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This stuff right here Flashcards

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1
Q

High Emetic Risk Drugs

A 
Streptozosin
Mechlorethamine
Darcarbazine
Cyclophosphamide >1.5gm/m2
Carboplatin AUC >6
Cisplatin
Doxorubicin + Cyclophosphamide
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2
Q

High Risk Antiemesis Combo regimen

A

5HT3 + NK + Steroid (and/or Benzo)

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3
Q

Antiemesis Rescue Tx

A

Something not already in use; D2A common for breakthrough

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4
Q

Febrile Neutropenia Empiric Coverage

A

Antipseudomonal Beta-Lactam (cephalosporin)

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5
Q

When to use gCSF

A

When patient is becoming neutropenic (>20% risk)

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6
Q

What to do as secondary prophylaxis if pt has history of Febrile Neutropenia and/or previous gCSF use

A

Add gCSF, if previously used then Reduce chemo or change Tx

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7
Q

What labs/levels are high risk for TLS?

A

Uric Acid (>8) Potassium >6; Phosphorous >6.5 and Calcium <7 or >14

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8
Q

Tx for Uric Acid abnormalities in TLS

A

Allopurinol (also can be used prophylaxis)

Rasburicase

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9
Q

Tx for Hyperkalemia in TLS

A 
Regular Insulin in D50W (if BG <250)
Nebulized Albuterol + Sodium Bicarbonate
Furosemide
SPS (sodium exchange)
Patiromer (Ca exchange)
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10
Q

Tx for Hyperphosphatemia if no Hypercalcemia

A

Calcium Carbonate
Calcium Acetate
Aluminum Hydroxide

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11
Q

Tx for Hyperphosphatemia if Hypercalcemia

A 
Renagel
Renvela
Lanthanum Carbonate
Ferric CItrate
Sucroferric Oxyhydride
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12
Q

Tx for Hypercalcemia

A

Hydrate First
Bisphosphanates
Calcitonin
* if refractory w/ Bisphosphanates may add denosumab

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13
Q

Strongest Mutation correlated with Breast Cancer

A

BRCA (1 and 2)

- also at higher risk for ovarian/prostate

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14
Q

Breast Cancer Tx if ER/PR (+) and HER-2 (+/-)

A

Hormone Tx

  • Tamoxifen or LHRH (premenopausal)
  • Aromatase inhibitor (postmenopausal)
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15
Q

Breast Cancer Tx if ER/PR (-) and HER2 (+)

A

Trastuzumab +/- (Carboplatin + Docetaxel)

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16
Q

Breast Cancer Tx if ER/PR (-) and HER2 (-)

A

Cyclophosphamide + Doxorubin + Taxane

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17
Q

Breast Cancer Emetogenic Regimen

A

Fosaprepitant + Dexmethasone + Ondansetron
PRN prochloperazine and Ativan
+ Olanzapine if refractory

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18
Q

Breat Cancer Trastuzumab adjunctive

A

Pentuzumab ( only w/ Trastuzumab)

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19
Q

Neratinib

A

Used in HER2 (+)
TKI; prevents formation of HER2 epitopes
Diarrhea major side effect

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20
Q

Lapatinib

A

Used in HER2 (+)

TKI; inhibits EGFR & HER2;

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21
Q

Pablociclib

A

Used in HER2(-) ER/PR (+)
Cyclin Depende Kinase inhibitor
Inhibits CDK4/6 by blocking retinoblastoma hyperphosphorylation

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22
Q

Androgen Deprivation Therapy Options

A
  1. Oriechiectomy (Castration)

2. Medical Androgen Deprivation (Chem Cast)

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23
Q

LHRH Agonist Place in therapy

A

Suppresses LH an FSH/Testosterone Production
Leuprolide
Goreselin
Triptorelin
- See initial disease flare up to 2 weeks; Use anti-androgens prior to Tx for 1-2wks

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24
Q

LHRH Antagonists

A

Use if high tumor burden
Binds to GNRH receptor in pituitary, directly suppresses androgen production
Degarelix agent of choice

