23. Chemotherapy of Neoplastic Disease II

Question 1

A 12 year old boy comes to his doctor his mother has noticed that a large growth has began to grow on his skin. It is biopsied and found to be malignant. The boy has a neurologic disorder in which has the characteristics of self mutilation what. Knowing these symptoms which medication should the doctor avoid in treating his cancer/

A.Troptochen 
B. Carboplatin
C. 6-MP
D.Bleomycin 
E. Etoposide 

RFA

Answer 1

Ans. C. 6MP- the boy’s symptoms should make you think of lesch neich syndrome, which is a HGPRT deficiency syndrome. HGPRT is how 6-MP is activated so without it the drug could not be transformed to thio-IMP and block formation AMP and GMP from IMP.

A. Troptochen- is a Topoisomerases I inhibitor

B. Carboplatin-covalently bonds to DNA and inhibits DNA synth.

D. Bleomycin- is an antitumor antibiotic and causes damages to DNA by oxidative damage and arrest cell in G2 phase, also has unique side effect of Pulmonary Fibrosis

E. Etoposide- is a Topoisomerase II inhibitor

Question 2

A 67 year old women is given an anthracycline to help treat her stage I osteosarcoma. What drug should the doctor compliment this treatment with to reduce the risk of cardiotoxity

A. Dexamethasone 
B. Leucovorin 
C. Dexrazoxane 
D. Allopurinol 
E. Mesna

RFA

Answer 2

Ans. C Dexrazoxane is given to patient on an anthracycline such as :Doxorubicin or Daunorubicin. Specifically to reduce cardiotoxicity .

A. Dexamethasone- is given to patients on Taxanes: Paclitaxel & Docetaxel to reduce peripheral neuropathy

B. Leucovorin- is given to patient on Methotrexate or 5-FU to potentiate and reduce side effect

D. Allopurinol- is given to patients on 6-MP to reduce purine build up

E. Mesna- is give to patient on Cyclophosphamide to reduce risk of hemorrhagic cystic.