Treatment of Malignancies

Question 1

how is neutropenic sepsis managed?

Answer 1

immediate broad spectrum antibiotics

Question 2

what is the first line treatment for neutropenic sepsis?

Answer 2

piperacillin + tazobactam

teicoplanin + aztreonam if pen allergic

Question 3

what can be given to prevent neutropenia during chemotherapy cycles?

Answer 3

growth factors i.e. GCSF

Question 4

how do monoclonal antibodies work?

Answer 4

target cells with the specific target protein

Question 5

name a monoclonal antibody used for haematological malignancies

Answer 5

rituximab

Question 6

how does rituximab work?

Answer 6

binds specifically to CD20 on B cells

Question 7

how is rituxumab administered?

Answer 7

subcutaneous injection

Question 8

name some other anti-B cell monoclonal antibodies

Answer 8

ofatumumab

obinutuzumab

Question 9

what monoclonal antibody can be given in hodgkin’s lymphoma?

Answer 9

brentuximab vedotin

Question 10

name two types of biological agents for haematological malignancies

Answer 10

proteosome inhibitors

IMIDs

Question 11

what is the role of the proteosome?

Answer 11

breaks down old proteins into amino acids for recycling

Question 12

how can proteosome inhibitors kill cancer cells?

Answer 12

blocking breakdown of proteins allows the accumulation of toxic proteins in the cells, causing apoptosis

Question 13

name a proteosome inhibitor

Answer 13

bortezomib

Question 14

what two malignancies can proteosome inhibitors be of benefit in?

Answer 14

mantle cell NHL

low grade NHL

Question 15

what are two possible complications of proteosome inhibitors?

Answer 15

nerve damage

low platelets

Question 16

name two IMIDs

Answer 16

lenalidomide

pomalidomide

Question 17

what malignancies are IMIDs mainly used for?

Answer 17

myeloma

other plasma cell disorders

Question 18

name a targeted treatment that can be used for CML

Answer 18

tyrosine kinase inhibitors

Question 19

name some tyrosine kinase inhibitors

Answer 19

imatinib
nilotinib
dasatinib

Question 20

what drugs can be used to target malignant B cells in CLL and mantel cell lymphoma?

Answer 20

ibrutinib

venetoclax

Question 21

how does chemo/radiotherapy work?

Answer 21

damages the DNA of cancer cells as it divides, causing the cell to die by the process of apoptosis

Question 22

what mutation can make treatment with chemo or radiotherapy harder?

Answer 22

mutations in p53

Question 23

what are the two groups of cytotoxic drugs?

Answer 23

cell cycle specific

non cell cycle specific

Question 24

which is more tumour specific - cell cycle specific or non specific?

Answer 24

specific

Question 25

name two groups of cell cycle specific cytotoxic drugs

Answer 25

antimetabolites | mitotic spindle inhibitors

Question 26

how do antimetabolites work?

Answer 26

impair nucleotide synthesis and incorporation

Question 27

name three antimetabolites

Answer 27

methotrexate 6-mercaptopurine hydroxyurea

Question 28

what is the method of action of methotrexate?

Answer 28

inhibits dihydrofolate reductase

Question 29

what is the method of action of 6-mercaptopurine?

Answer 29

incorporated into DNA causing strand breaks when it tries to replicate

Question 30

what is the method of action of hydroxyurea?

Answer 30

impaired deoxynucleotide synthesis

Question 31

name two mitotic spindle inhibitors

Answer 31

vinca alkaloids | taxotere

Question 32

name two vinca alkaloids

Answer 32

vincristine | vinblastine

Question 33

name three types of non cell cycle specific chemotherapy agents

Answer 33

alkylating agents platinum derivatives cytotoxic antibiotics

Question 34

name two alkylating agents

Answer 34

chlorambucil | melphalan

Question 35

what is the MoA of alkylating agents?

Answer 35

bind covalently to DNA bases causing strand breaks by free radical production

Question 36

name two platinum derivatives

Answer 36

cis-platinum | carboplatin

Question 37

what antibiotics are cytotoxic?

Answer 37

anthracyclines

Question 38

name some anthracyclines

Answer 38

daunorubicin doxorubicin idarubicin

Question 39

what are the general immediate side effects of cytotoxic drugs?

Answer 39

bone marrow suppression gut mucosa damage hair loss

Question 40

what cytotoxic drug can cause neuropathy?

Answer 40

vinca alkaloids

Question 41

what cytotoxic drug can cause cardiotoxicity?

Answer 41

anthracyclines

Question 42

what cytotoxic drug can cause nephrotoxicity?

Answer 42

cis-platinum