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Pharmacology 2 > Cancer > Flashcards

Cancer Flashcards

10 questions

1
Q

what drives the cancer progression?

A

oncogenes

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2
Q

what inhibits cancer progression?

A

tumor suppressors

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3
Q

what is cancer caused by?

A

DNA alterations

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4
Q

what is critical in the prevention of cancer?

A

DNA proofreading and repair

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5
Q

tumor suppressor proteins that are important for DNA repair; a mutation in these genes predisposes patients to cancer

A

BRCA 1 and 2

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6
Q

what is the most effective treatment for localized disease?

A

surgery

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7
Q

radiation that is done prior to surgery

A

neoadjuvant therapy

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8
Q

radiation that is done after surgery for residual disease

A

adjuvant therapy

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9
Q

what is chemotherapy dosing based on?

A

toxicities - the Maximal Tolerated Dose (MTD)

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10
Q

what helps to prevent cancer resistance to drugs?

A

combination therapy

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11
Q

what 2 kinds of cancer treatments are given orally?

A

hormonal-based therapy
kinase inhibitors

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12
Q

drugs that inhibit DNA synthesis

A

antimetabolites

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13
Q

drugs that inhibit mitosis

A

microtubule targeted agents

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14
Q

MOA of doxorubicin and adriamycin?

A

inserts into DNA to disrupt topoisomerase II-mediated replication

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15
Q

what 10 cancers is Doxorubicin/Adriamycin used in?

A

bladder
breast
leukemia
lung
lymphoma
myeloma
ovarian
sarcoma
stomach
thyroid

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16
Q

ADR of doxorubicin/adriamycin?

A

cardiotoxicity

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17
Q

in which patients should we not use doxorubicin/adriamycin?

A

patients with heart disease

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18
Q

liposomal formulated doxorubicin that has altered distribution; more goes to skin and less goes to heart - leading to skin rashes

A

doxil

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19
Q

-platin
and MOA?

A

platinum agents
crosslink DNA

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20
Q

in which 7 cancers are platinum agents used in?

A

brain
breast
bladder
cervical
head/neck
lung
testicular

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21
Q

which cancer is carboplatin used for?

A

ovarian

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22
Q

which cancer is oxaliplatin used for?

A

colorectal

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23
Q

2 ADR of cisplatin?

A

neurotoxicity
nephrotoxicity

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24
Q

ADR of carboplatin?

A

myelosuppression

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25
Q

ADR of all platinum agents?

A

hearing loss

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26
Q

antimetabolite that is a thymidine synthase inhibitor; prevents DNA synthesis

A

5-FU

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27
Q

what 6 cancers is 5-FU used for?

A

breast
basal cell carcinoma
colon
rectum
stomach
pancreas

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28
Q

3 ADR of 5-FU?

A

inflammation of mouth/skin
CNS damage
diarrhea

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29
Q

what is it called when one pathway is lost in cancer cells, and they become dependent on other pathways that normal cells are not dependent on?

A

synthetic lethality

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30
Q

collateral DNA damage as a result of cancer treatment can give rise to _____ _____

A

secondary cancers

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31
Q

what patients are at a high risk for secondary cancers over time?

A

pediatric patients

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32
Q

antimitotics against rapidly dividing tumors, hematological malignancies slow-growing tumors (prostate) and in non-dividing cells due to trafficking and signaling defects

A

microtubule targeted drugs

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33
Q

name the 3 microtubule destabilizers

A

“on the EVV on an exam, I’m destabilized”

eribulin
vinblastine
vincristine

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34
Q

what are the 6 uses for microtubule destabilizers?

A

lung cancer
leukemia
lymphoma
neuroblastoma
sarcoma
testicular

35
Q

name the 3 microtubule stabilizers

A

paclitaxel
docetaxel
ixabepilone

36
Q

what are the 8 uses for microtubule stabilizers?

A

breast
cervical
head/neck
lung
ovarian
pancreas
prostate
stomach

37
Q

what are the 4 ADR of microtubule targeting agents / antimitotic chemotherapies?

A

“M for marrow dysfunction, T for (neuro)toxicity/peripheral neuropathy, and A for abdominal disturbance/alopecia”

bone marrow dysfunction
GI disturbance
alopecia
peripheral neuropathy

38
Q

what is the defining marker of lymphoma?

A

CD30

39
Q

microtubule destabilizer that is combined with CD30, which is then separated when inside the cancer cell by cathepsin cleavage

A

MMAE

40
Q

what is the use for MMAE?

A

lymphoma

41
Q

2 ADR of MMAE?

A

peripheral neuropathy
neutropenia

42
Q

what is the most likely mechanism of drug resistance in cancer?

A

innate resistance

43
Q

what cancer cells lead to relapse/resistance? (3)

A

slow growing
can pump out drug
can evade immune system

44
Q

what are the 3 mechanisms of drug resistance in cancer?

A

specific (binding site change)
upregulation of complementary pathways (oncogene inhibited)
multidrug resistance (efflux pump)

45
Q

what is a strategy to avoid drug resistance in cancer?

