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Pulmonology > 08.26 - Pharmacology of Lung Cancer (Sweatman) - Questions > Flashcards

08.26 - Pharmacology of Lung Cancer (Sweatman) - Questions Flashcards

1
Q

Drug used for non-squamous NSCLC only

A

Bevacizumab

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2
Q

Which subtype harbors EGFR mutation

A

Adenocarcinoma

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3
Q

Why no Bevacizumab in Squamous Cell

A

High risk of bleeding

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4
Q

KRAS mutation can render __ drugs ineffective

A

Anti-EGFR

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5
Q

In what subtype is EML4-ALK more prevalent

A

2-7% of NSCLC, more in adeno

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6
Q

What type of patients are likely to have EML4-ALK

A

Nonsmokers, Light Smoking, Adeno

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7
Q

EML4-ALK produces activation of

A

MEK/ERK Pathway

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8
Q

Inhibitor of EML4-ALK

A

Crizotinib

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9
Q

Problem in TKI administration

A

Orally administered - Must be absorbed

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10
Q

Mutations (4) more common in Non-smokers

A

EGFR, EML4-ALK, HER2, hMSH2

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11
Q

What percent of patients have actionable mutations

A

60%

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12
Q

Top 3 mutations, in order, in adenocarcinomas

A

KRAS, EGFR, ALK

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13
Q

Which subtype of tumor should have mutation testing

A

Adenocarcinoma

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14
Q

Test for EGFR

A

DNA seq

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15
Q

Test for EML4-ALK

A

FISH

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16
Q

Treatment rationale for SCLC

A

Met occurs early so chemo/radiation is only option

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17
Q

Treatment rationale for NSLC

A

Surgical recision if early stage, Genetic testing if adeno

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18
Q

Standard treatment for SCLC

A

Etoposide + Cisplatin or Carboplatin

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19
Q

Standard treatment for NSCLC

A

Cisplatin + Taxel or other; Maintenance w/ Pemetrexed; Targeted; Bevacizumab if non-squamous

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20
Q

General MOA of Pemetrexed

A

DHFR inhibitor

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21
Q

General MOA of -platins

A

Form DNA intrastrand crosslinks and adducts

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22
Q

General MOA of Cyclophosphamide

A

Alkylating

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23
Q

General MOA of - Taxels

A

Microtubule stabilizer inhibiting de-polymerization

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24
Q

General MOA of Doxorubicin

A

Intercalator, Free Radicals, Topo 2 inhibition

25
Q

General MOA of Etoposide

A

DNA Topo 2 stabilizer

26
Q

General MOA of Gemcitabine

A

DNA polymerase inhibitor

27
Q

General MOA of Isfosfamide

A

Cross linker

28
Q

General MOA of -Tecans

A

DNA Topo 1 stabilizer

29
Q

General MOA of Vinca Alkyloids

A

Microtubule inhibitor

30
Q

Toxicity of Carboplatin

A

Blood chemistry dyscrasia

31
Q

Toxicity of Cisplatin

A

Nephro- and Oto-toxicity

32
Q

Toxicity of Cyclophosphamide

A

Hemorrhagic Cystitis (Mesna is protective), Pulmonary Fibrosis

33
Q

Toxicity of Docataxel

A

Sensory neuropathy

34
Q

Toxicity of Doxorubicin

A

CHF - Cardiotoxicity

35
Q

Toxicity of Etoposide

A

Infection, Alopecia

36
Q

Toxicity of Gemcitabine

A

Arthralgia

37
Q

Toxicity of Ifosfamide

A

Neurotoxicity, Renal failure (<10%)

38
Q

Toxicity of Irinotecan

39
Q

Toxicity of Paclitaxel

A

Myalgia and Arthralgia

40
Q

Toxicity of Pemetrexed

A

Elevated LFTs and Creatinine

41
Q

Toxicity of Topotecan

A

Hyperbilirubinemia

42
Q

Toxicity of Vinblastine

A

Neuropathic; Never give intrathecal

43
Q

Toxicity of Vinorelbine

A

Neutropenia; Never give intrathecal

44
Q

2 notable toxicities of Erlotinib

A

Rash; Interstitial lung-disease-type events

45
Q

General MOA of Afatinib

A

Covalent inhibitor of EGRF, HER2, and HER4

46
Q

2 most notable toxicities of Afatinib

A

Diarrhea, Rash

47
Q

Covalent inhibitor of EGRF, HER2, and HER4

48
Q

Advantage of Afatinib

A

Less toxic than Erlotinib

49
Q

Mutation that confers resistance of EGFR to TKI’s

50
Q

T790M mutation restores

A

ATP affinity of EGFR to WT levels

51
Q

2 notable toxicites of Crizotinib

A

GI, Visual Disorders

52
Q

General MOA of Crizotinib

A

Multi-kinase inhibitor, including ALK

53
Q

Sims and Diffs in toxicities of Erlotinib and Crizotinib

A

Both liver and eye; erlotinib rash, much less rash in crizotinib

54
Q

TKI’s that are CYP substrates

A

Crizotinib, Erlotinib

55
Q

Mutation that confers resistance to Crizotinib

A

G2032R ROS1

56
Q

MOA of Bevacizumab

A

Receptor of VEGFR fused to Fc fragment of an antibody - Prevents VEGF from binding its endogenous receptor sites

57
Q

2 notable toxicities of Bevacizumab

A

HTN/Thromboembolism; Fistula

58
Q

What subtype has highest adverse effects with Bevacizumab

A

Squamous - don’t use

Pulmonology (31 decks)

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