Oncology Flashcards
(162 cards)
Cats with GI LSA with CD4+ T cell lymphocytosis had a MST of ___ compared to those of CD5 low expressing T cell, which was ___ days.
272, 27.5, JVIM 2020
Which vinca alkaloid achieves highest pulmonary concentration?
Vinorelbine
Mechanism of action for procarbazine
antineoplastic drug that crosses the blood-brain barrier (BBB) and has some specificity for T cells. The cytotoxic effects of procarbazine are thought to be primarily via methylation of DNA bases
The mechanism of action that metronomic chemotherapy offers (how is it anti-neoplastic)
Anti-angiogenesis and immunomodulatory (as opposed to cytotoxic) - examples are lomustine, cyclophosphamide, chlorambucil
What does mesna do?
reduces the risk of cystitis associated with ifosfamide and cyclophosphamide by binding toxic metabolites in the urine (acrolein)
The P-glycoprotein pump has what significance for chemotherapy?
Contributes to multi-drug resistance.
What chemo drug classes are not substrates for Pglycoprotein pump?
Alkylating agents, platinum agents
Late radiation side effects generally occur at least how long after radiation?
Over 6 months
Common tumors that respond to radiation
Nasal carcinoma (not squam) and sarcoma (dog), nasal carcinoma and lymphoma (cat), pituitary tumors, most canine brain tumors, cat injection site sarcoma, dog agasaca/thyroid carcinoma/soft tissue sarcoma, most dog oral tumor ( melanoma, squam, fibrosarc)
Mechanism of Oncept (cancer vaccine)
nucleic acid vaccine containing tyrosinase which is essential for melanin - over-expressed in melanomas (conflicting evidence whether this is helpful)
Mechanism of action of toceranib (Palladia)
tyrosine kinase inhibitor - inhibits VEGFR2, PDGFRbeta, and KIT
Which of the following situations is Palladia not helpful? agasaca; non-resectable MCT; metronomic chemotherapy; possible microscopic hemangiosarcoma
Possible microscopic hemangiosarc; Palladia does not seem to be good for microscopic metastatic disease
What is Gr III neutropenia and thrombocytopenia?
Gr 3 - 500-999 (neutrophils), 25k-49k (plt)
Most nadirs occur when? Which are exceptions?
6-8d. Carboplatin - 14d (dog), 14-25d (cats); lomustine (cats) - anywhere from 8-28d
Give some chemo drugs that are inappropriate to give to MDR1
Vinca alkaloids, anthracycline (doxo, mitoxantrone),
Some breeds known to be affected by MDR1
Collie (rough or smooth)!, Australian Shepherd (miniature or standard)!, McNab, Silken Windhound, Long-haired Whippet!, Shetland Sheepdog, and German Shepherd
Increased risk of infection occurs when neutrophils are under what level?
<1k
Cumulative, sometimes irreversible thrombocytopenia can occur with which chemo agents?
Lomustine, melphalan, chlorambucil [discontinue if you note decreasing trend or plts drop below 100k-125k]
What to do if vinca alkaloid extravasates:
warm compresses, for 15-20 minutes duration, four times a day, for 2-3 days
What to do if doxorubicin, epirubicin or dactinomycin extravasates:
cold compresses on the site of injury for 15-20 minutes duration, four times a day, for 2-3 day; can follow with dexrazoxane
The most emetogenic chemotherapy drug?
Cisplatin
What is the “max dose range” of doxorubicin for a dog with no heart disease?
180-240 mg/m2
Cumulative and sometimes irreversible hepatotoxicity can occur with which chemo agent? What can be given to decrease the risk?
Lomustine (CCNU); Denamarin (S-adenosylmethionine and silybin)
Chemotherapy agents with known nephrotoxicosis?
Cisplatin (dogs - no cats but not b/c kidneys), streptozotocin (dogs), ifosfamide (dogs and cats), doxorubicin (cats), potentially CCNU in dogs if high dose pulse/metronomic