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Heme - Pharm > antineoplastics > Flashcards

antineoplastics Flashcards

1
Q

what are the 3 dosing regimens

A

induction, consolidation, and maintenace

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2
Q

describe induction therapy

A

high does combination therapy

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3
Q

describe consolidation therapy

A

repetition induction during remission

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4
Q

describe maintenance therapy

A

long term, low dose therapy during remission

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5
Q

define neo-adjuvant

A

before or during surgery/radiotherapy

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6
Q

define adjuvant

A

after surgery/rediotherapy

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7
Q

what are the advantages of combination therapy

A

increases maximum cell kill, kills heterogeneous cell populations, decreased tumor resistance

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8
Q

define metronomic dosing

A

the use of lower doses more frequently (ie everyday)

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9
Q

define hormesis

A

the concept that drugs have different effects at different concentrations. therefore a drug that kills cells at high concentration may drive proliferation at low concentrations

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10
Q

how does metronomic dosing take advantage of hormesis

A

by dosing frequently, drug serum concentrations never dip low enough to become pro-proliferative

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11
Q

what are the two ways that tumors can become resistant to therapy

A

adaptive/evasive and intrinsic

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12
Q

define intrinsic resistance

A

when the tumor cells are not responsive to a particular therapy due to pre-existing factors. drugs are never effective

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13
Q

define adaptive/evasive resistance

A

when the tumor cells are initially responsive to therapy, but become resistant due to acquired traits

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14
Q

how does metronomic dosing effect the immune system

A

decreases the activity of TREG Cells and upregulates dendritic cells and effector cells

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15
Q

what drug is particularly immunologically active during metronomic dosing

A

cyclophosphamide

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16
Q

what are the drawbacks to metronomic dosing

A

some drugs have cumulative dose dependent limits (doxarubicin, ect) and can’t be sued for an extended period of time. also, extended therapy is not good in children

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17
Q

what is the typical dosing regimen for acute myeloid leukemia

A

daunorubicin and ARA-C with or without thioguanine

18
Q

describe the mechanism of action of Gentuzumab

A

it is a monoclonal antibody that carries a pharmacologic payload. the antibody is endocytosed and the payload kills the cell. was not approved by the FDA

19
Q

what is the first line drug for postremission AML

A

cytarabine

20
Q

what drives proliferation in acute promyelocitic leukemia

A

PML/RARA fusion gene

21
Q

what drugs are useful in APL

A

ATRA and arsenic tetroxide

22
Q

how does ATRA work

A

it drive differentiation and then apoptosis of APL cells

23
Q

what is the mechanism of action of arsenic tetroxide

A

degrade PML-RARA fusion protein

24
Q

what is the black box warning for arsenic tetroxide

A

CV toxicity

25
Q

what dosing regimen is used in children with PML

A

ARTA and an anthocycline with or without cytarabine

26
Q

what is the PML consolidation therapy

A

cytarabine with an anthracycline or ATRA with idarubicin

27
Q

what is the PML maintenance therapy

A

ATRA, 6-mercaptopurine, and MTX

28
Q

what is the typical induction therapy for Acute Lymphoblastic Leukemia

A

prednisone, vincristine, and an anthracycline. imatinib is added if the patient is Ph+

29
Q

what is the ALL consolidation therapy

A

MTX + 6MP

30
Q

what is imatinib

A

a BCR-ABL inhibitor

31
Q

when is imatinib useful

A

first line treatment in chronic phase CML

32
Q

what are the 2nd gen BCR-ABL inhibitors

A

dasatinib and nilotinib

33
Q

what is the typical Chronic Lymphoblastic Leukemia treatment scheme

A

fludarabine with either cyclophosphamide, rituximab, or both

34
Q

what drugs are available for Hairy Cell Luekemia

A

cladribine, Interferon Alpha 2b, and pentostatin

35
Q

how does interferon alpha suppress tumors

A

it slows the cell cycle and drives differentiation

36
Q

how is Hodgkin Lymphoma treated

A

drug cocktail plus low dose radiotherapy

37
Q

what is used for low stage Non-Hodgkin lymphoma

A

COMP

38
Q

what is used for high stage Hodgkin Lymphoma

A

R-CHOP

39
Q

what 2 anit-CD20 MABs operate by delivering a radiotherapy payload

A

tositumomab and ibritumomab

40
Q

what 3 possible regimens are used against Burkitt Lymphoma

A

Cyclophosphamide + MTX, Vincrinstine + daunorubicin, or cytarabine

Heme - Pharm (1 decks)

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