Cancer Treatment Modalities Flashcards

1
Q

What are the primary treatments for cancer?

A
  1. Surgery
  2. Radiation
  3. Chemotherapy
  4. Hormone Therapy
  5. Immunotherapy
  6. Biological Therapy
  7. Targeted Therapy
  8. Transplantation
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2
Q

What is Methotrexate and what does it do?

A

Antifolate chemotherapeutic agent which inhibits folate-mediated DNA synthesis and stops cancer cell proliferation

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3
Q

What is Leucovorin and what does it do?

A

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)

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4
Q

What is medical oncology?

A

The prevention, diagnosis, treatment, and palliation of cancer using antineoplastic therapies including chemotherapy, targeted therapy, immunotherapy, and hormone therapy

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5
Q

What is adjuvant therapy?

A

Use of additional cancer treatment after the primary therapy to reduce risk of recurrence and incidence of metastatic disease

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6
Q

What is definitive therapy?

A

Use of radiation therapy as the primary treatment (with or without chemotherapy)

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7
Q

What is neoadjuvant therapy?

A

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

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8
Q

What is palliation?

A

Use of cancer treatment modalities, when disease cure and control cannot be achieved, to relieve side effects and symptoms and improve quality of life

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9
Q

What is prophylactic therapy?

A

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

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10
Q

Which 4 body cell types have rapid turnover and are especially susceptible to the effects of chemotherapy?

A

Bone marrow (blood cells), hair follicles, gonads, gastrointestinal mucosa (mouth, esophagus, stomach, intestine)

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11
Q

What are four cell cycle-nonspecific chemotherapy agents?

A

Alkylating agents, antitumor antibiotics, hormone therapies, nitrosoureas

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12
Q

What are some cell cycle specific chemotherapy agents and which phase of the cell cycle do they interfere with?

A

Antimetabolites (synthesis phase), camptothecins (synthesis phase), plant alkaloids and taxanes (mitosis phase), miscellaneous agents (various phases)

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13
Q

What are nine genetic mutations that are tested for to determine use of targeted therapy, and which cancers are they specific to?

A
  1. ALK (NSCLC)
  2. BCR-ABL (chronic myelogenous leukemia, acute lymphoblastic leukemia)
  3. BRCA (breast, ovarian)
  4. BRAF (melanoma, lung, breast)
  5. EGFR (NSCLC)
  6. ER & PR +/- status (breast)
  7. ERBB2 (formerly HER2+/-) (breast)
  8. JAK2 (bone marrow disorders, myeloproliferative diseases)
  9. KRAS (colon, NSCLC)
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14
Q

What is the mechanism of action for alkylating agents?

A

Interfere with DNA bases, causing breaks in DNA helix strands (prevents DNA replication and transcription of RNA)

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15
Q

What is the classification, route of administration, indication, and possible side effects of Bendamustine (Treanda)?

A
  • Alkylating agent
  • IV
  • B-cell non-Hodgkin lymphoma (NHL), chronic lymphocytic leukemia (CLL)
  • myelosuppression, mild N/V, fatigue, hypersensitivity infusion reaction, TLS
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16
Q

What is the classification, route of administration, indication, and possible side effects of Busulfan (Myleran or Busulfex)?

A
  • 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
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17
Q

What is the classification, route of administration, indication, and possible side effects of Carboplatin (Paraplatin)?

A
  • 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
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18
Q

What is the classification, route of administration, indication, and possible side effects of Carmustine (BCNU)?

A
  • Alkylating agent
  • IV
  • brain cancer, Hodgkin disease (HD), NHL, multiple myeloma (MM), cutaneous T-cell lymphoma
  • myelosuppression, N/V, hepatic/renal/pulmonary toxicity
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19
Q

What is the classification, route of administration, indication, and possible side effects of Chlorambucil (Leukeran)?

A
  • Alkylating agent
  • Oral
  • CLL, HD, NHL, breast, ovarian, testicular cancers
  • N/V, hyperuricemia, pulmonary toxicity, skin rash, seizure risk in children
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20
Q

What is the classification, route of administration, indication, and possible side effects of Cisplatin (Platinol, CDDP)?

A
  • 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
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21
Q

What is the classification, route of administration, indication, and possible side effects of Cyclophosphamide (Cytoxan, CTX)?

A
  • 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
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22
Q

What is the classification, route of administration, indication, and possible side effects of Dacarbazine (DTIC)

A
  • Alkylating agent
  • IV
  • HD, malignant melanoma, neuroblastoma, sarcomas, medullary thyroid cancer
  • myelosuppression, N/V, flu-like symptoms, CNS toxicity, photosensitivity
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23
Q

What is the classification, route of administration, indication, and possible side effects of Ifosfamide (Ifex)?

