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DRUGS > Cancer 1st Line Tx > Flashcards

Cancer 1st Line Tx Flashcards

1
Q

Breast:
- ER/PR(+)
- HER2(-)

A

RS <26: EndoTx
- PreMeno: Tx5yr +/- OS or AIx5yr + OS (Still PreMeno: Tx5yr or stop // Now PostMeno: AI or T x5yr)
- PostMeno: AIx5yr then AIx5yr OR Tx2-3yr then AIx5yr

RS >26: ChemoTx then EndoTx
- Dose Dense AC then Paclitaxel or TC (Docetaxel + Cytoxin)

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2
Q

Breast:
- ER/PR(+)
- HER2(+)

A

Tumor <0.5cm: adju EndoTx (PreMeno: Tx5yr +/- OS or AIx5yr + OS (Still PreMeno: Tx5yr or stop // Now PostMeno: AI or T x5yr)
- PostMeno: AIx5yr then AIx5yr OR Tx2-3yr then AIx5yr) +/- Chemo +HER2Tx (APT (adju Paclitaxel +Trastuzumab) or TCH+/- P (Docetaxel + Carbo + Trastu +/- Pertuzumab)

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3
Q

Breast:
- TNBC

A

Pembrolizumab + Paclitaxel + Carbo then Prembro + Doxorubucin + Cytoxin

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4
Q

Breast:
- Meta-HER2(+)

A

1st: Trastuzumab + Pertuz + Docetaxel
2nd: Trastu-Deruxtecan

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5
Q

Breast:
- Meta-HER2(-)

A

1st: AI + CDK4/6-i (Palbociclib)
2nd: Fulvestrant + CDK4/6-i

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6
Q

Prostate:
- Localized

A

ADT (GNRH agonist) +/- Anti-androgen Tx (Abiraterone or Enzalutamide)

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7
Q

Prostate:
- M0HSPC

A

GNHR agonist +/- ADT

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8
Q

Prostate:
- M0CRPC

A

Continue ADT and add ONE of: Enzalutamide, Apalutamide, Darolutamide

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9
Q

Prostate:
- M1HSPC

A
  • LOW Volume: ADT or ADT + Abiraterone and Prednisone, Enzalutamide, or Apalutamide
  • HIGH Volume: Docetaxel + ADT +/- Abiraterone or Daralutamide
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10
Q

Prostate:
- M1CRPC

A

1st: Docetaxel + Prednisone
2nd: Cabazitaxel + Prednisone
- IF PSMA(+) use: Pluvicto

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11
Q

Lung:
- SCLC

A
  • Limited: Radiation + EP or EC (Etop, cisP/Carbo)
  • Extensive: EC + Atezolizumab or Durvalumab
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12
Q

Lung:
- NSCLC (Resectable)

A
  • Non-Squamous: Cisplatin + Pemetrexed (or Carbo)
  • Squamous: Cisplatin + Gemcitabine or Docetaxel (or Carbo)
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13
Q

Lung:
- NSCLC (UnResectable)

A
  • Non-Squamous: Carbo/Cis + Pemetrexed OR Cis + Etop
  • Squamous: Paclitaxel + Carbo OR Cis + Etop
    (If any Tx not working: Durvalumab x1yr)
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14
Q

Lung: NSCLC
- Metastatic (Mutations Present)

A

Osimertinib (EGFR), Dabraf/Tramet (BRAF), Sotoasib (K-RAS)

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15
Q

Lung: NSCLC
- Metastatic (NO mutations)

A
  • Non-squamous: Carbo + Pemetrexed + Pembrolizumab
  • Squamous: Carbo + Prembrolizumab + Paclitaxel
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16
Q

Colorectal:
- Stage II (high risk)

A

FOLFOX or CapeOX

17
Q

Colorectal:
- Stage III

A

FOLFOX or CapeOX

18
Q

Colorectal:
- Metastatic

A

FOLFOX, CapeOX, FOLFIRI, FOLFIRINOX +/- Bevacizumab
- No K-RAS mut: + cetuximab or panitumumab
- dMMR or MSI-H (+): Nivolumab + Ipilimumab or Pembrolizumab
- HER2(+): Tastu +Pertu/Lapatinib or Trastu-Deruxtecan

