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Cancer Flashcards

1
Q

What are the charcteristics of cancer cells?

A
  1. Uncontrolled cellular growth
  2. Ability to invade adjacent structures and/or travel to distant areas
  3. Incapable of physiological functions of the mature tissue of origin
  4. Altered protein, enzymes systems, membrane characteristics and cytogenetics
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2
Q

TMN staging

A
  • TMN staging for solid tumors
    • Tumor
    • Nodal status
    • Metastasis
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3
Q

What does adjuvant chemotherapy mean? neoadjuvant chemotherapy?

A

adjuvant chemotherapy- giving chemo after surgery to reduce the risk of local and systemic recurrence

neoadjuvant chemotherapy- giving chemo prior to surgical intervention to reduce tumor size and to remove micrometastases

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4
Q

Cytotoxic chemotherapy

A

Toxic to all cells but specifically to those that are rapidly dividing cells

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5
Q

Wht does doubling time mean? Gompertizian growth? Log-kill hypothesis?

A
  • Doubling time- time it takes for tumor cell production to double in size
  • Gompertizian growth- early growth is exponential, but as tumor gets bigger, growth slows due to decreased nutrients/ blood supply
  • Log-kill hypothesis- a given dose of chemotherapy kills the same fraction of tumor cells regardless of the size of the tumor at the time of treatment
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6
Q

Cytotoxic dosing? Dose intensity vs dose density?

A

Dosing- weight based dose, actual weight

Dose density- want to give same amount of chemo at scheduled time

Dose intensity- compress dosing time as short as possible (more chemo in short period of time)

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7
Q

MOA of alklating agents? class side effects?

A

MOA- prevents cell division by cross-linking DNA strands

Myelosupression is dose limiting toxicity

ADR- nausea/ vomitting, myelosupression, alopecia, sterility/ infertility, secondary malignancies

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8
Q

Cyclophosphamide/ Ifosfamide

A

Alklating agent

Hemorrhagic cystitis (bladder bleeding) due to acrolein metabolite

Give ifosfamide with Mesna (binds acrolein and excreted through the urine)

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9
Q

Cisplatin

A

Alkylating Agents

Causes- nephrotoxicity, nausea/vomitting, ototxicity

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10
Q

Oxaliplatin

A

Alkylating Agent

Neuropathies (exacerbated by cold temp)

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11
Q

MOA of antimetabolite? class side effects?

A

MOA- compete with normal metabolite or falsely insert themselves for a metabolite normally incororated into DNA and RNA. Nucleotide synthesis. Works on S phase

ADR- myelosuppression, mucosities, mild N/V/D

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12
Q

Methotrexate (MTX)

A

Antimetabolite

Renal toxicity (do not give with Cisplatin)

Leucovorin rescue for high doses

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13
Q

Cytarabine

A

Antimetabolite

Cerebellar toxicity

Ocular irratation- use eye drops

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14
Q

Cepecitabine

A

Antimetabolite

Hand foot syndrome

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15
Q

MOA of antitumor antiboitics? anthracyclines? Bleomycin? Class ADR?

A

anthracyclines- block DNA and RNA transcription

Bleomycin- inhibits DNA synthesis (only cell cycle specific agent)

ADR- N/V, alopecia, stomatitis, myelsupression

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16
Q

Bleomycin

A

Antitumor antiboitc- lung toxicity, pulmonary fibrosis, interstitial pneumonities

17
Q

Anthracyclines

A

Doxarubicin- cardiotoxic-CHF

Life time max dose

Dexrazoxane- used to reduce cardiotoxicity with anthracylibes

18
Q

Taxanes and vinca alkaloids MOA?

