
88
Enzalutamide target
Androgen receptor
89
Enzalutamide drug class
Full AR antagonist
90
Enzalutamide cell cycle phase
G1
91
Enzalutamide indication
Metastatic and non-metastatic prostate cancer
92
Enzalutamide resistance mechanisms
AR mutation that results in androgen independent activation and prevent binding of AR antagonists = castration resistant prostate cancer (CRPC)
93
Abiraterone target
-17 alpha-hydrolase and C17,20 lyase
-CYP17 catalyzes conversion of pregnenolone and progesterone to DHEA and androstenedione
94
Abiraterone drug class
Steroid analog
95
Abiraterone cell cycle phase
G1
96
Abiraterone dose limiting side effect
Increased cholesterol
97
Tamoxifen target
Estrogen receptor
98
Tamoxifen drug class
SERM; partial agonist; prodrug (CYP2D6)
99
Tamoxifen cell cycle phase
G1
100
Tamoxifen indication
Pre and postmenopausal women with ER-positive breast cancer
101
Tamoxifen dose limiting side effects
Hot flashes; increased incidence of endometrial cancer
102
Tamoxifen drug interactions
CYP2D6 inhibitors
103
Tamoxifen resistance mechanisms
Variant of CYP2D6 that decreases metabolism of tamoxifen
104
Fulvestrant target
Estrogen receptor
105
Fulvestrant drug class
SERD; pure estrogen antagonist; no agonist effects
106
Fulvestrant cell cycle phase
G1
107
Fulvestrant indication
ER+ metastatic breast cancer - postmenopausal women who have progressed on other antiestrogen therapy
108
Prednisolone drug class
Corticosteroid
109
Prednisolone cell cycle phase
G1
110
Prednisolone indication
Used as palliative care for inflammation, edema and pain management
111
Letrozole target
Aromatase
112
Letrozole drug class
Non-steroidal competitive aromatase (CYP19) inhibitor
113
Letrozole cell cycle phase
G1
114
Letrozole indication
Postmenopausal breast cancer
115
Letrozole dose limiting side effects
Increased extent of bone density loss - increased risk of fracture
116
Exemestane target
Aromatase
117
Exemestane drug class
Steroidal aromatase inhibitor; suicide inhibitor (irreversible)
118
Exemestane cell cycle phase
G1
119
Exemestane indication
Postmenopausal ER+ breast cancer patients who have progressed on antiestrogen therapy
120
Exemestane dose limiting side effects
-Minimal toxicity
-Hot flashes
-Occasional peripheral edema
-Weight gain
-Increased cholesterol
121
Leuprolide target
GnRH receptor
122
Leuprolide drug class
GnRH analog
123
Leuprolide cell cycle phase
G1
124
Leuprolide indication
Premenopausal
125
Leuprolide dose limiting side effects
-Transient worsening symptoms to initial (flare) effects
-Long term: hot flashes, sexual dysfunction, gynecomastia
126
Imatinib target
BCR-Abl tyrosine kinase
127
Imatinib drug class
Type 2 small molecule Bcr-Abl inhibitor
128
Imatinib cell cycle phase
G1
129
Imatinib indication
Primary indication for chronic myeloid leukemia (CML) and GIST
130
Imatinib dose limiting side effects
-N/V
-Fluid retention (edema)
-Neutropenia
-Thrombocytopenia
131
Imatinib resistance mechanisms
"Gatekeeper" T315I mutation
132
Imatinib genetic testin
Philadelphia chromosome
133
Ponatinib target
BCR-Abl tyrosine kinase
134
Ponatinib drug class
Bcr-Abl inhibitor
135
Ponatinib cell cycle phase
G1
136
Ponatinib indication
T315I mutation
137
Ponatinib genetic testing
Can inhibit the T315I mutation
138
Midostaurin target
fms-like tyrosine kinase 3 (FLT3) in AML
139
Midostaurin drug class
First gen FLT3 inhibitor for AML
140
Midostaurin cell cycle phase
G1
141
Crenolanib target
fms-like tyrosine kinase 3 (FLT3) in AML
142
Crenolanib drug class
Second gen (more specific) FLT3 inhibitor for AML
143
Crenolanib cell cycle phase
G1
144
Quizartinib target
fms-like tyrosine kinase 3 (FLT3) in AML
145
Quizartinib drug class
