Cancer Chemotherapy Flashcards
What are the primary types of cancer discussed?
Solid tumors and hematologic malignancies.
How do normal cells transform into cancer cells?
Through malignant transformation involving proto-oncogenes converting to oncogenes and inactivation of tumor suppressor genes.
What are the main methods of cancer treatment?
Surgery, radiation, and pharmacologic therapy.
What are the phases of cancer treatment?
Induction, consolidation, and maintenance.
What is the significance of the therapeutic index in cancer chemotherapy?
It is narrow, indicating a small margin between effective and toxic doses.
How are cancer drugs categorized based on their mechanism of action?
Cell-cycle specific and cell-cycle nonspecific.
What is the strategy behind combination cancer chemotherapy?
Using agents with differing mechanisms of action, minimal drug-drug interactions, and varying organ toxicities.
What are some limitations of cancer chemotherapy?
Drug resistance, drug toxicity, and expression of anti-apoptotic proteins.
What are vesicants in the context of cancer chemotherapy?
Drugs that can cause skin blistering or local tissue damage if extravasated.
What are the main categories of cancer chemotherapeutics mentioned?
DNA synthesis inhibitors, DNA topoisomerase inhibitors, enzyme and proteasome inhibitors, mitotic inhibitors, DNA alkylating and intercalating drugs
What are common side effects of cancer chemotherapy?
Myelosuppression, nausea and vomiting, thrombocytopenia, leukopenia, alopecia, and organ toxicities.
What are the common toxicities associated with cancer chemotherapy?
Myelosuppression, nausea and vomiting, thrombocytopenia, leukopenia, alopecia, organ toxicities.
Which drugs are classified as DNA synthesis inhibitors?
Fluorouracil, capecitabine, cytarabine, mercaptopurine, methotrexate, pemetrexed
What is the mechanism of action for vinca alkaloids?
IV administration, no CNS penetration, cell cycle specific to M phase
What is the mechanism of action for fluorouracil (5-FU)?
Inhibits thymidylate synthetase, preventing thymidine and DNA synthesis.
What are the common adverse effects of taxanes?
Myelosuppression, alopecia, hypersensitivity reactions, fluid-retention syndrome
What are the indications for capecitabine (Xeloda)?
Breast cancer, gastric cancer (off-label), colorectal cancer.
How is cytarabine (Cytosar-U) administered?
Oral, IV, or intrathecal administration.
Which cancers are treated with nitrogen mustards?
Acute and chronic lymphocytic leukemia, non-Hodgkin lymphoma, breast cancer, ovarian cancer, neuroblastoma
What is a major adverse effect of mercaptopurine (Purinethol)?
Myelosuppression.
What is a dose-limiting adverse effect of cyclophosphamide?
Myelosuppression, hemorrhagic cystitis, cardiotoxicity, neurotoxicity, nephrotoxicity
What is the mechanism of action of temozolomide?
It adds a methyl group to guanine residues, causing DNA damage and tumor cell death.
What is the role of leucovorin in methotrexate therapy?
Rescue therapy to mitigate toxicity, given 24 hours after methotrexate.
What are the primary indications for carmustine?
Brain tumors, Hodgkin lymphoma, and non-Hodgkin lymphoma.
What type of cancer is pemetrexed (Alimta) primarily used to treat?
Metastatic non-small cell lung cancer.
What is the primary indication for busulfan?
Chronic myeloid leukemia
What is a significant adverse effect of anthracyclines?
Cardiotoxicity.
What are the adverse effects of platinum-based drugs?
Nausea/vomiting, mild myelosuppression, nephrotoxicity, ototoxicity, cochleotoxicity, vestibulotoxicity
What is the role of dexrazoxane in chemotherapy?
It chelates ferric iron to prevent free radical formation.
What is the common mechanism of action for DNA synthesis inhibitors?
They are cell cycle specific, targeting the S phase to inhibit DNA synthesis.
What is the mechanism of action for temozolomide?
Alkylating agent that adds a methyl group to guanine residues, causing DNA damage and tumor cell death
What is the treatment for overdose/toxicity of fluorouracil and capecitabine?
Uridine triacetate (Vistogard).
Which cancers are treated with topoisomerase I inhibitors like irinotecan and topotecan?
Colon cancer, solid tumors, and lymphomas.
What are the adverse effects of high doses of fluorouracil (5-FU)?
Organ toxicities and hand-foot syndrome.
Which cancers are treated with platinum-based drugs?
Testicular cancer, ovarian cancer, cervical cancer, bladder cancer, lung cancer
What is the primary mechanism of action for BCR-ABL inhibitors?
Inhibition of BCR-ABL tyrosine kinase, leading to decreased tumor cell proliferation and apoptosis.
What are common adverse effects of BCR-ABL inhibitors?
Nausea, vomiting, diarrhea, edema, and myalgia.
What is the primary indication for BCR-ABL inhibitors?
Chronic myeloid leukemia
What are common adverse effects of BCR-ABL inhibitors?
Nausea, vomiting, diarrhea, edema, myalgia
What is the primary indication for imatinib?
Chronic myeloid leukemia.
Which mutations are associated with gastrointestinal stromal tumors?
c-kit mutations
What is the mechanism of action for erlotinib?
Inhibition of epidermal growth factor receptor (EGFR) tyrosine kinase
What is a notable adverse effect of topoisomerase II inhibitors like etoposide?
Myelosuppression.
What is the pharmacokinetic property of carmustine that aids in its effectiveness?
It is highly lipophilic.
What is a key requirement for erlotinib’s effectiveness?
EGFR gene mutation
What is the primary indication for bortezomib?
Multiple myeloma
What is a major caution for all anti-neoplastic agents?
Interference with fetal development
Which drugs are commonly used to treat acute lymphocytic leukemia?
Vincristine, cyclophosphamide, doxorubicin, mercaptopurine
What is the treatment for chronic myeloid leukemia?
Imatinib, dasatinib, busulfan
Which drugs are frequently used for breast cancer treatment?
Doxorubicin, lapatinib, cyclophosphamide, methotrexate, paclitaxel, fluorouracil, capecitabine
What is the mechanism of action for sunitinib?
Blocks angiogenesis
What are common adverse effects of sunitinib?
Skin rash, fatigue, nausea, hypertension
