Cancer Drugs

Question 1

Cyclophosphamide MOA

Answer 1

Alkylating agent: alkylates DNA on N7 and O6 of guanine, adds an alophatic chain

Question 2

Major side effect of alkylating agents

Answer 2

Leukogenic: partial or total chromosomal deletions may cause a 2nd cancer

Question 3

Cancers treated wih cyclophosphamide

Answer 3

Burkitts, CLL, non hodgkins, breast cancer surgery, organ transplant

Question 4

Bleomycin MOA

Answer 4

Creates free radicals through Fe2+ and O2 interactions which causes DNA strand breaks

Question 5

Cancers treated with bleomycin

Answer 5

Leukemia, testicular and ovarian cancer

Question 6

Cisplatin, carboplatin, and oxaliplati MOA

Answer 6

Adds platin to N7 and O6 of guanine which causes intrachain crosslinking

Question 7

Major side effect of cisplatin, oxaliplatin, and carboplatin

Answer 7

Hearing loss

Question 8

Anthracyclines (doxorubicin/daunorubicin) MOA

Answer 8

Intercalates between DNA bases which inhibits topoisomerase II causing DNA strand breaks

Question 9

Etoposide MOA

Answer 9

Inhibits topoisomerase II causing strand breaks

Question 10

Methotrexate MOA

Answer 10

Folate antagonistand competitive inhibitor of dihydrofolate reductase which inhibits thymidylate and purine sythesis

Question 11

Cancers treated with methotrexate

Answer 11

Lung, colon, and ALL

Question 12

Leucoverin rescue

Answer 12

Selective rescue of normal cells which allows or higher dosing of methotrexate

Question 13

Asparginase MOA

Answer 13

Converts L-aspargine to aspartic acid which depletes aspargine required or DNA synthesis

Question 14

Cancer treated with asparginase

Answer 14

Lymphocytic leukemia

Question 15

Hydroxyurea MOA

Answer 15

Inhibits ribonucleotide diphosphate reductase which is the rate limiting step in dNTP synthesis

Question 16

Vinea alkaloid MOA

Answer 16

Inhibits microtubule formation (M phase specific)

Question 17

Vinblastine MOA

Answer 17

M phase specific

Question 18

Cancer treated with vinblastine

Answer 18

Hodgkins and childhood leukemias

Question 19

Treatment options for Hogkins

Answer 19

ABVD:
Adriamycin
Bleomycin
Vinblastine
Dicarbazine

Question 20

Paclitaxel MOA

Answer 20

Promotes microtubule formation but prevents disassembly (M phase specific)

Question 21

How glucocorticoids treat cancer

Answer 21

Decrease lymphocytes, antiinflammatiory

Question 22

Cancer treated with glucocorticoids

Answer 22

All leukemias

Question 23

Induction therapy for ALL

Answer 23

Glucocorticoid, vincristine, asparaginase

Question 24

Imatinib mesylate (Gleevec) MOA

Answer 24

Signal transduction inhibitor

Question 25

Cancer treated with Gleevec

Answer 25

CML

Question 26

Drug alternative to treat CML with Gleevec resistance

Answer 26

Desatinib: it has a sloppier fit to ATP binding pocket so it is more difficult for tumor cells to have mutations that make them resistant

Question 27

Bevacizumab (Avastin) MOA

Answer 27

Monoclonal Ab against VEGF

Question 28

Thalidomide MOA

Answer 28

Immune stimmulant –> T cell and NK activation
Antiangiogenic
Induces apoptosis
Decreases adhesion of myeloma cells to bone marrow stromal cells

Question 29

Bortezomib MOA

Answer 29

Proteosome inhibitor

Inhibits proteolysis

Question 30

Arsenic (ATO) MOA

Answer 30

Induces apoptosis by increasing free radicals –> mitochondrial damage –> caspase activation
Decreases VEGF
Stimulates apoptosis in supporting endothelial cells as well