Type II FLT3 inhibitor for AML
146
Quizartinib cell cycle phase
G1
147
Quizartinib indication
Specific for internal tandem duplication (ITD) mutations
148
Quizartinib genetic testing
Internal tandem duplication (ITD) mutations
149
Sirolimus target
Inhibit the mammalian target of Rapamycin (mTOR; serine-threonine kinase)
150
Sirolimus drug class
Rapamycin analogues
151
Sirolimus cell cycle phase
G1
152
Sirolimus drug interactions
Inhibits immune response by blocking IL-2 signaling transduction
153
Alectinib target
Anaplastic lymphoma kinase (ALK)
154
Alectinib drug class
ALK inhibitors
155
Alectinib cell cycle phase
G1
156
Alectinib indication
ALK-positive NSCLC who have progressed on or intolerant to crizotinib
157
Alectinib genetic testing
Fusion gene of ALK to ELM4
158
Dabrafenib target
BRAF-V600
159
Dabrafenib drug class
Second gen BRAF-V600 inhibitor
160
Dabrafenib cell cycle phase
G1
161
Dabrafenib indication
Combination with trametinib for BRAF V600E/K-mutant metastatic melanoma
162
Dabrafenib drug interactions
Activation of wild type BRAF remains a problem, combination with trametinib seems to stem from induction of squamous cell carcinomas
163
Dabrafenib genetic testing
BRAF-V600 mutations
164
Trametinib target
MEK1 and MEK2
165
Trametinib drug class
Type III allosteric MEK inhibitor
166
Trametinib cell cycle phase
G1
167
Trametinib indication
Combination with dabrafenib
168
Trametinib dose limiting side effects
-RASH
-Diarrhea
-Lymphedema
169
Trametinib drug interaction
Not indicated for patients that have received prior BRAF inhibitor therapy
170
Acalabrutinib target
Bruton's tyrosine kinase (BTK); also targets Cys481
171
Acalabrutinib drug class
Second gen covalent BTK inhibitor
172
Acalabrutinib cell cycle phase
G1
173
Acalabrutinib indication
B-cell lymphoma: Mantle cell lymphoma and chronic lymphocytic leukemia
174
Gefitinib target
EGFR tyrosine kinase
175
Gefitinib drug class
First gen reversible EGFR inhibitor
176
Gefitinib cell cycle phase
G1
177
Gefitinib indication
Approved for NSCLC with exon 19 or 21 mutations
178
Gefitinib dose limiting side effects
-Fatigue
-Rash
-Diarrhea
179
Gefitinib resistance mechanisms
T790M causes resistance
180
Gefitinib genetic testing
EGFR exon 19 or exon 21 (L858R) mutation
181
Afatinib target
Covalent inhibitor of all ErbB receptors
182
Afatinib drug class
Covalent EGFR inhibitor - second gen
183
Afatinib cell cycle phase
G1
184
Afatinib indication
Approved for EGFR mutant NSCLC with EGFR mutations
185
Afatinib dose limiting side effects
Better rash tolerance
186
Afatinib resistance mechanisms
T790M causes resistance
187
Afatinib genetic testing
EGFR RGQ PCR Kit (QIAGEN) for detection of EGFR exon 19 deletions or exon 21 (L858R) substitution mutations
188
Osimertinib target
EGFR tyrosine kinase
189
Osimertinib drug class
Third gen covalent EGFR inhibitor
190
Osimertinib cell cycle phase
G1
191
Osimertinib indication
Effective for T790M mutant EGFR (replace gefitinib)
192
Osimertinib resistance mechanisms
C797 mutation that abrogates covalent binding
193
Lapatinib target
EGFR and HER2
194
Lapatinib drug class
-EGFR and HER2 reversible inhibitor
-Small molecule TKI
195
Lapatinib cell cycle phase
G1
196
Lapatinib indication
Approved in combination with capecitabine for the treatment of advanced metastatic breast cancer in patients who have progressed on other therapies
197
Lapatinib dose limiting side effects
-Diarrhea
-Nausea
-Vomiting
-Reversible decrease in cardiac function (watch for signs of CHF)
198
Tucatinib target
HER2
199
Tucatinib drug class
Small molecule TKI HER2 inhibitor
200
Tucatinib cell cycle phase
