Hem-Onc: Other cancer drugs

Question 1

Cisplatin: mech

Answer 1

Cross-link DNA

Question 2

Cisplatin: uses

Answer 2

testicular, bladder, ovary, and lung carcinomas

Question 3

Cisplatin: tox

Answer 3

Nephrotoxicity and acoustic nerve damage.

Prevent nephrotoxicity with amifostine (free radical scavenger) and chloride diuresis

Question 4

Amifostine:

Answer 4

free radical scavenger, used to prevent nephrotoxicity in cisplatin and carboplatin

Question 5

Carboplatin: mech

Answer 5

cross-link DNA

Question 6

Carboplatin: uses

Answer 6

testicular, ovary, bladder, and lung carcinomas

Question 7

Carboplatin: tox

Answer 7

Nephrotoxicity, and acoustic nerve damage.

Prevent nephrotoxicity with amifostine (free radical scavenger) and chloride diuresis

Question 8

Etoposide: mech

Answer 8

CCS: G2 phase

eTOPOside inhibits TOPOisomerase II –> increased DNA degredation

Question 9

Etoposide: uses

Answer 9

solid tumors (particularly testicular and small cell lung cancer), leukemias, lymphomas

Question 10

Etoposide: tox

Answer 10

Myelosuppression, GI irritation, alopecia

Question 11

Teniposide: mech

Answer 11

CCS: G2 phase

Inhibits topoisomerase II –> Increased DNA degredation

Question 12

Teniposide: uses

Answer 12

Solid tumors (particularly testicular and small cell lung cancer), leukemias, lymphomas

Question 13

Teniposide: tox

Answer 13

Myelosuppression, GI irritation, alopecia

Question 14

Irinotecan: mech

Answer 14

Inhibit topoisomerase I and prevent DNA unwinding and replication

Question 15

Irinotecan: uses

Answer 15

Colon cancer

Question 16

Irinotecan: tox

Answer 16

Severe myelosuppression, diarrhea

Question 17

Topotecan: mech

Answer 17

Inhibit topoisomerase I and prevent DNA unwinding and replication

Question 18

Topotecan: uses

Answer 18

Ovarian and small cell lung cancers

Question 19

Topotecan: tox

Answer 19

Severe myelosuppression, diarrhea

Question 20

Topotecan: tox

Answer 20

Severe myelosuppression, diarrhea

Question 21

Hydroxyurea: mech

Answer 21

Inhibits ribonucleotide reductase –> decreases DNA Synthesis (S-phase specific)

Question 22

Hydroxyurea: uses

Answer 22

Melanoma, CML, sickle cell disease (increases HbF)

Question 23

Hydroxyurea: uses

Answer 23

Melanoma, CML, sickle cell disease (increases HbF)

Question 24

Hydroxyurea: tox

Answer 24

Bone marrow suppression, GI upset

Question 25

Hydroxyurea: tox

Answer 25

Bone marrow suppression, GI upset

Question 26

Prednisone, Prenisolone: mech

Answer 26

May trigger apoptosis. May even work on nondividing cells | Suppresses mitosis in lymphocytes

Question 27

Prednisone, Prednisolone: uses

Answer 27

Most commonly used glucocorticoids in cancer chemotherapy. Used in CLL, non-Hodgkin lymphomas (part of combination chemotherapy regimen). Immunosuppressants (ex. autoimmune dx)

Question 28

Prednisone, Prednisolone: tox

Answer 28

Cushing-like symptoms; weight gain, central obesity, muscle breakdown, cataracts, acne, osteoporosis, HTN, peptic ulcers, hyperglycemia, psychosis

Question 29

Tamoxifen: mech

Answer 29

CCS: G1 phase Selective Estrogen Receptor Modulater (SERM) Receptor antagonists in breast and agonist in bone. Block binding of estrogen to ER + cells

Question 30

Tamoxifen: uses

Answer 30

Breast cancer treatment (tamoxifen only) and prevention.

Question 31

Tamoxifen: tox

Answer 31

Partial agonist in endometirum, which increases risk of endometrial cancer; "hot flashes"

Question 32

Raloxifene: mech

Answer 32

CCS: G1 phase Selective Estrogen Receptor Modulater (SERM) Receptor antagonist in breast and agonist in bone Blocks binding of estrogen to ER + cells

Question 33

Raloxifene: uses

Answer 33

Breast cancer prevention, prevention of osteoporosis

Question 34

Raloxifene: tox

Answer 34

no increase in endometrial carcinoma because it is an endometrial antagonist!

Question 35

Trastuzumab (Herceptin): mech

Answer 35

CCS: G1 phase Monoclonal Ab against HER-2 (c-erbB2), a tyrosine kinase receptor. Helps kill breast cancer cells that overexpress HER-2, through inhibition of HER2-initiated cellular signaling and Ab-dependent cytotoxicity

Question 36

Trastuzumab (Herceptin): uses

Answer 36

HER-2 + breast cancer and gastric cancer (tras2zumab)

Question 37

Trastuzumab (Herceptin): tox

Answer 37

Cardiotoxicity. "HEARTceptin" damages the HEART

Question 38

Imatinib (Gleevec): mech

Answer 38

CCS: G1 phase Tyrosine kinase inhibitor of bcr-abl (Philadelphia chromosome fusion gene in CML) and c-Kit (common in GI stromal tumors)

Question 39

Imatinib (Gleevec): uses

Answer 39

CML and GI stromal tumors

Question 40

Imatinib (Gleevec): tox

Answer 40

fluid retention

Question 41

Rituximab: mech

Answer 41

Monoclonal Ab against CD20, which is found on most B-cell neoplasms

Question 42

Rituximab: uses

Answer 42

Non-Hodgkin lymphoma, rheumatoid arthritis (with MTX), ITP

Question 43

Rituximab: tox

Answer 43

Increased risk of progressive multifocal leukoencephalopathy

Question 44

Vemurafenib: mech

Answer 44

small molecule inhibitor of forms of B-Raf kinase with the V600E mutation

Question 45

Vemurafenib: uses

Answer 45

Metastatic melanoma

Question 46

Bevacizumab: mech

Answer 46

Monoclonal antibody against VEGF. Inhibits angiogenesis

Question 47

Bevacizumab: uses

Answer 47

Solid tumors (colorectal cancer, renal cell carcinoma)

Question 48

Bevacizumab: tox

Answer 48

Hemorrhage and impaired wound healing

Question 49

Bevacizumab: tox

Answer 49

Hemorrhage and impaired wound healing

Question 50

Erlotinib: mech

Answer 50

EGFR tyrosine kinase inhibitor

Question 51

Erlotinib: uses

Answer 51

non-small cell lung carcinoma

Question 52

Erlotinib: tox

Answer 52

Rash