274 - Chemotherapy Basics Flashcards
Which of the following have the long-term potential side effect of cardiotoxicity? Select all that apply
- Carboplatin
- Trastuzumab
- Etoposide
- Doxorubicin
- Vincristine
B - Trastuzumab
D - Doxorubicin
Trastuzumab: antibody against the HER2 tyrosine kinase receptor; used in the treatment of HER2-positive breast and gastric cancer
Doxorubicin (an anthracycline): multiple MOA, including inhibition of topoisomerase II, inhibition of DNA and RNA synthesis by intercalation with DNA, DNA strand excision, and generation of free radicals
Anthracyclines are associated with cardiomyopathy
The large trial is started on IV ferrous derpunmaltose (Punoferric), a new FDA approved treatment for irony deficiency. There has been a concern for numusemia from Punoferric. The trial involved prospective 6 months follow up of ferrous derpunmaltose (Punoferric) and a comparator arm of ferric carboxypuntose (Punjectafer) to evaluate primary safety and efficacy outcomes. A total of 500 patients in each arm are expected to be occurred. What phase best describes this trial?
- Preclinical
- Phase 1
- Phase 2
- Phase 3
- Phase 4
E. Phase 4
After FDA approval, phase 4 trials are to study long-term effects
Which of the following targeted therapies is used in the treatment of Philadephia Chr. + ALL or CML?
- Pembrolizumab (Keytruda)
- Gemtuzumab ozogamicin (Mylotarg)
- Imatinib (Gleevec)
- Liposomal daunorubicin and cytarabine (Vyxeos)
- Gefitinib (Iressa)
C. Imatinib (Gleevec)
inhibits the tyrosine kinase that results from the abnormal BCR-ABL gene.
Which of the following are Vinca alkaloids? Select all that apply
- Vincristine
- Paclitaxel
- Eribulin
- Vinorelbine
- Vinblastine
A. Vincristine
D. Vinorelbine
E. Vinblastine
What is the mechanism of action of 5-fluorouracil?
Pyrimidine analog
- Normally, thymidylate synthase converts dUMP -> dTMP in DNA synthesis
- 5-FU causes thymidylate synthase to incorporate FdUMP, a metabolite of 5-FU into cells, resulting in cell death
Which of the following have the short-term potential side effect of myelosuppression? Select all that apply
- Carboplatin
- Trastuzumab
- Etoposide
- Doxorubicin
- Vincristine
A - Carboplatin
C - Etoposide
D - Doxorubicin
E - Vincristine
Which of the following statements best describes the modern state of oncology pharmaceuticals?
- Thanks to targeted therapy, we have now eliminated off target side effects, offering low side effect options for all cancer states.
- Thanks to modern advancements, oncology care is moving to completely pill based outpatient care setting for all cancer types.
- Thanks to multidisciplinary efforts and recent revolutions in targeted therapy, such as pembrolizumab, we are seeing declining national death rates in cancer patients.
- Despite modern advancements, “old-fashioned” chemotherapy remains the preferred category treatment for all cancer types.
C
Thanks to multidisciplinary efforts and recent revolutions in targeted therapy, such as pembrolizumab, we are seeing declining national death rates in cancer patients.
What is the goal of phase 1 clinical trials?
Define drug toxicity - what dose will you bring into phase 2?
If a patient were to have neutropenia from chemotherapy treatment, when would the nadir of his ANC typically occur?
- ~2 days after treatment
- 7-14 days after treatment
- 21-28 days after treatment
- 3 months after treatment
B. 7-14 days after treatment
Felt like SAS was super nit-picky about “7 days vs. 7-10 days” - Please suggest an edit if you can shed some light :)
What is the difference between “dose intense” and “dose dense” dosing?
Dose intense: increase the dose, same frequency
Dose dense: same dose, increase the frequency (less time inbtwn doses)
Which of the following medications is most likely to cause numbness/tingling in a patient’s hands?
A. 5-FU push
B. 5-FU continuous infusion pump
C. Leucovorin
D. Oxaliplatin
E. Palonosetron
F. Dexamethasone
G. Fosaprepitant
D. Oxaliplatin
Cisplatins are known to cause peripheral neuropathy
Which of the following drugs are cell cycle specific for M phase? Select all that apply
- Vincristine
- Fluorouracil
- Busulfan
- Etoposide
- Cytarabine
- Paclitaxel
A. Vincristine
F. Paclitaxel
Vinca alkyloids and taxanes are M-phase specific
- Both mess with microtubules
- Vincristine prevents microtubule polymerization
- Paclitaxel prevents de-polymerization of microtubules
How long after surgery (ex: port placement) should you wait to give bevacizumab (Avisatatin)?
Why?
7 days
Bevacizumab is a VEGF inhibitor that causes delayed wound healing; Don’t want to mess with wound healing within 1 week after surgery
How does leucovorin affect the toxicity of:
- 5-fluorouracil:
- Methotrexate:
- 5-fluorouracil: Leucovorin increases toxicity
- Results in increased buildup of toxic metabolite
- Methotrexate: leucovorin decreases toxicity
- Reverses action of MTX, thus reducing toxicity
Leucovorin (folinic acid analong) speeds up thymidylate synthase (converts dUMP to dTMP in pyrimidine synthesis)
What is the goal of Phase 2 clinical trials?
to provide the general response rates at the maximum dose
