Cancer Clinical Case Disucssion

Question 1

trastuzumab

Answer 1

1. monoclonal antibody against HER-2 (erb B2), a tyrosine kinase
2. helps kill breast cancer cells to overexpress HER-2, possible through antibody-dependent cytotoxicity

Question 2

what is the toxicity of trastuzumab?

Answer 2

cardiotoxicity

Question 3

mech for carboplatin?

Answer 3

cross-link DNA

Question 4

what is the clinical use for carboplatin?

Answer 4

testicular, bladder, ovary

Question 5

what is the toxicity of carboplatin?

Answer 5

1. nephrotoxicity

2. acoustic nerve damage

Question 6

how can the nephrotoxicity of carboplatin be prevented?

Answer 6

amifostine (free radical scavenger) and chloride diuresis

Question 7

what is the mech of cyclophophamide?

Answer 7

covalently X-link (interstrand) DNA at guanine N-7

Question 8

is cyclophosphamide required to be bioactivated by the liver?

Answer 8

yes

Question 9

what is the toxicity of cyclophosphamide?

Answer 9

cystitis partially prevented with mensa (thiol group of mensa binds toxic metabolite)

Question 10

what is the mech of doxorubicin (Adriamycin)?

Answer 10

1. generate free radicals

2. noncovalently intercalate in DNA –> breaks in DNA

Question 11

what is the side effect of doxorubicin?

Answer 11

cardiotoxicity (dialated cardiomyopathy)

Question 12

what is used to prevent cardiotoxicity of doxorubicin?

Answer 12

Dexrazoxane (iron chelating agent), used to prevent cardiotoxicity

Question 13

what is the mech for paclitaxel?

Answer 13

hyperstabilize polymerized microtubules in M-phase, so that mitotic spindle cannot break down (anaphase cannot occur)

Question 14

what is the main clinical usage of paclitaxel?

Answer 14

ovraian and breast carcinomas

Question 15

what can cause neurotoxicity (areflexia, peripheral neuritis), paralytic ileus?

Answer 15

vincristine, vinblastine

Question 16

dyspena can be caused by

Answer 16

doxorubicin (cardiomyoparthy), pleural effustion caused by (trastuzumab)

Question 17

docitaxel and trastuzumab could case

Answer 17

dyspnea (shortness of breath)

Question 18

what can cause diarrhea

Answer 18

capecitabine, GI toxicities

Question 19

what is a newer orally effective form of 5-FU?

Answer 19

capectabine

Question 20

what is given to lessen the risk of infection (prevent neutropenia)?

Answer 20

Filgrastim is a granulocyte colony-stimulating factor (G-CSF) analog used to stimulate the proliferation and differentiation of granulocytes

Question 21

MOPP is for

Answer 21

Hodgkin Dz

Question 22

MOPP is

Answer 22

mechlorethamine, vincristine, procarbazine, prednisone

Question 23

testicular cancer is treated

Answer 23

with bleomycin

Question 24

side effect of etoposide?

Answer 24

AML, alopecia

Question 25

toxicity of carboplatin/cisplatin

Answer 25

nephrotoxicity, acoustic nerve damage