Cancer Treatment Modalities Flashcards
What are the primary treatments for cancer?
- Surgery
- Radiation
- Chemotherapy
- Hormone Therapy
- Immunotherapy
- Biological Therapy
- Targeted Therapy
- Transplantation
What is Methotrexate and what does it do?
Antifolate chemotherapeutic agent which inhibits folate-mediated DNA synthesis and stops cancer cell proliferation
What is Leucovorin and what does it do?
Folate analog; used to prevent methotrexate toxicity or enhance effectiveness of drugs that target enzymes that use folate as a cofactor (such as 5-FU)
What is medical oncology?
The prevention, diagnosis, treatment, and palliation of cancer using antineoplastic therapies including chemotherapy, targeted therapy, immunotherapy, and hormone therapy
What is adjuvant therapy?
Use of additional cancer treatment after the primary therapy to reduce risk of recurrence and incidence of metastatic disease
What is definitive therapy?
Use of radiation therapy as the primary treatment (with or without chemotherapy)
What is neoadjuvant therapy?
Use of one or more treatment modalities before the primary therapy to reduce the size of the primary tumor, improve the effectiveness of surgery, and decrease the incidence of metastatic disease
What is palliation?
Use of cancer treatment modalities, when disease cure and control cannot be achieved, to relieve side effects and symptoms and improve quality of life
What is prophylactic therapy?
Use of radiation to relieve symptoms, such as pain, bleeding, neurological compromise, or airway obstruction to improve quality of life or treat life-threatening problems
Which 4 body cell types have rapid turnover and are especially susceptible to the effects of chemotherapy?
Bone marrow (blood cells), hair follicles, gonads, gastrointestinal mucosa (mouth, esophagus, stomach, intestine)
What are four cell cycle-nonspecific chemotherapy agents?
Alkylating agents, antitumor antibiotics, hormone therapies, nitrosoureas
What are some cell cycle specific chemotherapy agents and which phase of the cell cycle do they interfere with?
Antimetabolites (synthesis phase), camptothecins (synthesis phase), plant alkaloids and taxanes (mitosis phase), miscellaneous agents (various phases)
What are nine genetic mutations that are tested for to determine use of targeted therapy, and which cancers are they specific to?
- ALK (NSCLC)
- BCR-ABL (chronic myelogenous leukemia, acute lymphoblastic leukemia)
- BRCA (breast, ovarian)
- BRAF (melanoma, lung, breast)
- EGFR (NSCLC)
- ER & PR +/- status (breast)
- ERBB2 (formerly HER2+/-) (breast)
- JAK2 (bone marrow disorders, myeloproliferative diseases)
- KRAS (colon, NSCLC)
What is the mechanism of action for alkylating agents?
Interfere with DNA bases, causing breaks in DNA helix strands (prevents DNA replication and transcription of RNA)
What is the classification, route of administration, indication, and possible side effects of Bendamustine (Treanda)?
- Alkylating agent
- IV
- B-cell non-Hodgkin lymphoma (NHL), chronic lymphocytic leukemia (CLL)
- myelosuppression, mild N/V, fatigue, hypersensitivity infusion reaction, TLS
What is the classification, route of administration, indication, and possible side effects of Busulfan (Myleran or Busulfex)?
- Alkylating agent
- Oral (Myleran) or IV (Busulfex)
- chronic myelogenous leukemia (CML), hematopoietic cell transplantation (HCT) preparation, polycythemia vera
- myelosuppression, N/V/D, mucositis, hepatic toxicity, adrenal insufficiency, pulmonary symptoms, insomnia, dizziness, anxiety alopecia
What is the classification, route of administration, indication, and possible side effects of Carboplatin (Paraplatin)?
- Alkylating agent
- IV
- breast, bladder, cervix, endometrial, esophageal, germ cell, head and neck, lung, and ovarian cancers and sarcomas
- myelosuppression, hypomagnesemia, N/V, taste changes, renal toxicity, hypersensitivity reaction, mild alopecia, peripheral neuropathy
What is the classification, route of administration, indication, and possible side effects of Carmustine (BCNU)?