A

Taxanes- prevent microtubule disassembly

vinca alkaloids- prevent microtubule formation

Both workin M phase

19
Q

Docetaxel and Pactitaxel

A
  • Docetaxel- neuropathies, peripheral edema, hypersensitive reactions (due to solubilizing agents)
  • Pactitaxel- neuropathies, hypersensitive reactions (due to solubilizing agents)
    • premedicate with H1 and H2 blockers plus steroids
20
Q

Vincristin

A

Vinca alkaloid,

neuropathy, constipation DO NOT GIVE INTRATHECALLY (DEADLY)

21
Q

Irinotecan

A

Prevent DNA repair in cancer cells

Topoisomerase 1 inhibitor- diarrhea (cholinergic reaction)

Treat with atropine loperamide

22
Q

Etoposide

A

Prevent DNA repair in cancer cells

Topoisomerase II inhibitor- secondary cancer

23
Q

Asparaginase

A

Prevent DNA repair in cancer cells

Enzyme- natural product

Hypersensitivity reactions, hyperglycemia, pancreatitis, coagulopathy

24
Q

Marine based products- Eribulin and Trabectedin

A
  • Eribulin-
    • sea sponge
    • microtubule like agent
    • toxicities- fatigue peripheral neuropathies, N/V
  • Trabectedin
    • Sea squirt
    • alkylating agent
    • toxicities- fatigue, hand-foot mouth syndrome, N/V, hepatic damage
25
Q

Tamoxifen

A

SERM

Pre/ Post menopausal women

ADR- contracts, endometrial cancer, VTE, *CYP269 active metabolitle* INTERACTION WITH SSRI

26
Q

Letrozole, anatrozole, exemestane

A

Aromatase inhibitors- inhibits the conversion of androgens to estrogens

Postmenopasual women (preferred)

ADR- osteoporosis, factures, arthralgias

27
Q

Raloxifene

A

NOT USED FOR THE TREATMENT OF BREAST CANCER

only for primary prevenetion

28
Q

Leuprolide, goserelin, triptorelin

A

LHRH agonist- inhibit the pituitary (through negative feedback) from relasing LH and FSH which stops stimulation of the testes to produce testoserone (can also be used in breast cancer with same MOA but stops stimuation of ovaries to produce estrogen)

Initially there is a tumor flare before negative feedback loop works

29
Q

Degarelix

A

LHRH antagonist- directly inhibits pituatary from realeasing LH and FSH

30
Q

Bicalutamide, flutamide, nilutamide, enzalutamide, apalutamide, abiraterone

A

Anti- androgen- blocks androgen recepotors only

Only for prostate cancer

31
Q

MOA of targeted therapy? Monoclonal antibodies and molecularly targeted therapy? Class ADR?

A

MOA- prevent tumor cells from entering cell cycle or target signals that trigger cancer growth, metastasis and immortaility

Monoclonal antibodies- antibodies that match an antigen on the cencer cell surface molecularly targeted therapy- block signaling inside the cell

ADR- fatigie, hair thining, N/V, myelosupression, hair dipigmentation, dysphonia, hypothyroidism

QT prolongation- nitotinib, pazopanib, ponatinib

32
Q

VEGF(R) inhibitor- bevacizumab, sunitinab, pazapanib, regorafenib

A

Inhibit formation of new blood vessles

ADR- hypertension, proteinuria, bleeding, impaired wound healing

33
Q

EGFR inhibitors- erlotinib, gefitinib, alectinib, cetuximab, panitumumab

A

Acneiform rash

Rash indicates the treatment is working

Treatment- tetracyclines, topical antiboitics

34
Q

mTOR inhibitors- everolimus, sirolimus, temsirolimus

A

ADR- hyperglycemia, dyslipidemia, mucosal sensitivity, Ulcers

DDI- 3A4 inhibitor

Treat ulcers with- dexamethasone s/s

35
Q

BCR-ABL mutation

A

Periorbital edema

CYP 3A4 substates

36
Q

CD20- rituximab, ofatumumab, obinutuzumab

A

Targeted B cell therapy for lymphoma, and leukemia

Infusion reactions, myelosupression

37
Q

HER2 inhibition- Trastuzmab, pertuzumab

A

cardiotoxicity

do not give same time as anthyrcyclines

38
Q

HER2 inhbition- lapatinib

A

ADR- Fatigue, diarrhea, hand-foot syndrome, drug interactions with strong 3A4 inducers/ inhibitors

Pharm (9 decks)

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