Lecture 3 - Cancer Potpurri

Question 1

chemotherapy-induced nausea/vomiting is mediated by the emesis center in the _____

Answer 1

medulla

Question 2

_____ is a dopamine antagonist used to reduce vomiting that does not cross the BBB very well = less risk of _____ side effects

Answer 2

domperidone;

extrapyramidal

Question 3

what anti-histamine blocks dopamine receptors as well and is used to treat vomiting?

Answer 3

promethazine

Question 4

_____ antagonizes 5HT3 receptors and also decreases _____ stimulation

Answer 4

ondansetron, vagal

Question 5

what drug can cause GI perforation?

Answer 5

bevacizumab

Question 6

the small molecule Tyrosine Kinase inhibitors lapatinib, sunitinib, and pazopanib all can cause ____ toxicity

Answer 6

liver

Question 7

which cancer drug class classically causes more severe bone marrow suppression?

Answer 7

alkylating agents ie cyclophosphamide/busulfun

cell cycle NON SPECIFIC

Question 8

what is the order of hematologic toxicity, for RBCS, platelets, PMNs

Answer 8

neutropenia first –> thrombocytopenia (Esp nitrosureas) –> anemia

Question 9

what can be used to treat/prevent neutropenia?

Answer 9

GM-CSF

Question 10

name 2 drugs that have a side effect of increased risk hemorrhage

Answer 10

bevacizumab
sorafenib/carfilzomib

also ponatinib

Question 11

____ can cause photosensitivy/severe sunburn

Answer 11

5-FU;

also MTX

Question 12

doxorubicin and dactinomycin are associated with _____ ____ reaction, when a drug causes an inflammatory rxn to a tissue previously exposed to radiotherapy

Answer 12

radiation recall

Question 13

tyrosine kinase inhibitors and EGFR antibodies both cause a ____ rash. this correlates with a _____ response rate and outcome

Answer 13

acneiform;

higher

Question 14

what drug can cause hemorrhagic cystitis?

what do you use to prevent it?

Answer 14

cyclophosphamide/isofosfamide;

MESNA and hydration

Question 15

premedication is mandatory for all patients treated with _____ to prevent hypersensitivity reactions

Answer 15

taxols (paclitaxel)

Question 16

what 3 drugs are associated with severe extravasation reactions?

Answer 16

anthracyclines, nitrogen mustards, vinca alkaloids

Question 17

what anti-cancer drug can cause:

bladder cancer =
sterility/infertility =
nephrotoxicty and deafness =

Answer 17

cyclophosphamide;
alkylating agents (ie cyclophosphamide;

cisplatin

Question 18

the use of a ____ carrier with doxorubicine has reduced cardiac toxicity

Answer 18

liposomal

Question 19

sirolimus/rapamycin can cause what 2 metabolic toxicities?

Answer 19

insulin resistance;

hyperlipidemia

Question 20

hypertension is seen with drugs that inhibit _____

Answer 20

angiogenesis

Question 21

what is the main reason for anti-cancer treatment failure?

Answer 21

chemoresistance

Question 22

an increase in drug efflux is coded for by the _____ gene. this causes increased expression of _____

Answer 22

multi-drug resistance;

P-glycoprotein (a drug transport protein)

Question 23

combination chemotherapy regimens reduce both ____ and ______

Answer 23

tumor resistance;
toxicity

in theory

Question 24

_____ therapy is chronic, equally spaced low doses of drug without extended rest periods

Answer 24

metronomic

Question 25

______ is a new drug that targets cyclin dependent kinases

Answer 25

flavopiridol

also downregulates VEGF
causes neutropenia and diarrhea

Question 26

____ ____ is using drugs other than anticancer drugs to weaken pathways that enable cancer cells to survive

Answer 26

drug repositioning