- Alkylating agent
- IV
- brain cancer, Hodgkin disease (HD), NHL, multiple myeloma (MM), cutaneous T-cell lymphoma
- myelosuppression, N/V, hepatic/renal/pulmonary toxicity
What is the classification, route of administration, indication, and possible side effects of Chlorambucil (Leukeran)?
- Alkylating agent
- Oral
- CLL, HD, NHL, breast, ovarian, testicular cancers
- N/V, hyperuricemia, pulmonary toxicity, skin rash, seizure risk in children
What is the classification, route of administration, indication, and possible side effects of Cisplatin (Platinol, CDDP)?
- Alkylating agent
- IV
- bladder, cervical, esophageal, head and neck, lung, prostate, ovarian, stomach, and testicular cancers and NHL
- myelosuppression, N/V (acute & delayed), metallic taste, renal toxicity, hypomagnesemia, hypocalcemia, hypophosphatemia, SIADH, ototoxicity, hypersensitivity infusion reaction, peripheral neuropathy
What is the classification, route of administration, indication, and possible side effects of Cyclophosphamide (Cytoxan, CTX)?
- Alkylating agent
- IV, Oral, Intrapleural (IP)
- breast, endometrial, lung, ovarian, and testicular cancers, CLL, NHL, HD, MM, mycosis fungoides, neuroblastoma, Wilms’ tumors, sarcomas
- myelosuppression, N/V, bladder and/or cardiac toxicity, SIADH, alopecia
What is the classification, route of administration, indication, and possible side effects of Dacarbazine (DTIC)
- Alkylating agent
- IV
- HD, malignant melanoma, neuroblastoma, sarcomas, medullary thyroid cancer
- myelosuppression, N/V, flu-like symptoms, CNS toxicity, photosensitivity
What is the classification, route of administration, indication, and possible side effects of Ifosfamide (Ifex)?
- Alkylating agent
- IV
- bladder, cervical, germ cell, head and neck, and lung cancers, HD, NHL, sarcoma
- myelosuppression, N/V, anorexia, bladder toxicity, SIADH, neurotoxicity (seizure, lethargy), alopecia
What is the classification, route of administration, indication, and possible side effects of Mechlorethamine (aka nitrogen mustard)?
- Alkylating agent
- IV
- CLL, CML, HD, NHL, mycosis fungoides, breast and lung cancers
- myelosuppression, N/V, hyperuricemia, pain/inflammation at injection site, alopecia
What is the classification, route of administration, indication, and possible side effects of Melphalan (Alkeran)?
- Alkylating agent
- IV, Oral
- breast and ovarian cancers, MM, HCT, polycythemia vera, neuroblastoma
- myelosuppression, N/V/D, mucositis, hypersensitivity infusion reaction
What is the classification, route of administration, indication, and possible side effects of Oxaliplatin (Eloxatin)?
- Alkylating agent
- IV
- colorectal and pancreatic cancers
- N/V/D, neurotoxicity (peripheral neuropathy, cold sensitivity, laryngopharyngeal dysesthesia), hepatic toxicity, allergic reaction
What is the classification, route of administration, indication, and possible side effects of Temozolomide (Temodar)?
- Alkylating agent
- Oral
- astrocytoma, glioblastoma
- myelosuppression, N/V/C, fatigue, headache, hepatic toxicity, photosensitivity, rash
What is the classification, route of administration, indication, and possible side effects of Thiotepa (Thioplex)?
- Alkylating agent
- IV, intramuscular (IM), intrathecal (IT), subcutaneous (SC)
- bladder, breast, and ovarian cancers, HD, NHL
- myelosuppression, N/V, mucositis, renal toxicity (hemorrhagic cystitis), skin changes (rash, bronzing)
What is the mechanism of action for antimetabolites?
Interfere with DNA synthesis by acting as false metabolites; incorporated into the DNA strand or block essential enzymes
What is the classification, route of administration, indication, and possible side effects of Azacitidine (Vidaza)?
