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Hematology/Immunology Part 2 > Cancer Chemotherapy > Flashcards

Cancer Chemotherapy Flashcards

1
Q

What are the primary types of cancer discussed?

A

Solid tumors and hematologic malignancies.

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2
Q

How do normal cells transform into cancer cells?

A

Through malignant transformation involving proto-oncogenes converting to oncogenes and inactivation of tumor suppressor genes.

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3
Q

What are the main methods of cancer treatment?

A

Surgery, radiation, and pharmacologic therapy.

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4
Q

What are the phases of cancer treatment?

A

Induction, consolidation, and maintenance.

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5
Q

What is the significance of the therapeutic index in cancer chemotherapy?

A

It is narrow, indicating a small margin between effective and toxic doses.

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6
Q

How are cancer drugs categorized based on their mechanism of action?

A

Cell-cycle specific and cell-cycle nonspecific.

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7
Q

What is the strategy behind combination cancer chemotherapy?

A

Using agents with differing mechanisms of action, minimal drug-drug interactions, and varying organ toxicities.

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8
Q

What are some limitations of cancer chemotherapy?

A

Drug resistance, drug toxicity, and expression of anti-apoptotic proteins.

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9
Q

What are vesicants in the context of cancer chemotherapy?

A

Drugs that can cause skin blistering or local tissue damage if extravasated.

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10
Q

What are the main categories of cancer chemotherapeutics mentioned?

A

DNA synthesis inhibitors, DNA topoisomerase inhibitors, enzyme and proteasome inhibitors, mitotic inhibitors, DNA alkylating and intercalating drugs

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11
Q

What are common side effects of cancer chemotherapy?

A

Myelosuppression, nausea and vomiting, thrombocytopenia, leukopenia, alopecia, and organ toxicities.

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12
Q

What are the common toxicities associated with cancer chemotherapy?

A

Myelosuppression, nausea and vomiting, thrombocytopenia, leukopenia, alopecia, organ toxicities.

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13
Q

Which drugs are classified as DNA synthesis inhibitors?

A

Fluorouracil, capecitabine, cytarabine, mercaptopurine, methotrexate, pemetrexed

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14
Q

What is the mechanism of action for vinca alkaloids?

A

IV administration, no CNS penetration, cell cycle specific to M phase

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15
Q

What is the mechanism of action for fluorouracil (5-FU)?

A

Inhibits thymidylate synthetase, preventing thymidine and DNA synthesis.

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16
Q

What are the common adverse effects of taxanes?

A

Myelosuppression, alopecia, hypersensitivity reactions, fluid-retention syndrome

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17
Q

What are the indications for capecitabine (Xeloda)?

A

Breast cancer, gastric cancer (off-label), colorectal cancer.

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18
Q

How is cytarabine (Cytosar-U) administered?

A

Oral, IV, or intrathecal administration.

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19
Q

Which cancers are treated with nitrogen mustards?

A

Acute and chronic lymphocytic leukemia, non-Hodgkin lymphoma, breast cancer, ovarian cancer, neuroblastoma

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20
Q

What is a major adverse effect of mercaptopurine (Purinethol)?

A

Myelosuppression.

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21
Q

What is a dose-limiting adverse effect of cyclophosphamide?

A

Myelosuppression, hemorrhagic cystitis, cardiotoxicity, neurotoxicity, nephrotoxicity

22
Q

What is the mechanism of action of temozolomide?

A

It adds a methyl group to guanine residues, causing DNA damage and tumor cell death.

23
Q

What is the role of leucovorin in methotrexate therapy?

A

Rescue therapy to mitigate toxicity, given 24 hours after methotrexate.

24
Q

What are the primary indications for carmustine?

A

Brain tumors, Hodgkin lymphoma, and non-Hodgkin lymphoma.

25
Q

What type of cancer is pemetrexed (Alimta) primarily used to treat?

A

Metastatic non-small cell lung cancer.

26
Q

What is the primary indication for busulfan?

A

Chronic myeloid leukemia

27
Q

What is a significant adverse effect of anthracyclines?

A

Cardiotoxicity.

28
Q

What are the adverse effects of platinum-based drugs?

A

Nausea/vomiting, mild myelosuppression, nephrotoxicity, ototoxicity, cochleotoxicity, vestibulotoxicity

29
Q

What is the role of dexrazoxane in chemotherapy?

A

It chelates ferric iron to prevent free radical formation.

30
Q

What is the common mechanism of action for DNA synthesis inhibitors?

A

They are cell cycle specific, targeting the S phase to inhibit DNA synthesis.

31
Q

What is the mechanism of action for temozolomide?

A

Alkylating agent that adds a methyl group to guanine residues, causing DNA damage and tumor cell death

32
Q

What is the treatment for overdose/toxicity of fluorouracil and capecitabine?

A

Uridine triacetate (Vistogard).

33
Q

Which cancers are treated with topoisomerase I inhibitors like irinotecan and topotecan?

A

Colon cancer, solid tumors, and lymphomas.

34
Q

What are the adverse effects of high doses of fluorouracil (5-FU)?

A

Organ toxicities and hand-foot syndrome.

35
Q

Which cancers are treated with platinum-based drugs?

A

Testicular cancer, ovarian cancer, cervical cancer, bladder cancer, lung cancer

36
Q

What is the primary mechanism of action for BCR-ABL inhibitors?

A

Inhibition of BCR-ABL tyrosine kinase, leading to decreased tumor cell proliferation and apoptosis.

37
Q

What are common adverse effects of BCR-ABL inhibitors?

A

Nausea, vomiting, diarrhea, edema, and myalgia.

38
Q

What is the primary indication for BCR-ABL inhibitors?

A

Chronic myeloid leukemia

39
Q

What are common adverse effects of BCR-ABL inhibitors?

A

Nausea, vomiting, diarrhea, edema, myalgia

40
Q

What is the primary indication for imatinib?

A

Chronic myeloid leukemia.

41
Q

Which mutations are associated with gastrointestinal stromal tumors?

A

c-kit mutations

42
Q

What is the mechanism of action for erlotinib?

A

Inhibition of epidermal growth factor receptor (EGFR) tyrosine kinase

43
Q

What is a notable adverse effect of topoisomerase II inhibitors like etoposide?

A

Myelosuppression.

44
Q

What is the pharmacokinetic property of carmustine that aids in its effectiveness?

A

It is highly lipophilic.

45
Q

What is a key requirement for erlotinib’s effectiveness?

A

EGFR gene mutation

46
Q

What is the primary indication for bortezomib?

A

Multiple myeloma

47
Q

What is a major caution for all anti-neoplastic agents?

A

Interference with fetal development

48
Q

Which drugs are commonly used to treat acute lymphocytic leukemia?

A

Vincristine, cyclophosphamide, doxorubicin, mercaptopurine

49
Q

What is the treatment for chronic myeloid leukemia?

A

Imatinib, dasatinib, busulfan

50
Q

Which drugs are frequently used for breast cancer treatment?

A

Doxorubicin, lapatinib, cyclophosphamide, methotrexate, paclitaxel, fluorouracil, capecitabine

51
Q

What is the mechanism of action for sunitinib?

A

Blocks angiogenesis

52
Q

What are common adverse effects of sunitinib?

A

Skin rash, fatigue, nausea, hypertension

Hematology/Immunology Part 2 (9 decks)

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