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PHARM: GI Tumors Flashcards

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1
Q

Targeted therapy for Colorectal cancer.

A

Bevacizumab

Cetuximab

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2
Q

Targeted therapy for Gastric cancer.

A

Glutamic Acid

Trastuzumab

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3
Q

Targeted therapy for GI carcinoid tumor.

A

Methysergie

Octreotide

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4
Q

Targeted therapy for GIST.

A

Imatinib

Sunitinib

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5
Q

Targeted therapy for pancreatic cancer.

A

Erlotinib

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6
Q

Targeted therapy for Liver Cancer

A

Sorafenib

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7
Q

MOA: Her-2 neu Antibody; HER2 is downregulated, CDK-p27 accumulates and cell cycle arrest occurs. Inhibits constitutive HER2 cleavage/shedding mediated by metalloproteases (may correlate with clinical activity)

A

Trastuzumab

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8
Q

MOA: rhu-MAb of VEGF

A

Bevacizumab

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9
Q

MOA: Inhibitor of many RTKs like PDGFR-alpha and –beta, VEGFR, KIT, FLT3, CSR-1R, RET

A

Sunitinib

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10
Q

MOA: rh/mMAb of EGFR

A

Cetuzimab

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11
Q

MOA: Oral multi-kinase inhibitor targeting serine/threonine and receptor TK in both tumor and vasculature. Target examples: Raf, VEGF, PDGFR-beta, Kit, FLT-3, RET

A

Sorafenib

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12
Q

MOA: EGFR-TKI

A

Erlotinib

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13
Q

MOA: SS analog; reduces duodenal HCO3-, amylase, gastric acidity and inhibits gallbladder contrations and bile secretion as well as meal-induced increases in SMA and portal venous flow

A

Octreotide

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14
Q

MOA: Nutritional supplement; used to counterbalance deficiencies of HCl in gastric juice

A

Glutamic Acid

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15
Q

MOA: Serotonin inhibitor in GI tract

A

Methysergide

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16
Q

MOA: Oral TKI as adjuvant treatment following complete resection of Kit (CD117) positive GIST

A

Imatinib

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17
Q

MOA: Reduced folate; synergizes with 5-FU

A

Levucovorin

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18
Q

TOXICITY: Diarrhea and dehydration

A

Leucovorin

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19
Q

TOXICITY: Bleeding, GI perforation, wound dehiscence, HTN, Hypersensiivity

A

Bebacizumab

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20
Q

TOXICITY: GI toxicities (pain, bloating, N/V, constipation, stomatitis, dyspepsia) common. CHF. Neurologic toxicity, fluid retention, edema.

A

Imatinib

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21
Q

TOXICITY: GI toxicity (N/V, diarrhea) prolonged bleeding, elevated LFTs, ocular toxicities; rarely interstitial lung disease

A

Erlotinib

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22
Q

TOXICITY: Monitor blood glucose because drug inhibits insulin and glucagon. Dose related diarrhea (so give with methysergide)

23
Q

TOXICITY: LVEF dysfunction and cardiomyopathy. Severe infusion-related reactions including anaphylaxis, angioedema, and pulmonary toxicity (worse in patients w/ COPD, asthma, respiratory insufficiency)

24
Q

TOXICITY: Cardiac arrest, respiratory arrest, and/or sudden death; infusion reactions. Acneiform rash common (76-88%), severe in
up to 17% of patients

25
TOXICITY: Hand-foot skin reaction characterized by redness, pain, swelling or blisters on the palms of the hands or soles of the feet. Generally appears in first 6 weeks of treatment.
Sorafenib
26
TOXICITY: Thrombocytopenia and bleeding. QT prolongation (sometimes fatal), GI complications including GI perforation.
Sunitinib
27
What drug is also a Vasoconstrictor of large and small arteries; used for migraine therapy?
methysergide
28
Which cancer has the following treatment plan: Radiation therapy (70% 5YS even if used alone); Radiation + Cisplatin, 5-FU, Mitomycin leads to improved outcomes?
anal cancer
29
What are folfox and folfiri used for?
colorectal cancer
30
What is folfox?
5-FU + Leucovorin + oxaplatin
31
What is folfiri?
5-FU + Leucovorin + irinotecan
32
How can you tell that a patient with esophageal cancer has invasion to muscularis propria and metastasis?
dysphagia
33
How may EBV viral infection lead to gastric cancer?
DNA methylation, miss-match repair
34
How may microsatellite instability lead to gastric cancer?
DNA miss-match repair
35
If a gastric cancer is HER2 positive, what drug is added to the 5-FU and cisplatin?
Trastuzumab
36
Why is glutamic acid given with gastric cancer?
ancillary agent that is employed as a gastric acidifier to counterbalance deficiencies of HCl in gastric juice
37
What type of tumors are rare malignancies arising from cells linking the endocrine and CNS?
GI carcinoid tumors
38
TRUE or FALSE: GI carcinoid tumors are highly responsive to treatments.
FALSE: no protocol has shown objective tumor response rate of > 15%
39
Why can octreotide only be given for 1 year?
tachyphylaxis (not as bad with long-acting formulations) and/or disease progression
40
Why do you give methysergide in GI carcinoid treatment?
serotonin antagonist used to inhibit diarrhea arising from serotonin effects in the GI tract
41
What drug used to treat GI carcinoid tumors inhibits disease progression and provides symptom relief in 75% of patients?
INF-alpha
42
What is the problem with INF-alpha?
Toxicity is severe (alopecia, anorexia, fatigue, weight loss, fever, flu-like syndrome, myelosuppression)
43
What type of tumors are 80% KIT-mutants?
GI stromal tumors
44
Why is treatment with cytotoxic chemotherapy futile in GIST?
P-gp overexpression pumps the drug out
45
What is the first line treatment for unresectable, metastatic, or recurrent GIST?
Imatinib mesylate
46
What is the problem with imatinib?
majority of patients eventually develop imatinib resistance due to secondary mutations in a separate portion of the KIT-coding sequence
47
What treatment of pancreatic cancer alleviates the malabsorption caused by exocrine insufficiency (that leads to malnutrition)?
pancreatic enzyme replacement
48
What is FOLFIRINOX and what cancer is it used in?
Pancreatic cancer | leucovorin + fluorouracil + irinotecan + oxiplatin
49
What is the synergistic combination used in pancreatic cancer?
5-FU/Folinic Acid (Leucovorin)
50
For what type of cancer is TACE used?
liver cancer
51
What does TACE stand for?
trans-catheter arterial chemoembolization)-
52
What is injected in TACE?
doxorubicin
53
How does TACE spare normal tissue and minimizes dispersion of drug away from the tumor site?
Super-selective catheterization of segmental arteries feeding tumor

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