19
Q

Melanoma:
- Stage 1B or 2A

A

Clinical trial, observation

20
Q

Melanoma:
- Stage 2B or 2C

A
  • Clinical trial, observation, or Pembrolizumab
21
Q

Melanoma:
- Stage III

A

Nivolumab, Prembrolizumab, or Dabraf/Tramet (if BRAF mut)

22
Q

Melanoma:
- Metastatic

A
  • Anti-PD1 MonoTx or BRAF mut Tx
  • if high risk: Nivoumab/ipilimumab
    -2nd Line: Pembro/Low dose Ipilimumab
23
Q

Ovarian:
- Initial

A

Paclitaxel + Carbo (Carbo dose= AUCx(GFR + 25)
- if BRCA mut: PARP-i

24
Q

Ovarian:
- Metastatic

A
  • Plat Sensitive: Carb/Cis + Paclitaxel
  • Plat Resistant: Liposomal Doxorubucin
25
Q

Hodgkin Lymphoma:
- Stage I-II Favorable

A
  • ABVD (Doxorubicin, Bleomycin, Vinblastine, Dacarbazine)
  • Radiation
26
Q

Hodgkin Lymphoma:
- Stage I-II Unfavorable

A
  • ABVD (Doxorubicin, Bleomycin, Vinblastine, Dacarbazine)
  • Radiation
27
Q

Hodgkin Lymphoma:
- Stage III-IV

A
  • ABVD (Doxorubicin, Bleomycin, Vinblastine, Dacarbazine) +/- Radiation
  • If young pt: AAVD (Swap Bleo for Brentuximab Vendotin) (more toxic)
28
Q

Hodgkin Lymphoma:
- Relapse

A
  • Autologous stem cell rescue
29
Q

Non-Hodgkin Lymphoma:
- Diffuse Large B-Cell Lymphoma (DLBCL) All stages

A

R-CHOP (Rituximab, Cytoxin, Doxorubicin, Vincristine, Prednisone)

30
Q

Non-Hodgkin Lymphoma:
- DLBCL Stage III/IV + IPI >2 or Bulky Stage II

A

Pola-R-CHP (Polatuzumab Vedotin, Rituximab, Cytoxin, Doxorubicin, Prednisdone)

31
Q

Non-Hodgkin Lymphoma:
- Relapsed DLBCL/Aggressive NHL

A
  • Salvage chemo then autologous stem cell rescue
  • CAR-T
  • Epcoritamab or Glofitamab (BiTE’s)
32
Q

Multiple Myeloma

A

Autologous stem cell transplant candidate?
- Yes: 3 drug regimen, then stem cell harvest
- No: 3 drug regimen

33
Q

Chronic Myeloid Leukemia (CML)

A

BCR-ABL-i: Dasatinib, Nilotinib, Bosutinib, or Imatinib
- if T3151 mut: Ponatinib or Ascimib

34
Q

Chronic Lymphoid Leukemia (CLL)
- Stage III/IV

A
  • Zanubrutinib or Acalabrutinib (ATK-i) +/- Obinutuzumab (or Rituximab)
  • Venetoclax + Obinutuzumab
35
Q

Acute Myeloid Leukemia (AML)
- Induction

A
  • High intensity: Cytarabine (7d) + Anthracycline (3d) (7+3)
  • Low Intensity: Venetoclax + Azacitidine or Decitabine
  • if FLT3 mut: Midostaurin, quizartinib, or gilteritinib
36
Q

Acute Myeloid Leukemia (AML)
- Consolidation

A
  • HiDAC (High dose Cytarabine)
  • or Continue Venetoclax +Aza/Decitibine
37
Q

Acute Lymphoblastic Leukemia (ALL)
- Induction

A
  • HyperCVAD (PART A: Hyper-fractionated Cytoxin, Vincristine, Doxorubicin, Dexamethasone –> PART B: High dose Methotrexate, Cytarabine, Methylprednisolone)
  • If BCR-ABL(+): add TKI
  • Peds: +/- Pegaspargase
38
Q

Acute Lymphoblastic Leukemia (ALL)
- Maintenance

A
  • BCR-ABL (+): TKI, Vincristine, Prednisone
  • BCR-ABL (-): Methotrexate, 6=MP, Vincristine
39
Q

Lymphoma: Non-Hodgkin L
- maintenance for high risk after stem cell transplant

A

Brentuximab vedotin

DRUGS (17 decks)

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