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25
AntiAndrogens
Used in combo w/ LHRH for androgen deprivation | Bicalutamide agent of choice
26
Abiraterone
Androgen Biosynthesis inhibitor binds CYP17, blocking androgen synthesis in testes, adrenal and tumors Significant DDIs: 3A4, 2C8, 2D6, 1A2
27
Chemo Tx in Prostate Cancer
used if metastazing | - Docetaxel or Cabazitaxel
28
Enzalutamide
Pure androgen blocker, More Hormonal side effects than bicalutamide Decreases seizure threshold
29
Limited Stage SCLC Tx
Cisplatin + Etoposide (EP) and Radiation
30
Extensive Stage SCLC Tx
Etoposide + Cisplatin Etoposide + Carboplatin Cisplatin + Irinotecan (Asians?)
31
Extensive SCLC Single Agent Tx
``` Topotecan Irinotecan Gemcitabine Paclitaxel Docetaxel Vinorebine Etoposide ```
32
Extensive SCLC 2nd line Combo
Cyclphosphamide + Doxorubicin + Vincrisitine (CAV) Nivolumab or Ipilumumab Combos increase toxicity
33
Mutation free NSCLC SCC
Platinum Doublet (No pemetrexed)
34
Mutation Free NSCLC LCC
Platinum Doublet with Pemetrexed Carboplatin + Paclitaxel + Bevacizumab Carboplatin + Pemtrexed + Pembroluzumab
35
EGFR Mutation NSCLC
Afatinib, Erlotnib, getfitinib
36
ALK Mutation NSCLC
Alectinib, Crizotinib, Ceritnib
37
ROS1 Mutation NSCLC
Crizotinib | Ceritnib
38
BRAF v600 Mutation NSCLC
Dabrafenib + Trametinib
39
PD-li Mutation NSCLC
Pembrolizumab
40
Gynecologic Malgnancies Stage Ic-III Tx
Platinum/Taxan Combo (IV or IP) (Ic = OV) (III = IP) NO Oxaliplatin
41
Calvert Equation
Dose = AUC x (GFR +25) Max GFR = 125 Used for Carboplatin Dosing
42
Plt Resistant Recurrent Gyne Malig Tx
Single agent (non platinum) +/- Bevacizumab
43
Recurrent Gyne malig Tx (plt sensitive)
Platinum doublet +/- Bevacizumab
44
Recurrent (>2) gyne malig tx
Parp Inhibitors Olaparib Rucaparib Niraparib
45
Colon Cancer Stage III Category 1 tx
FOLFOX | or CAPEOX
46
Colon Cancer Stage IV Tx
FOLFIRI (inc mortality except in stage IV) FOLFOX CAPEOX
47
Colon Cancer Tx w/ KRAS/NRAS wild type
Cetuximab | Panitimumab
48
Colon Cancer EGFR inhibitor Major Toxicity
Skin Toxicity - Papulopoustular Skin Rash - Xenosis - Fissures - Alopecia
49
Non-Mismatch Repair Deficient Colon Cancer Tx
Nivolumab | Pembrolizumab
50
ALL Induction Tx
Vincristine + Prednisone + Daunorubucin + L-Aasparaginase
51
ALL CNS Chemo Tx
Intrathecal Chemo - Methotrexate - Cytarabine
52
ALL Consolidation Tx
Non-universal combo tx | Daunorubicin, Vincristine, Prednisone, Asparaginase, Methotrexate, Cytaraine, Doxorubicin, Mercaptopurine, Thioguanine
53
ALL maintenance Tx
Decreasing doses of - Mercaptopurine - Methotrexate - Vincristine - Prednisone
54
ALL w/ Philadelphia Mut Tx
BCR-ABL Tyrosine Kinase Inhibitors | - Dasatninb, Imatinib, Nilotinib
55
ALL Salvage Tx for anti-CD19
Blinatumomab | Tisagenlecleucel
56
ALL Salvage Tx for anti CD22
Inotuzumab
57
Blinatumomab MoA
CD-19 dicted CD3 T-cell engager, forms cytolytic synapse between cytotoxic T cell and cancer target B-cell. Mediates the production of cytolytic proteins, release of inflammatory cytokines and proliferation of T cells, resulting in lysis of CD 19 + cells
