Cancer Pharmacotherapy EXAM 2 Flashcards
What does grading and staging tell about the progression of cancer?
Grade 1: well-differentiated (slow growth)
Grade 3: poorly differentiated (fast growth, aggressive)
Stage 1-4: TNM system (cancer-specific)
how far has it spread
Stage 3 cancer is considered to be in which part of the body?
Lymph nodes
Stage IV distant organs
Which drugs are in the following regimen?
-R-CHOP:
-AC -> T:
Anthracycline+Cyclophsophomamide T: paclitaxel
-ESHAP
Surgical movement is ideal for which type of cancer cells
-small and at an early stage
solid tumors (no leukemia, or lymphoma bc it is in the blood)
Which types of cancer cells are ideal for radiation therapy?
-small tumor
-close to the surface of the body
example for the pancreas we would also have to penetrate the stomach (damage to the stomach, and less radiation gets to the pancreas due to absorption from the stomach)
Which equation is used for dosing in chemotherapy?
!!!
DuBois
Mosterllar equation
-> calculate BSA (m2) !!!
Know how to convert pt to kg, and inch to cm !!!
Convert 1 inch into cm and 1 kg into pounds.
How many inches in 6’1’’
1 inch = 2.54 cm
1 kg = 2.2 pounds
12*6 = 72 + 1 inch = 73 inch –> 185.42 cm
What is the dose for drug X based on height, weight and BSA?
<5% difference range for the dose is OK
we don’t have to know the equation
What is the definition of definitive therapy?
it is expected to cure the cancer with drug chemotherapy and/or radiation (not surgery)
Adjuvant therapy definition
after surgery (of primary tumor)
+
systemic chemotherapy to increase the chance of a cure;
-killing the remaining cancer cells which are in the log phase and susceptible to drug therapy
What is the definition of Neoadjuvant therapy?
adjunctive therapy (chemo) before surgery to improve the chance of cure
for example a cancer near to blood vessel that cant be cut out before we shrink the cancer with chemo
What is the definition of Palliative txt?
decrease the burden of disease, so they live longer (not trying to cure the cancer)
Which drugs have the most benefit after surgical removal as adjunctive therapy?
Immune checkpoint inhibitors (ICI) as adjuvant therapy
-Ipilimumab (Yervoy) - CTLA-4
-nivolumab (Opdivo) - PD-1 targeting
-pembrolizumab (Keytruda) - PD-1 targeting
immune cells (natural immune system?) works best when the number of cancer cells is lower
bc after removing the cancer cells (surgery), the remaining cells are in an early stage where they grow at a fast rate
Cytarabin is given in which interval and why?
it runs 24h for 7 days to make sure it actually hit the cancer (leukemia) in the S-phase multiple times
The dose of anticancer drugs is often discovered in which phase of a trial?
Phase I
the purpose is to find the most toxic dose that is tolerable
Which cancers are solely treated with drug chemotherapy?
mostly leukemia and lymphomas
What are the expected side effects of a VAMP regimen?
Vincristine: Neuroptahy
Amethopterin (precursor Mtx): Myelosuppression, Mucositis
6-MP –> Myelosuppression
Prednisone
Prednisone kills which type of cancer cells?
lymphocytes
In terms of cycles, how is adjunctive therapy different from palliative therapy?
adjunctive therapy is planned with a definite time to stop the therapy (trying to cure)
compared to palliative therapy (endless, lower dose)
may be stopped bc it grows despite giving drugs, or cancer becomes untreatable
