Cancer Drugs & Diagnostic Tests

Question 1

Radiotracers such as __________ are utilized in PET Scans, as they sequester into Cancerous Tissues that have increased sugar demands.

Answer 1

Fluorodeoxyglucose

Question 2

What pt.’s should we avoid conducting MRIs on (if at all possible)?

Answer 2

Those with metal prosthetics… Metal heats up from the magnetic waves being shot out by machine.

Question 3

If a cancer is in Stage III, what is unique about it?

Answer 3

-Cancerous invasion of surrounding tissues & localized Lymph Nodes.

Question 4

If a cancer is in Stage IV, what is unique about it?

Answer 4

-Metastasized into another bodily organ.

Question 5

What are normal male Hematocrit counts? Normal female Hematocrit counts?

Answer 5

Male: 41-50
Female: 36-48

Question 6

Platelet Tests examine what parameters?

Answer 6

-Platelet Count
-Mean Platelet Volume
-Platelet Distribution Width

Question 7

CA-125 is a Tumor Marker of what cancer type?

Answer 7

Ovarian Cancer

Question 8

CD25 is a Tumor Marker of what cancer type?

Answer 8

Non-Hodgkin’s Lymphoma

Question 9

EGFR is a Tumor Marker of what cancer type?

Answer 9

Non-Small Cell Lung Cancer

Question 10

Estrogen Receptors are Tumor Markers of what cancer type?

Answer 10

Breast Cancer

Question 11

CTC’s are useful in the diagnosis of what cancers?

Answer 11

-Prostate Cancer
-Colorectal Cancer
-Breast Cancer

Question 12

How do Nitrogen Mustard drugs work?

Answer 12

-Formation of reactive Aziridinium intermediate attracts N7 residue of Guanine, leading to DNA alkylation.

Question 13

Model Nitrogen Mustard drugs?

Answer 13

Cyclophosphamide
Ifosfamide
Chlorambucil
Estramustine
Melphalan

Question 14

How do Nitrosurea Alkylating Agents work?

Answer 14

-Chloroethylene cleavage attracts O6 Guanine residues, leading to DNA alkylation.

Question 15

Model Nitrosurea Alkylating drugs?

Answer 15

Carmustine
Lomustine
Nimustine
Streptozocin

Question 16

Why is Streptozocin a unique Nitrosurea Alkylating drug?

Answer 16

-Different MOA… No Chloroethylene residue present, so a Methyl Cation is generated (which then attracts O6 Guanine residues as seen prior).

Question 17

Model Platinum Alkylating Agents?

Answer 17

Carboplatin
Cisplatin
Oxaliplatin

Question 18

MOA of Busulfan?

Answer 18

-Mesylate cleavage & formation of R-CH2+ intermediate… N7 Guanine then links to it.

Question 19

Busulfan is used to treat what cancer?

Answer 19

Chronic Myelogenous Leukemia

Question 20

Procarbazine is used to treat what cancers?

Answer 20

-Stage III / IV Non-Hodgkin’s or Hodgkin’s Lymphomas

-Gliomas

Question 21

Cytarabine is an _______ agent that incorporates into DNA or RNA, leading to miscoding events.

Answer 21

anti-metabolic

Question 22

What cell cycle phase is Cytarabine useful in?

Answer 22

S Phase (as it prevents the conversion of Cytidylic Acid into 2’-Deoxycytidylic Acid)

Question 23

Taxane drugs work in what cell cycle phase?

Answer 23

M Phase (as it inhibits microtubular disassembly)

Question 24

Model Taxane agents?

Answer 24

Paclitaxel
Docetaxel

Question 25

Vinca Alkaloids act in what cell cycle phase?

Answer 25

M Phase (oppose Taxanes in that they prevent microtubular assembly & polymerization)

Question 26

Model Vinca Alkaloid agents?

Answer 26

Vincristine
Vinblastine
Vindesine
Vinorelbine

Question 27

Antitumor Antibiotics all end in what?

Answer 27

“rubicin”…

Daunorubicin
Doxorubicin
Epirubicin
Idarubicin

Mitoxantrone is exception!

Question 28

What is the other name for Antitumor Antibiotics?

Answer 28

Anthracyclines

Question 29

How do Anthracyclines work?

Answer 29

-DNA intercalating agents that insert between two base pairings & induce breaks… Leads to Apoptotic responses.

Question 30

What is the significance of the PARP enzyme?

Answer 30

-Is the only DNA repair mechanism present in cancer cells!

Question 31

Why are healthy cells spared from the effects of PARP Inhibitor drugs?

Answer 31

-Other DNA repair mechanisms exist!

Question 32

PARP Inhibitors end in what?

Answer 32

“parib”…

Olaparib
Rucaparib
Niraparib
Iniparib
Talazoparib

Question 33

Model Tyrosine Kinase Inhibitors?

Answer 33

“tinib”…

Imatinib
Gefitinib

Question 34

Imatinib prevents cellular proliferation & induces apoptosis in ___-___ expressing cancer cells.

Answer 34

BCR-ABL

Question 35

Gefitinib inhibits ____, which prevents that pathway’s DNA synthesis promotion, cell proliferation signals, migrative abilities & cell survival.

Answer 35

EGFR

Question 36

Trastuzumab & Pertuzumab bind differing subdomains of ____ Receptors, thus preventing homo & heterodimerization.

Answer 36

HER2

Question 37

1) Trastuzumab binds what HER2 subdomain?

2) Pertuzumab binds what HER2 subdomain?

3) These drug therapies are often combined with what Anti-Mitotic agent?

Answer 37

1) Subdomain IV

2) Subdomain II

3) Docetaxel

Question 38

The desirable drug to give for Early-Staged HER2+ Breast Cancers is what?

Answer 38

T-DM1 (Trastuzumab & Emtansine)

Question 39

The desirable drug to give for Recurrent HER2+ Breast Cancers is what?

Answer 39

Combo of Trastuzumab + Docetaxel

or

Combo of Pertuzumab + Docetaxel

Question 40

Bortezomib is an _______-_______ agent that binds 26S proteasomes, thereby preventing the degradation of pro-_______ factors.

Answer 40

Apoptosis-Inducing ; apoptotic

Question 41

How does Bevacizumab work?

Answer 41

-Binds VEGF Receptor & prevents Angiogenesis (starves cancer cells).

Question 42

Other model Angiogenesis Inhibitor drug?

Answer 42

Sunitinib

Question 43

Of the following drugs, which one(s) serve(s) as a PD-1 Receptor Inhibitor?

Atezolizumab
Cemiplimab
Avelumab
Pembrolizumab
Durvalumab
Nivolumab

Answer 43

Cemiplimab
Pembrolizumab
Nivolumab

Atezolizumab, Avelumab, & Durvalumab are PD-L1 Inhibitors (bind the Ligand, NOT THE RECEPTOR)!!!