Cancer Drugs

Question 1

MOA of Imiquimod

Answer 1

1. direct activation of TLR 7 and 8
2. adenosine receptor blocker
3. activation of NFkB - upregulats the cytokines like TNF alpha and ILs

• also can negatively modulate GLI in hedgehog pathway

Question 2

Adverse effects of imiquimod

Answer 2

1. increases photosensitivity
2. compromises condom and diaphragm
3. benzyl alcohol and paraben components may be allerginic - skin rxns

Question 3

MOA Vismodegib

Answer 3

SMO inihibitor

Question 4

Adverse effects of Vismodegib

Answer 4

1. Intrauterine fetal death
2. Male-mediated teratogencity
3. Pregnancy
4. restrictions on blood donation
5. GI toxicities are common
6. wt loss, fatigue, alopecia

Question 5

MOA of Aldesleukin

Answer 5

binds to IL2 receptor - indiscriminate activation of immune system

Question 6

CIed of Aldesleukin

Answer 6

w/ significant CNS, cardiac, pulm, renal/hepatic dz, etc.

*capillary leak syndrome

Question 7

What tests will be run for Aldesleukin?

Answer 7

Thallium, PFTS, daily CXR

Question 8

MOA of Interferon Alpha

Answer 8

binds to receptor, JAK/STAT pathway

Question 9

Adverse effects of Interferon

Answer 9

1. FLS
2. Neutropenia, leukopenia, anemia, alopecia
3. Elevated hepatic enzymes
4. cough and dyspnea, Pulmonary problems

Question 10

tests for interferon

Answer 10

LFT, CBC, CxR,

Question 11

MOA of Ipilimumab

Answer 11

CTLA4 Ab - bolsters antitumor response of immune system

Question 12

Adverse effects of Ipilimumab

Answer 12

severe and fatal immune-mediated adverse rxns –> dermatitis including toxic epidermal necrolysis

Question 13

BBW’s of Ipilimumab

Answer 13

adrenal insufficiency, diarrhea, GBS, hepatitis, hyper/hypothyroidism, myasthenia gravis, peripheral neuropathy, pregnancy, serious rash

Question 14

MOA of sorafenib

Answer 14

multi-kinase inhibitor

Question 15

Adverse effect of sorafenib

Answer 15

1. hepatitis - elevated LFTS
2. hand foot syndrome, rash/desquamation and anemia = most common
3. bone marrow suppression and neutropenia - CBC
4. increased incidence of bleeding

Question 16

MOA of trametinib

Answer 16

MEK inhibitor— for V600E and V600K

Question 17

Adverse effects of trametinib

Answer 17

1. rapid onset of skin toxicity
   2 GI toxicity - diarrhea, stomatitis, anemia
2. Decreased LVEF
3. HTN, hemorrhage
4. retinal pigment epithelial detachment, ILD, cardiomyopathy

Question 18

MOA of vermurafenib

Answer 18

mutated BRAF (V600E) inhibitor

Question 19

Adverse effects of vermurafenib

Answer 19

1. QT prolongation and TP – ECG and electrolyte monitoring
2. increased photosensivity
3. Cutaneous SCC in 1/4th pts
4. SJS possible
5. uveitis, iritis, retinal vein occlusion
6. elevated serum creatinine; LFTS required

Question 20

MOA of carmustine

Answer 20

both alkylation and carbamolyation of aa

Question 21

MOA of cyclophosphamide and dacarbazine

Answer 21

pro-drug of active alklyating moiety

Question 22

MOA of cisplatin

Answer 22

forms DNA intrastrand crosslinks and adducts

Question 23

MOA of TCA

Answer 23

chemical peel; rapidly penetrates and cauterizes skin, keratin,

Question 24

Adverse effects of TCA

Answer 24

burning, inflammation, and localized tenderness