Cancer Chemotherapy Flashcards
Mechanism of action of cellular metabolites of fluorouracil?
Irreversible inhibition of thymidylate synthase
What drug most likely responsible to hemorrhagic cystitis?
Cyclosphophamide
After several cycles of chemotherapy. A patient was found to have a high resting pulse rate. A noninvasive radionuclide scan revealed evidence of cardiomyopathy. The drug that is most likely responsible for the cardiac toxicity is
Doxorubicin
A patient with multiple myeloma was started in bortezomib after 2 rounds of other combination chemotherapy did noth have any effect. What is the mechanism of action of bortezomib?
Inhibition of 26S proteasome
Neuropathy is a toxic effect of vincristine.
neuropathy
most common symptom of autonomic neuropathy
Constipation
Nephrotoxicity is a characterisitc toxicity of
Cisplatin
A cancer cell that is resistant to the effects of both vincristine and methotrexate probably has developed the resistance as a result of which of the following mechanisms?
Increased expression of a P-glycoprotein transporter
what drug used in the ABVD and MOPP regimen is a cell cycle specific?
Plant alkaloids
The anticancer drug most commonly associated with pulmonary toxicity is ______
Bleomycin
All of the following agents have been used in drug regimens for the treatment of breast carcinoma. Which one has specific activity in a subset of female breast cancers
Trastuzumab
If allopurinol is used adjunctively in cancer chemotherapy to offset hyperuricemia. the dosage of this anticancer drug should be reduced to 25% of normal
Mercaptopurine
This drug is used in combination therapy for non Hodkin’s lymphoma. Due to its selectivity it is expected, it is expected to be less myelosuppresive compared with the elastic agents
RItuximab
This antimetabolite inhibits DNA polymerase and is one of the most active drugs in leukemia. although myelosuppresion is dose limiting, the drug may also cause cerebellar dysfunction, including ataxia and dysarrthria
Cytarabine
Cyclophosphamide
Forms DNA cross links, resulting in inhibition of DNA synthesis and function
Breast cancer, ovarian, cancer, non-Hodkin’s lymphoma, chronic lymphocytic leukemia, neuroblastoma
Nausea and vomiting
Myelosuppression, alopecia, hemorrhagic cystitis
Methothrexate
Inhibits DHFR, resulting in inhibition of synthesis of thidylate, purine nucletodies, serine, and methionine
Breast cancer, head and neck cancerm primary CNS lymphoma, non-Hodkin’s lymphoma, bladder cancer, choriocarcinoma
Mucositis, diarrhea
Myelosuppression
6 mercaptopurine
Inhibits de nove purine synthesis
AML
Nausea and vomiting
Myelosuprresion, immunosuprpesion, hepatotoxicity
5 fluorouracil
Inhibits thymidylate synthase, and its metabolites are incoprorated into RNA and DNA, all resulting in inhibition of DNA synthesis and functioning and in RNA processing
GI cancers, breast cancer, head and neck cancer, heaptocellular cancer
Nause, mucositis, diarrhea
Myelosuppresion, neutotoxicity
Vincristine
Inteferes with microtubule assembly, resulting in impaired mitosis
ALL, Hodkin’s and non-Hodgkin’s. Lymphoma, Wilm’s tumor, neuroblastoma
NONE
Neurotoxicity with peripheralneuropathy, paralytic ileus, myelosuppression, alopecia, inappropriate ADH secretion
Etoposide
Imhibits topoisomerase II, resulting in DNA damage
Lung cancerm non-Hodkin’s lymphoma, gastric cancer
Nausea and vomiting
Alopecia, myelosuppression
Topocetan
Inhibits topoisomerase II, resulting in DNA damage
Small cell lung casncer ovarian, cancer
Nausea, vomiting, diarrhea
Myelosuppresion
Paclitaxel
Interferes with microtubule disassmebly resulting in impaired mitosis
Breast, lung, ovarian, Gastroesophageal, prostate, bladder, and head and neck cancers
Nausea, vomiting, hypotension, arrhythmias, hypersensitivity
Myelosuppression, peripheral sensory neuropathy
Doxurubicin
Oxygen free radicals bind to DNA causing strand breakage; inhibits topoisomerase II: intercalates into DNA
Lymphomas, myelomas, sarcomas, and breast, lung, ovarian and thyroid cancers
Nausea, arrhytmias
Alopeciasm myelosuppression, cardiomyopathy pulmonary fibrosis
Imatinib
Inhibits bcr-abl tyrosine kinase and other receptor tyrosine kinases
Chronic myelogenous leukemia, gastrointestinal stromal tumor
Nausea and vomiting
Fluid retention with ankle and periorbital edema, diarrhea, myalgias, heart failure
Trastuzumab
Inhibits binding of VEGF to its receptor, resulting in inhibition of tumor vascularization
Colorectal, breast, non small cell lung, and renal cancer
Hypertension, infusion reaction
Arterial thromboembolic events, GI perforations, wound healing complications, proteinuria
Bortezomib
Reversibly inhibits chymotrypsin-like activity of the 26S proteosome
multiple myeloma
Hypotension, edema, GI upset
Peripheral neuropathy, cardiac dysfunction
traps acrolein released from cyclophosphamide and thus reduces the incidence of hemorhhagoc cystitis
Mesna (mercaptoethanesulfonate)
a form of tetrahydrofolate that is accumualted more readily by normal than by neoplastic cells
Leucovorin
Inhibits free radical formation and affords protection against the cardiac toxicity
Dextrazoxane
Alkylating agents
- Cyclophosphamide
- Mechlorethamine
- Platinum analogs
- Busulfan
treatment regimen for Hodkin’s lymphoma
ABVD
- Doxorubicin (Adriamycin)
- Bleomycin
- vincristine
- decarbazine
- prednisone
Regimen for non-hodkin’s lymphoma
CHOP regimen
- Cyclocphosphamide
- Doxorubicin
- vincristine
- prednisone
- rituximab
Regimen for testicular cancer
PEB regimen
- cisplastin (platinol)
- Etoposide
- bleomycin
drug with marked vesicant (blister-forming) actions
Mechlorethamine
Most specific for S2
Cytarabine
Antimetabolites
- Methotrexate
- Mercaptopurine (6-MP) and Thiohuanine (6-TG)
- Fluorouracil
- Cytarabine
- Gemcitabine
