416 Targeted Cancer Therapies Flashcards
Toxicities of traditional chemotherapy
Bone marrow suppression N/V Peripheral neuropathy Diarrhea Stomatitis Alopecia Nephrotoxicity Fatigue
Toxicities of targeted therapy
Hand foot syndrome Skin rash Edema Hypothyroidism Nausea Diarrhea QT prolongation Skin discoloration
MOA of tyrosine kinase inhibitors
Tyrosine kinase phosphorylates tyrosine
TK receptors bind with other substances to trigger a series of reactions
-block TK receptors to stop cascade
Tyrosine kinase inhibitors
EGFR HER2/Neu c-KIT Bcr-abl Platelet derived growth factor
Bcr-abl TK inhibitors*
Imatinib (Gleevec)* Dasatinib Nilotinib Bosutinib Ponatinib
EGFR TK inhibitors*
Erlotinib (Tarceva)
Geritinib
Afatanib
Osimertinib
Common SE of EGFR TKIs
Rash***
Diarrhea
Elevated LFTs
ALK inhibitors
Cirzotinib
Ceritinib
Alectinib
MOA and indication for ALK’s
MOA: EML4-ALK fusion
Indication: ALK + NSCLC
HER2/Neu inhibitor*
Lapatinib (Tykerb)*
Lapatinib toxicities
Hand foot syndrome GI toxicity Interstitial lung disease LVEF decreases QT prolongation CYP3A4
BRAF inhibitors
Vemurafenib
Trametinib
Dabrafenib
Cobimetinib
Indication for BRAF inhibitors
Malignant melanoma (V600E mutation of BRAF gene)
Bruton’s TKIs
Ibrutinib
Toxicities of Ibrutinib
Bleeding Neutropenia Increase SCr Transient increase in lymphocytes*** Reduce dose if given with CYP3A4 inhibitor
Phosphinositide 3-kinase inhibitor
Idealisib
Toxicities of Idelalisib
Hepatotoxicity Diarrhea Colitis Intestinal perforation Pneumonitis
Multi-kinase inhibitors for renal cell carcinomas
Sunitinib malate (VEGF, platelet derived GF) Sorafenib (VEGF, platelet derived GF) Pazopanib (VEGF, PDGFR, c-KIT) Axitinib (VEGF, PDGFR, c-KIT) Regorafenib (VEGF, PDGFR, c-KIT, BRAF)
Toxicities of Regorafenib
Hand foot skin reaction
Hypertension
Hepatotoxicity (BBW)
Pain and muscle stiffness
Cyclin-dependent kinases (CDK4 and CDK6 inhibitors)
Palbociclib
Ribociclib
Nomenclature for monoclonal antibodies:
- o
- xi
- zu
- u
- o = mouse (100% mouse)
- xi = chimeric (34% mouse)
- zu = humanized (10% mouse)
- u = human (100% human)
Toxicities of monoclonal antibodies
Acute allergic reaction
-NEED code cart available
CD20 targeted antibody agents*
Rituximab (Rituxin)*
Ofatumuab
Obinutuzumab
Toxicities of Rituximab
Infusion related reaction
TLS*
Reactivation of Hep B*
CMV
Toxicities of Ofatumumab
Severe infusion reactions Prolonged thrombocytopenia and neutropenia Reactivation of Hep B Intestinal obstruction Severe infection
Toxicities of Obinutuzumab
PML Reactivation of Hep B Prolonged neutropenia Infusion reaction TLS
Anti-VEGF monoclonal antibody agents*
Bevacizumab (Avastin)*
Ramucirumab
Toxicities of Bevacizumab
GI perforation Delayed wound healing*** Thrombotic events HTN Bleeding*** Proteinuria
Toxicities of Ramucirumab
HTN (monotherapy)
Neutropenia (combo)
BBW: hemorrhage
CD52 targeted antibody agents
Alemtuzumab
Toxicities of Alemtuzumab
PROLONGED immunosuppression***
Infusion related reactions
EGFR targeted monoclonal antibody agents
Cetuximab
Panitumumab
Necitumumab
Toxicities of Cetuximab and Panitumumab
Colon cancer (wild type KRAS)
Skin rash***
Infusion related reactions
Toxicities of Necitumumab
BBW: cardiopulmonary arrest
Hypomagnesemia
Dermatitis skin rash
Anti-HER2/Neu monoclonal antibodies*
Trastuzumab (Herceptin)*
Pertuxumab
Ado-trastuzumab emtansine
Toxicities of Trastuzumab
DLT is cardiovascular***
Infusion reaction
Rash
Myelosuppression
Toxicities of Pertuzumab
Left ventricular dysfunction Infusion reaction Rash Myelosuppression Pregnancy
PD-1 checkpoint inhibitors*
Ipilimumab
Nivolumab (Opdivo)*
Pembrolizumab (Keytruda)*
Atezolizumab
Toxicities of PD-1 inhibitors
Autoimmune mediated SE: Interstitial lung disease/pneumonitis Colitis Hepatitis Nephritis Endocrinopathies
BiTE agent
Blinatumomab
