Cancer Pharmacology 2 Flashcards
The discovery and use which drug dramatically increased the length of survival in patients with ALL?
What 4 drugs are all active against ALL?
What combination is used to induce remission?
MTX
6-mercaptopurine, cyclophosphamide, vincristine and daunorubicin.
Vincristine and prednisone, plus 1 other agent.
What is given as a prophylactic in ALL against CNS leukemia?
Intrathecal MTX
What is the most active agent for AML?
What agent is preferred?
How is remission achieved in AML?
Cytarabine
Idarubicin
After remission is achieved, chemo is required to maintain remission and to induce cure (Cytarabine).
What is the standard first-line therapy in previously untreated patients with CML?
Imatinib
What 2 drugs were initially used for patients with CML who were intolerant to Imatinib, but now is believed to be as suitable of a therapy?
What other drug can be used?
Dasatinib and Nilotinib
Busulfan
What are the 2 most widely used alkylating agents used for CLL?
What is meant by COP and CHOP?
Chlorambucil (often used w/ prednisone) and cyclophasphamide.
COP: *cyclophosphamide combined with *vincristine and prednisone.
CHOP: *cyclophosphamide combined with *vincristine, prednisone and *doxorubicin.
Bendamustine used with prednisone is approved for what?
CLL
What is Fludarabine indicated for?
CLL
What is the MOA of Ofatumumab?
What makes it unique?
What is it indicated for?
It is a human IgG1 antibody that binds to a different CD20 epitope than Rituximab.
It maintains activity in Rituximab-resistant tumors.
It is approved for CLL that is refractory to Fludarabine.
What chemotherapy regimen is used once the stage I to stage IIA transition has occurred in HL?
ABVD: Doxorubicin Bleomycin Vinablastine Dacarbazine
What regimens may be used in the advanced stages of HL (stage III and stage IV)? (MOPP, ABVD, Stanford V)
MOPP: mechlorethamine, vincristine, procarbazine and prednisone.
ABVD: doxorubicin, bleomycin, vinblastine, and dacarbazine.
Stanford V: doxorubicin, vinblasine, mechlorethamine, vincristine, bleomycine, etoposide and prednisone.
What combination chemotherapy is used in Diffuse Large Cell NHL?
CHOP: cyclophosphamide, doxorubicin, vincristine and prednisone (best initial therapy).
What chemotherapy is given in initial pharmacological treatment of Follicular NHL?
Bendamustine + rituximab
What is given for Multiple Myeloma?
MP protocol: melphalan + prednisone
What regimens are used in Stage II Breast Cancer (node positive disease, 1-3)?
CMF: cyclophosphamide, MTX, 5-fluorouracil.
FAC: 5-fluorouracil, doxorubicin, cyclophosphamide.
What 2 drugs are given for hormone-refractory prostate cancer that provides palliation in patients with bone pain and considered the “standard of care”?
What other drug combo is approved?
Docetaxel and prednisone - standard if care
Mitoxantrone and prednisone
What 3 regimens are used as adjuvant therapy for patiients with CRC in high risk stage II and III?
FOLFOX: leucovorin, 5-fluorouracil and oxaliplatin.
XELOX: capecitabine (xeloda) and oxaliplatin.
-used after surgery and reduces recurrence by 35%.
FOLFIRI: leucovorin, 5-fluorouracil and irinotecan.
-Ziv-afilbercept may be added.
What 3-drug combo is used as the standard treatment combination for NSCLC? What histology must they have?
Bevacizumab plus carboplatin and paclitaxel. They must have non-squamous histology.
What combination is given if a patient with NSCLC is not a good candidate for Bevacizumab or has SCC histology? (2/3)
(Cisplatin or carboplatin) and cetuximab
What drugs can be used in maintenance chemotherapy for NSCLC? (4)
Pametrexed
Erlotinib
Afatinib
Osimertinib
What drug combination is used in SC NSCLC? (3)
What drug is used in cancers that have progressed on or after platinum-based chemotherapy?
What is used as second-line monotherapy in patients who have failed a platinum-based regimen?
Cisplatin, gemcitabine and necitumumab.
Nivolumab
Topotecan
What is the 3-drug regimen for testicular cancer?
PEB: cisplatin, etoposide and bleomycin
What are the 2 most active cytotoxic agents against malignant melanoma?
What 2 drugs are approved for unresectable or metastatic melanoma as monotherapy?
Dacarbazine and cisplatin
Nivolumab and pembrolizumab
What is the drug class used for brain cancers?
What is used as a single agent?
What is the 3-drug regimen?
What is used alone or in combo and has shown clinical activity against adult GBM?
Nitrosureas
Carmustine
PCV: *procarbazine, lomustine and *vincristine
Bevacizumab
Drug regimen:
6-mercaptopurine, cyclophosphamide, vincristine and daunorubicin.
Remission achieved via: vincristine and prednisone + 1 of the above.
ALL
Drug regimen:
*Cytyrabine + Idarubicin
AML
Drug regimen:
Imatinib
Basatinib + nilotinib
Busulfan
CML
Drug regimen:
Chlorambucil + prednisone
Cyclophosphamide, vincristine + prednisone (COP)
Cyclophosphamide, doxorubicin, vincristine + prednisone (CHOP)
Bendamustine
Fludarabine
CLL
Drug regimen:
Doxorubicin, bleomycin, vinblastine + dacarbazine (ABVD)
Doxorubicin, vinblastine, mechlorethamine, vincristine, belomycin, etoposide, + prednisone (Stanford V)
Mechlorethamine, vincristine, procarbazine + prednisone (MOPP)
HL stage III and IV (advanced stages)
Drug regimen:
Cyclophosphamide, doxorubicin, vincristine + prednisone (CHOP)
R-CHOP
DLBCL
Drug regimen:
Bendamustine + rituximab
Follicular lymphoma
Drug regimen:
Melphalan + prednisone
MM
Drug regimen:
Cyclophosphamide, MTX + 5-FU (CMF)
5-FU, doxorubicin + cyclphosphamide (FAC)
Breast cancer stage I -> stage II
Drug regimen:
Doxorubicin, bleomycin, vinblastine + dacarbazine (ABVD)
HL stage I and stage IIA
Drug regimen:
Mitoxantrone + prednisone
Docetaxel + prednisone
Prostate cancer
Drug regimen:
Bevacizumab, carboplatin + paclitaxel
NSCLC (non-squamous)
Druge regimen:
Cisplatin, gemcitabine + necitumumab
Nivolumab
NSCLC (squamous)
Drug regimen:
(Cisplatine + carboplatin) OR (cisplatin + irinotecan)
Platinum therapies
SCLC
List the major adverse-effect(s) of the following:
Cisplatin Bleomycin Doxorubicin Vincristine/Vinblastine Cyclophosphamide
Cisplatin: otoxicity + nephrotoxicity.
Bleomycin: pulmonary fibrosis.
Doxorubicin: cardiotoxicity.
Vincristine/Vinblastine: peripheral neuropathy.
Cyclophosphamide: hemorrhagic cystitis.