58
ALL CNS prophylaxis measures
Do not do with Kids (mental Retardation alert)
59
AML/ANLL Induction Tx
Anthracycline x 3 days Cytarabine x7 days (3 and 7)
60
AML/ANLL Consolidation Tx
high doses of Cytarabine
61
APL Induction Tx
Tretinoin PO + Arsenic (low risk) | Anthracycline +/- Cytarabine (High Risk)
62
Pre AHSCT Tx
Busulfan and Cyclophosphamide
63
CLL Chemo Immuno Tx
Fludarabine + Cyclophosphamide + Rituximab (FCR) Pentostatin + Cyclophosphadmie + Rituximab (PCR) Bendamustine + Rituximab (BR)
64
CLL P13-K Delta inhibitor Tx
Idelalisib
65
CLL Bruton's Tyrosine Kinase Inhibitor
Ibrutinib
66
CLL Selective BCL02 inhibitor
Venetoclax
67
CLL tx w/ adjuvant Chlorambucil
Ofatumumab | Obinutuzumab
68
CLL CD52 inhibitor
Alemtuzumab
69
HSV/VZV Infection Prophylaxis
Acyclovir/Valacyclovir
70
PCP infection prophylaxis
SMX/TMP Dapson Atovaquone Pentamidine
71
Hepatitis B Infection Prophylaxis
Entecavir, Tenofovir and Lamivudine
72
CMV Infection Prophylaxis
Serial PCRs | Valganciclovir
73
Hypogammaglobulinemia Tx
IV Ig
74
Autoimmune Hemolytic Anemia Tx
High dose steroids Rituximab Alemtuzumab
75
Immune Thrombocytopenia
High Dose steroids IV Ig, Rituximab, Rho Ig, Immunosuppressants Romiplostim, Eltrombopag
76
Richter Syndrome Tx
Combination Chemo
77
CML Acute Frontline Tx
Hydroxyurea | TLS prophylaxis w/ Allopurinol
78
CML Primary Tx
Imatinib, Dastatinib or Nilotinib | D or N if high risk
79
CML Tx after TKI failure
Bosutinib Ponatinib Omacetaxine
80
MM Clinical Manifestation
``` CRAB Calcium elevation Renal Insufficiecy Anemia Bone Disease ```
81
MM low/Int Induction Tx
VRD | Bortezomib, Lenalidomide and Dexamethasone
82
MM High risk Induction Tx
KRD | Carfilzomib, Lenalidomide and Dexamethasone
83
MM Elder/Frail Tx
RD | Lenalidomide and Dexamethasone
84
Immunomodulators used in MM
Lenalidomide | Thalidomide
85
Immunomodulator ADRs
Teratogenicity VTE Myelosuppression Peripheral Neuropathy
86
Proteasome inhibitors and target
Bortezomib (26S) Carflizomib (20S) Ixasomib (20s, reversible)
87
MM Maintenance Tx
Lenalidomide or Bortezomib
88
MM Salvage Tx
Daratumumab | Elotuzumab
89
Osteo Support in MM
Bisphosphonates Pamidronate Zoledronic Acid
90
Elotuzumab MoA
(SLAMF7) Direction activation of NK cells
91
Daratumumab target
(CD38)
92
"B Symptoms"
Fever Drenching Night Sweats Weight Loss >10% Body weight
93
Hodgkin Chemo Tx Standards
ABVD Stanford V BEACOPP
94
ABVD
``` ABVD Doxorubicin Bleomycin Vinblastine Dacarbazine ```
95
Stanford V
``` Doxorubicin Vinblastine Mechlorethamine Vincristine Bleomycin Etoposide Prednisone ```
96
BEACOPP
``` Bleomycin Etoposide Doxorubicin Cyclophosphamide Vincristine Procarbazine Prednisone ```
97
Hodgkin Salvage Tx
AutoSCT --> Brentuximab, Nivolumab, Prembrolizumab
98
Non-Hodgkin Diffuse Large C CEll Tx
RCHOP or R-Bendamustine Rituximab, Cyclphosphamide, Doxorubicin, Vincristine, Prednisone Rituximab + Bendamustine
99
Non-Hodgkin Follicular Tx
Bendamustine + Rituximab | Bendamustine + Obintuzumab
100
Burkitts Lymphoma Tx
RCHOP

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