A

combination chemotherapy

46
Q

luteinizing hormone releasing hormone agonist that upregulates the release of androgen, leading to feedback inhibition, eventually inhibiting the release of FSH and LH

A

leuprolide (lupron)

47
Q

luteinizing hormone antagonist that prevents LHRH from binding to receptors in the pituitary gland

A

degarelix (firmagon)

48
Q

what are the uses for LHRH agonists and LH antagonists?

A

androgen-depending prostate cancer

49
Q

8 ADR of LHRH agonists and LH antagonists?

A

associated with androgen deprivation

hot flashes
decreased bone density
loss of muscle mass
weight gain
insulin resistance
ED
low libido
cognitive impairments

50
Q

inhibitors of androgen receptor activity that directly bind and inhibit activity of testosterone receptors at multiple levels (2)

A

bicalutamide (cased)
enzalutamide (xtandi)

51
Q

-lutamide

A

inhibitors of androgen receptor activity

52
Q

what are the uses for inhibitors of androgen receptor activity? (2)

A

hormone-responsive prostate cancer
castration resistant prostate cancer

53
Q

prostate cancer that continues to grow despite low levels of androgen

A

castration resistant prostate cancer

54
Q

GnRh/LHRH agonists that stop the ovaries from making estrogen (2)

A

leuprolide (lupron)
goserelin (zoladex)

55
Q

what is the use for GnRH/LHRH agonists?

A

hormone-positive breast cancer in premenopausal women

56
Q

aromatase inhibitors that inhibit conversion of androgens into estrogens (3)

A

anastrozole (arimidex)
letrozole (femara)
exemestane (aromasin)

“Ana Let’s her Ex do whatever he wants” = postmenopausal

57
Q

what is the use for aromatase inhibitors?

A

hormone-positive breast cancer in postmenopausal women

58
Q

selective estrogen receptor modulator that is an antagonist in breasts and an agonist in uterus and bone

A

tamoxifen (novadex)

59
Q

what is the use for selective estrogen receptor modulators?

A

estrogen-positive breast cancer in premenopausal women

60
Q

estrogen receptor antagonist that is used for hormone-positive breast cancer in postmenopausal women

A

fulvestrant (faslodex)

61
Q

antibody that binds to HER2 receptors on tumor cells, preventing activation of HER2, blocking tumor growth and survival

A

Herceptin (trastuzumab)

62
Q

what is the use for trastuzumab?

A

HER2 positive breast cancer

63
Q

what is the most effective treatment option for triple negative breast cancer?

A

chemotherapy

64
Q

kinase inhibitor that inhibits ABL tyrosine kinase activity, used for CML

A

gleevec (imatinib)

65
Q

caused by a single chromosomal translocation event that generates a hybrid gene/fusion protein known as BCR-ABL

A

CML

66
Q

molecularly targeted kinase inhibitors can be effective in _____ _____ molecular settings when the main pathway driving the tumor can be _____

A

well defined
inhibited

67
Q

why aren’t kinase inhibitors a good long-term treatment for other cancers, besides CML?

A

resistance occurs by upregulating complementary pathways

68
Q

VEGF inhibitory antibody that inhibits the growth of vasculature in cancer

A

bevacizumab (avastin)

VAS for vasculature

69
Q

what are the 5 uses of VEGF inhibitory antibody?

A

cervical
colorectal
glioblastoma
ovarian
renal

70
Q

VEGF kinase inhibitors that inhibit the growth of vasculature in cancer (2)

A

sorafenib (nexavar)
sunitinib (sutent)

71
Q

what are the 3 uses of sorafenib?

A

hepatocellular (liver)
renal
thyroid

“sora like sorry = HRT (hurt)”

72
Q

what are the 3 uses of sunitinib?

A

GI
pancreas
renal

73
Q

8 ADR of chemotherapies that block angiogenesis?

A

hemorrhage
clots
GI perforation
hypertension
healing defects
fatigue
diarrhea
cardiac failure

74
Q

what anticancer drugs can promote long-term survival advantages in 30% of patients with high mutational burden?

A

checkpoint inhibitors

75
Q

work by inhibiting mechanisms that cancer cells use to evade detection by the immune system / “take the brake off the immune system”

A

checkpoint inhibitors

76
Q

name the 4 PD-1 inhibitors that block signaling of the T cell immune checkpoint (PD-1)

A

keytruda
opdivo
tecentriq
imfinzi

77
Q

which 2 checkpoint inhibitors can be used for melanoma and lung cancer?

A

keytruda
opdivo

78
Q

besides melanoma and lung cancer, what can keytruda be used for? (2)

A

head/neck
high mutational burden

79
Q

besides melanoma and lung cancer, what can opdivo be used for? (2)

A

renal
lymphoma

80
Q

2 uses for tecentriq and imfinzi?

A

urothelial (bladder)
lung

81
Q

CTLA-4 inhibitor - (CTLA-4 usually regulates antitumor immune response initiation)

A

yervoy

82
Q

what is the use for yervoy?

A

melanoma

83
Q

what are the ADR for checkpoint inhibitors (PD-1 inhibitors and CTLA-4 inhibitors)?

A

autoimmune effects months after treatment

Pharmacology 2 (22 decks)

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