Cancer Drugs

Question 1

MOA and toxicity: cisplatin

Answer 1

Cross-links DNA

Peripheral neuropathy, ototoxicity, myelosuppression

Question 2

MOA and toxicity: cyclophosphamide

Answer 2

Alkylation, DNA cross-linking

Myelosuppression, hemorrhagic cystitis

Question 3

MOA and toxicity: cytarabine

Answer 3

DNA polymerase inhibitor

Myelosuppression

Question 4

MOA and toxicity: 5-fluorouracil

Answer 4

Inhibits thymidylate synthetase

Myelosuppression, GI toxicity

Question 5

MOA and toxicity: hydroxyurea

Answer 5

Inhibits ribonucleotide reductase

Myelosuppression, GI toxicity

Question 6

MOA and toxicity: methotrexate

Answer 6

Inhibits DHFR

Myelosuppression

Question 7

MOA and toxicity: 6-thioguanine

Answer 7

Inhibits purine metabolism

Myelosuppression

Question 8

MOA and toxicity: bleomycin

Answer 8

Causes free radical formation –> damages DNA

Pulmonary fibrosis, radiation recall, skin lesions

Question 9

MOA and toxicity: bevacizumab

Answer 9

VEGF inhibitor

Risk of bleeding AND thrombosis

Question 10

MOA and toxicity: cetuximab

Answer 10

EGFR inhibitor

Acneiform rash

Question 11

MOA and toxicity: crizotinib

Answer 11

ALK (anaplastic lymphoma kinase) inhibitor

Bradycardia, visual disturbances

Question 12

MOA and toxicity: erlotinib

Answer 12

EGFR inhibitor

Acneiform rash

Question 13

MOA and toxicity: imatinib

Answer 13

Tyrosine kinase inhibitor (ABL, Kit, PDGF-R)

Fluid retention -> ankle and periorbital edema, mild myelosuppression

Question 14

MOA and toxicity: ritiximab

Answer 14

Binds CD20 to kill B cells

Myelosuppression, serum sickness

Question 15

MOA and toxicity: sunitinib

Answer 15

Tyrosine kinase inhibitor (VEGF, PDGF-R, c-kit)

Hemorrhage risk, hyperkeratosis and skin rashes

Question 16

MOA and toxicity: trastuzumab

Answer 16

Her-2/NEU inhibitor

Cardiotoxicity (decreased ejection fraction, HF)

Question 17

MOA and toxicity: vemurafenib

Answer 17

BRAF kinase inhibitor

Skin lesions

Question 18

MOA and toxicity: paclitaxel

Answer 18

Stabilizes microtubules, doesn’t let them disassemble

Myelosuppression, peripheral neuropathy

Question 19

MOA and toxicity: vincristine

Answer 19

Prevents microtubule synthesis and formation

Myelosuppression, peripheral neuropathy

Question 20

MOA and toxicity: bortezomib

Answer 20

Inhibits proteasome -> apoptosis

Myelosuppression, peripheral neuropathy

Question 21

MOA and toxicity: asparaginase

Answer 21

Degrades asparagine in circulation -> starves tumor cells

Hypersensitivity reactions

Question 22

MOA and toxicity: anastrozole

Answer 22

Aromatase inhibitor

Estrogen withdrawal symptoms

Question 23

MOA and toxicity: leuprolide

Answer 23

GnRH analog –> castration (decreased LH and testosterone)

Steroid withdrawal symptoms

Question 24

MOA and toxicity: tamoxifen

Answer 24

Selective estrogen receptor modulator (for estrogen receptor pos. breast cancers)

Estrogen withdrawal symptoms, increased risk of endometrial cancer

Question 25

MOA and toxicity: dactinomycin

Answer 25

Intercalates into DNA -> blocked DNA synthesis

Myelosuppression

Question 26

MOA and toxicity: doxorubicin

Answer 26

Topo-II inhibitor

Myelosuppression, dilated cardiomyopathy

Question 27

MOA and toxicity: etoposide

Answer 27

Topo-II inhibitor

Myelosuppression

Question 28

MOA and toxicity: irinotecan

Answer 28

Topo-I inhibitor

Myelosupression, bad diarrhea

Question 29

Name a tyrosine kinase inhibitor that can treat CML.

Answer 29

Imatinib

Question 30

Her-2/NEU positive breast cancers can be treated with…?

Answer 30

Trastuzumab

Question 31

Estrogen receptor positive breast cancers can be treated with…?

Answer 31

Tamoxifen

Question 32

What drug should you consider in a post-menopausal patient with breast, ovarian, or endometrial cancer (or prostate cancer in a man)?

Answer 32

Anastrozole (aromatase inhibitor)