- Antimetabolite
- IV, Subcutaneous (SC)
- CML, myelodysplastic syndrome (MDS)
- myelosuppression, N/V/C/D, fatigue, hypokalemia, renal toxicity
What is the classification, route of administration, indication, and possible side effects of Capecitabine (Xeloda)?
- Antimetabolite
- Oral
- Colon, esophageal, pancreas, rectal, and metastatic breast cancers
- myelosuppression, N/V/D, fatigue, increased bilirubin, hand-foot syndrome
What is the classification, route of administration, indication, and possible side effects of Cytarabine (ARA-C)?
- Antimetabolite
- IV, intramuscular (IM), intrathecal (IT), subcutaneous (SC)
- acute lymphoblastic leukemia (ALL), acute promyelocytic leukemia (APL), acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML), B-cell non-Hodgkin lymphoma (NHL)
- myelosuppression, N/V, mucositis, anorexia, acute pancreatitis, neurotoxicity (lethargy, confusion), hepatic toxicity, pulmonary toxicity, conjunctivitis, keratitis
What is the classification, route of administration, indication, and possible side effects of Fludarabine (Fludara)?
- Antimetabolite
- IV
- CLL, NHL, acute leukemia
- myelosuppression, N/V/D, neurotoxicity, rash
What is the classification, route of administration, indication, and possible side effects of Fluorouracil (5-FU)?
- Antimetabolite
- IV, topical
- breast, colon, rectal, cervical, gastrointestinal tract, head and neck, pancreatic, ovarian, hepatobiliary, neuroendocrine, and stomach cancers, unknown primary cancer, thymic cancer
- myelosuppression, N/V/D, mucositis, taste changes, hand-foot syndrome, cardiac toxicity, photosensitivity
What is the classification, route of administration, indication, and possible side effects of Gemcitabine (Gemzar)?
- Antimetabolite
- IV
- bladder, breast, lung, ovarian, and pancreatic cancers, NHL, sarcoma
- myelosuppression, N/V, pulmonary toxicity, rash, flu-like symptoms
What is the classification, route of administration, indication, and possible side effects of Hydroxyurea (Hydrea)?
- Antimetabolite
- Oral
- CML, blood disorders, head and neck and ovarian cancers
- myelosuppression, N/V/D, mucositis, darkening or thickening of nails
What is the classification, route of administration, indication, and possible side effects of Mercaptopurine (6-MP)?
- Antimetabolite
- Oral
- ALL, APL, lymphoma, ulcerative colitis, Crohn’s disease
- myelosuppression, N/V/D, mucositis, hepatic toxicity, hyperuricemia
What is the classification, route of administration, indication, and possible side effects of Methotrexate (MTX)?
- Antimetabolite
- IM, IV, IT, oral
- bladder, breast, head and neck cancers, NHL, ALL, osteosarcoma, rheumatoid arthritis
- myelosuppression, nausea, mucositis, oral and GI ulcerations, renal and/or hepatic toxicity, photosensitivity
What is the classification, route of administration, indication, and possible side effects of Pemetrexed (Alimta)?
- Antimetabolite
- IV
- mesothelioma, lung cancer
- myelosuppression, N/V/D, fatigue, rash, usually require folic acid and B12 supplementation to reduce side effects
What is the classification, route of administration, indication, and possible side effects of Thioguanine (6-TG)?
- Antimetabolite
- Oral
- AML, CML
- myelosuppression, N/V/D, mucositis, hepatic and/or renal toxicity, rash
What is the mechanism of action for antitumor antibiotics and anthracycline antitumor antibiotics?
Inhibit cell division by binding to DNA and interfering with RNA synthesis
What is the classification, route of administration, indication, and possible side effects of Bleomycin (Blenoxane)?
- Antitumor antibiotic
- IV, SC, IM
- HD, NHL, head and neck cancer, SCC of skin, cervix, vulva and testes, melanoma, malignant pleural effusions
- pulmonary or renal toxicity, hyperpigmentation, skin and nail changes, hypersensitivity infusion reaction