Cancer Pharmacotherapy EXAM 2

Question 1

What do grading and staging tell about the progression of cancer?

Answer 1

Grade 1-3: well (slow growth) or poorly differentiated (fast growth)

Stage 1-4: TNM system (cancer-specific)
how far has it spread

Question 3

Which drugs are in the following regimen?

Answer 3

R-CHOP
AC -> T
ESHAP

Question 4

Surgical removement is ideal for which type of cancer cells

Answer 4

-small and at an early stage

solid tumors (no leukemia, or lymphoma bc it is in the blood)

Question 5

Which types of cancer cells are ideal for radiation therapy?

Answer 5

-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)

Question 6

Which equation is used for dosing in chemotherapy?

Answer 6

DuBois
Mosterllar equation

Know how to convert pt to kg, and inch to com

Question 7

Convert 1 inch into cm and 1 kg into pounds?

Answer 7

1 inch = 2.54 cm

1 kg = 2.2 pounds

Question 8

What is the dose for drug X based height and weight and BSA?

Answer 8

<5% difference range for the dose is OK
we don’t have to know the equation

Question 9

What is the definition of definitve therapy

Answer 9

it is expected to cure the cancer with drug chemotherapy and/or radiation (not surgery)

Question 10

Adjuvant therapy definition

Answer 10

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

Question 11

Neoadjuvant

Answer 11

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

Question 12

What is the definition of Palliative txt?

Answer 12

decrease the burden of disease, so they live longer (not trying to cure the cancer)

Question 13

Which drugs have the most benefit after surgical removal as adjunctive therapy?

Answer 13

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 cells (surgery) the cells are in an early stage where they grow at a fast rate

Question 14

Which phase of a trial do most findings of cancer drugs stem from?

Answer 14

Phase I

patients are treated with the highest possible dose to see what is the most tolerable dose

Question 15

Cytarabin is given in which interval and why?

Answer 15

it runs 24h for 7 days to make sure it hits the cancer (leukemia) in the S-phase

Question 16

Which cancers are solely treated with drug chemotherapy?

Answer 16

mostly leukemia and lymphomas

Question 19

What are the expected side effects of a VAMP regimen?

Answer 19

Vincristine
Amethopteerin
6-MP
Prednisone

Question 20

Prednisone kills which type of cancer cells?

Answer 20

lymphocytes

Question 21

In terms of cycles, how is adjunctive therapy different from palliative therapy?

Answer 21

adjunctive therapy is planned with a definite time to stop the therapy (trying to cure)

compared to palliative therapy (endless, lower dose)
stopped bc it grows despite giving drugs, or txt becomes untreatable