Scammell- pharmocological Rx of breast cancer

Question 1

does combination birth control pills for premenopausal patients have a link to breast cancer

Answer 1

no

Question 2

does topical vaginal estrogen products have a link to breast cancer in peri and post-menopausal patients

Answer 2

no

Question 3

increases risk of breast cancer BUT reduces risk of endometrial cancer

Answer 3

progestin

Question 4

____ approved that is an estrogen antagonist at breast and endometrium while getting estrogen benefits elsewhere

Answer 4

SERM

Question 5

hormonal therapy taken for ____ years for breast cancer treatment

Answer 5

5-10

Question 6

selective estrogen receptor modulator (SERM) used to treat breast cancer in premenopausal women

Answer 6

Tamoxifen

Question 7

increased risk of endometrial cancer and blood clots with this medicine

Answer 7

Tamoxifen

Question 8

aromatase inhibitor used to treat breast cancer in postmenopausal women

Answer 8

Letrozole, Anastrazole

Question 9

won’t see estrogenic effects with _____ inhibitors b/c estradiol levels are low

Answer 9

aromatase

Question 10

SE of hormonal therapy

Answer 10

menopausal symptoms, risk of endometrial cancer and blood clots

Question 11

___ promotes the growth of cancers that are estrogen receptor +

Answer 11

estrogen

Question 12

hormone receptor + means ___ and ___ receptor +

Answer 12

estrogen and progesterone

Question 13

___ increases progesterone receptor synthesis, so ____ receptor + tissues have both ER and PR

Answer 13

estrogen

Question 14

stop estrogen from acting (SERM or SERD) OR
lower estradiol levels (aromatase inhibitor) OR
inhibit estradiol secretion

Answer 14

hormone therapies

Question 15

if the cancer is ER- and PR-, ___ therapy is ineffective

Answer 15

hormone

Question 16

Estrogens agonists at some tissues, BUT
estrogens antagonists at others

Answer 16

SERM (selective estrogen receptor modulators)

Question 17

to treat ER + breast cancer: antagonist at the breast; agonist at the endometrium and clotting factors (endometrial cancer and blood clot risks)

Answer 17

Tamoxifen

Question 18

SERM that is pro-fertility, antagonist at hypothalamus and increase in GnRH

Answer 18

Clomiphene

Question 19

SERD (selective ER depleter or down-regulator); blocks the estrogen receptor and the receptor is degraded intracellularly
Second-line therapy in metastatic breast cancer after initial failure

Answer 19

Fulvestrant

Question 20

SE of this drug is hot flashes and night sweats due to antagonism of some effects of estrogen

Answer 20

Fulvestrant

Question 21

letrozole, anastrazole, exemestane

Answer 21

aromatase inhibitors

Question 22

used in premenopausal women for fertility induction + postmenopausal women for breast cancer treatment

Answer 22

Letrozole, Anastrazole

Question 23

SE of aromatase inhibitors

Answer 23

bone thinning, osteoporosis

Question 24

acts at GnRH receptor and downregulates entire pathway; decreases FSH secretion and decreases estradiol

Answer 24

Leuprolide

Question 25

feedback at hypothalamus and pituitary to decrease FSH secretion; decrease FSH secretion and decrease estradiol

Answer 25

progestin and androgen

Question 26

is expressed on 20% of breast cancer cells and stimulates growth

Answer 26

HER2

Question 27

monoclonal antibody to HER2 Main side effect is cardiovascular especially if combined with doxorubicin

Answer 27

Trastuzumab (Herceptin)

Question 28

targets HER2 but at a different site than trastuzumab; given together for synergistic effect

Answer 28

Pertuzumab

Question 29

the monoclonal antibodies to treat breast cancer can be used with what other 2 inhibitors

Answer 29

tyrosine kinase inhibitor CDK 4/6 inhibitor

Question 30

Answer 30

do not get chemo

Question 31

topoisomerase II inhibitor used to treat triple - breast cancer

Answer 31

doxorubicin

Question 32

main toxicity of doxorubicin

Answer 32

cardiac

Question 33

stabilizes microtubules; used to treat triple - breast cancer

Answer 33

paclitaxel

Question 34

main SE of paclitaxel

Answer 34

neuropathy

Question 35

inhibits thymidylate synthase; used to treat triple - breast cancer

Answer 35

5--fluorouracil

Question 36

main SE of 5-fluorouracil

Answer 36

neurotoxicity

Question 37

alkylates DNA; used to treat triple - breast cancer

Answer 37

cyclophosphamide

Question 38

main SE of cyclophosphamide

Answer 38

hemorrhagic cystitis

Question 39

Inhibit osteoclastic activity, decrease bone turnover; used in osteoporosis, bone pain and bone metastasis of breast cancer

Answer 39

bisphosphonates

Question 40

Monoclonal Ab that inhibits osteoclast activity by binding to RANK; used in osteoporosis and bone pain for bone metastasis of breast cancer

Answer 40

Denosumab