Approved as a second line therapy in combination with trastuzumab and capecitabine for the treatment of advanced metastatic breast cancer who have progressed on other therapies
201
Tucatinib dose limiting side effects
Reduced side effects compared to lapatinib or covalent pan-ErbB inhibitors
202
Tucatinib genetic testing
HER2+ breast cancer
203
Trastuzumab, pertuzumab target
HER2
204
Trastuzumab, pertuzimab drug class
Recombinant humanized mAB
205
Trastuzumab, pertuzimab indication
Primary indication is the treatment of breast cancers that overexpress HER2
206
Trastuzumab, pertuzimab dose limiting side effects
-Flu-like symptoms
-Risk of cardiomyopathy/CHF
-Increases myelosuppression when used in combo with chemo
-Risk of hypersensitivity reactions (immune response)
207
Trastuzumab, pertuzimab drug interactions
-Trastuzumab used in combo with pertuzimab-different binding sites for HER2 increases efficacy; drug synergy
-Pertuzimab inhibits dimerization
208
Trastuzumab, pertuzimab genetic testing
HER2 expression
209
Cetuximab target
EGFR - completely inhibits binding of EGF and TGF-alpha
210
Cetuximab drug class
Recombinant chimeric mAB
211
Cetuximab indication
Primary indication is in the treatment of colorectal and head and neck cancers
212
Cetuximab dose limiting side effects
-Severe infusion reaction (~3%), acneiform rash, asthenias, fever
213
Bevacizumab target
VEGF (ligand) - blocks interaction with endothelial receptors
214
Bevacizumab drug class
Recombinant humanized MAB
215
Bevacizumab indication
-Used in combination with 5-FU based chemotherapy for first-line treatment of metastatic colorectal cancer
-No evidence of efficacy as single agent
216
Ramucirumab target
VEGFR (receptor)
217
Ramucirumab drug class
VEGFR (receptor) inhibitor mAB
218
Ramucirumab indication
-Used in combination with 5-FU based chemotherapy for first-line treatment of metastatic colorectal cancer
-No evidence of efficacy as single agent
219
Rituximab target
-Binds CD20 in normal B lymphocytes and immature pre-B cells -> inhibiting B-cell proliferation
-CD20 works with B-cell receptor (BCR) to drive proliferation of B-cells
220
Rituximab indication
B-cell lymphomas (non-Hodgkin's lymphoma), that target different binding sites on CD20
221
Daratumumab target
CD38 - a multifunctional transmembrane protein highly expressed on plasma B cells that make antibodies
222
Daratumumab indication
Multiple myeloma - cancer of malignant plasma cells
223
Ipilimumab target
CTLA-4 receptor - reverses cytotoxic T lymphocyte inhibition caused by CTLA-4 receptor allowing it to destroy tumor cells
224
Ipilimumab drug class
Recombinant human mAB
225
Ipilimumab indication
Approved for treatment of advanced metastatic melanoma
226
Ipilimumab dose limiting side effect
Severe immune-mediated adverse effects (inflammatory response)
227
Ipilimumab synergetic drugs
May require high dose corticosteroids to combat inflammatory response
228
Pembrolizumab target
Binds PD-1 receptor expressed on T-cells and blocks interaction with PD-L1 and PD-L2 -> blockade of PD-1 prevents inhibitory signaling within T-cells leading to enhanced tumor cell killing
229
Pembrolizumab drug class
mAB
230
Pembrolizumab indication
-Approved for the treatment of advanced metastatic melanoma following treatment with ipilimumab and a BRAF inhibitor (if BRAF positive)
-Approved for NSCLC if positive for PD-L1
230
Pembrolizumab genetic testing
PDL1 test for treatment of NSCLC
230
Atezolizumab target
Binds PD-L1 receptor (expressed on macrophages and tumor cells) - blocking interaction with PD-1 on T-cells leading to enhanced tumor killing
231
Atezolizumab drug class
PD-L1 mAB
232
Trastuzumab emtansine target
-Trastuzumab: HER2/Neu receptor
-Emtansine: inhibits microtubule assembly
233
Trastuzumab emtansine drug class
-ADC
-Emtansine = cytotoxic agent; microtubule destabilizer
233
Trastuzumab emtansine indication
Approved for second line treatment for HER2-positive metastatic breast cancer
234
Trastuzumab emtansine dose limiting side effect
-Trastuzumab adverse effects
-Thrombocytopenia
-Hepatotoxicity
235
Trastuzumab emtansine drug interactions
Emtansine toxicity significantly reduced because of selective HER2 targeting
236
Trastuzumab emtansine genetic testing
HER2
237
Bilnatumomab target
Binds to CD3 and brings activated T-cell into proximity of CD19
238
Bilnatumomab drug class
Bispecific T-cell engager
239
Bilnatumomab indication
Non-Hodgkin lymphomas
240
Mosunetuzumab target
CD3 and CD20
241
Mosunetuzumab drug class
Bispecific T-cell engager
242
Mosunetuzumab dose limiting side effect
Cytokine release syndrome - when immune system responds too aggressively
243
Teclistamab target
CD3 on T-cells and B-cell maturation antigen (BCMA) of multiple myeloma cells
244
Teclistamab drug class
Bispecific T-cell engager
245
Taquetamab target
CD3 on T-cells and GPRC5D on multiple myeloma cells
246
Teclistamab drug class
Bispecific T-cell engager
247
Sipuleucel-T target
Antigen presenting cells (APCs) activated by ex vivo treatment with PAP-GM-CSF - stimulates patients own immune system to attack cancer
248
Sipuleucel-T drug class
PAP-GM-CSF
249
Sipuleucel-T indication
Minimally symptomatic metastatic hormone refractory prostate cancer
250
Sipuleucel-T dose limiting factor
-Mostly limited to flu-like symptoms
-Possible increased risk of stroke
251
CAR-T target
T-cell activation using CD19 as the target
252
CAR-T drug class
Chimeric antigen receptor (CAR) T cells
253
CAR-T indication
B-cell leukemia
254
Olaparib target
PARP trapping to DNA
255
Olaparib drug class
Poly ADP ribose polymerase (PARP) inhibitor
256
Olaparib indication
Cancers with BRCA1/2 mutations
257
Olaparib genetic testing
BRCA1/2 + PARP inhibitor = synthetic lethality
258
Palbociclib target
Cdk4/6
259
Palbociclib drug class
-Kinase inhibitor - targets kinases directly involved with cell cycle control
-Targets ALL replicating cells
260
Palbociclib cell cycle phase
G1
261
Palbociclib indication
Cancers arising due to BRCA mutations
262
Palbociclib dose limiting side effect
-Neutropenia
-Nausea
-Fatigue
-Diarrhea
-Vomiting
263
Palbociclib genetic testing
BRCA1/2
264
Bortemzomib target
26S proteasome = ubiquitin-proteasome pathway important for regulation of intracellular proteins
265
Bortemzomib drug class
Proteasome inhibitor - blocks ubiquitination-disrupts homeostasis causing cell death
266
Bortemzomib indication
Multiple myeloma (B-cell malignancy)
267
5-azacytidine target
DNA and DNMT enzymes - part of DNA methylation
268
5-azacytidine drug class
DNMT inhibitor - blocks DNA methylation - causes reactivation of tumor suppressor genes
269
5-azacytidine indication
Myelodysplastic syndrome
270
Venetoclax target
BCL-2; anti-apoptotic protein
271
Venetoclax drug class
-BCL-2 inhibitor
-First FDA approved small molecule that inhibits a protein-protein interaction
272
Venetoclax indication
Chronic lymphocytic leukemia
273
Venetoclax drug interactions
-Combination with 5-azacitidine for AML
-PGP substrate
-CYP3A4
274
Pomalidomide target
Binds Cereblon to induce it to ubiquitinate and degrade IKZF TFs that are important in lymphocyte development and regulate cell survival
275
Pomalidomide drug class
Thalidomide analog - anti-angiogenic activity
276
Pomalidomide indication
Multiple myeloma and Kaposi sarcoma
277
What does every patient need when on Pomalidomide?
Patients must be signed up for the REMS program