A
  • 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
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24
Q

What is the classification, route of administration, indication, and possible side effects of Mechlorethamine (aka nitrogen mustard)?

A
  • Alkylating agent
  • IV
  • CLL, CML, HD, NHL, mycosis fungoides, breast and lung cancers
  • myelosuppression, N/V, hyperuricemia, pain/inflammation at injection site, alopecia
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25
Q

What is the classification, route of administration, indication, and possible side effects of Melphalan (Alkeran)?

A
  • Alkylating agent
  • IV, Oral
  • breast and ovarian cancers, MM, HCT, polycythemia vera, neuroblastoma
  • myelosuppression, N/V/D, mucositis, hypersensitivity infusion reaction
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26
Q

What is the classification, route of administration, indication, and possible side effects of Oxaliplatin (Eloxatin)?

A
  • Alkylating agent
  • IV
  • colorectal and pancreatic cancers
  • N/V/D, neurotoxicity (peripheral neuropathy, cold sensitivity, laryngopharyngeal dysesthesia), hepatic toxicity, allergic reaction
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27
Q

What is the classification, route of administration, indication, and possible side effects of Temozolomide (Temodar)?

A
  • Alkylating agent
  • Oral
  • astrocytoma, glioblastoma
  • myelosuppression, N/V/C, fatigue, headache, hepatic toxicity, photosensitivity, rash
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28
Q

What is the classification, route of administration, indication, and possible side effects of Thiotepa (Thioplex)?

A
  • 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)
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29
Q

What is the mechanism of action for antimetabolites?

A

Interfere with DNA synthesis by acting as false metabolites; incorporated into the DNA strand or block essential enzymes

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30
Q

What is the classification, route of administration, indication, and possible side effects of Azacitidine (Vidaza)?

A
  • Antimetabolite
  • IV, Subcutaneous (SC)
  • CML, myelodysplastic syndrome (MDS)
  • myelosuppression, N/V/C/D, fatigue, hypokalemia, renal toxicity
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31
Q

What is the classification, route of administration, indication, and possible side effects of Capecitabine (Xeloda)?

A
  • Antimetabolite
  • Oral
  • Colon, esophageal, pancreas, rectal, and metastatic breast cancers
  • myelosuppression, N/V/D, fatigue, increased bilirubin, hand-foot syndrome
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32
Q

What is the classification, route of administration, indication, and possible side effects of Cytarabine (ARA-C)?

A
  • 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
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33
Q

What is the classification, route of administration, indication, and possible side effects of Fludarabine (Fludara)?

A
  • Antimetabolite
  • IV
  • CLL, NHL, acute leukemia
  • myelosuppression, N/V/D, neurotoxicity, rash
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34
Q

What is the classification, route of administration, indication, and possible side effects of Fluorouracil (5-FU)?

A
  • 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
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35
Q

What is the classification, route of administration, indication, and possible side effects of Gemcitabine (Gemzar)?

A
  • Antimetabolite
  • IV
  • bladder, breast, lung, ovarian, and pancreatic cancers, NHL, sarcoma
  • myelosuppression, N/V, pulmonary toxicity, rash, flu-like symptoms
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36
Q

What is the classification, route of administration, indication, and possible side effects of Hydroxyurea (Hydrea)?

A
  • Antimetabolite
  • Oral
  • CML, blood disorders, head and neck and ovarian cancers
  • myelosuppression, N/V/D, mucositis, darkening or thickening of nails
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37
Q

What is the classification, route of administration, indication, and possible side effects of Mercaptopurine (6-MP)?

A
  • Antimetabolite
  • Oral
  • ALL, APL, lymphoma, ulcerative colitis, Crohn’s disease
  • myelosuppression, N/V/D, mucositis, hepatic toxicity, hyperuricemia
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38
Q

What is the classification, route of administration, indication, and possible side effects of Methotrexate (MTX)?

A
  • 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
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39
Q

What is the classification, route of administration, indication, and possible side effects of Pemetrexed (Alimta)?

A
  • Antimetabolite
  • IV
  • mesothelioma, lung cancer
  • myelosuppression, N/V/D, fatigue, rash, usually require folic acid and B12 supplementation to reduce side effects
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40
Q

What is the classification, route of administration, indication, and possible side effects of Thioguanine (6-TG)?

A
  • Antimetabolite
  • Oral
  • AML, CML
  • myelosuppression, N/V/D, mucositis, hepatic and/or renal toxicity, rash
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41
Q

What is the mechanism of action for antitumor antibiotics and anthracycline antitumor antibiotics?

A

Inhibit cell division by binding to DNA and interfering with RNA synthesis

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42
Q

What is the classification, route of administration, indication, and possible side effects of Bleomycin (Blenoxane)?

A
  • 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
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43
Q

What is the classification, route of administration, indication, and possible side effects of Dactinomycin (Actinomycin D)?

A
  • Antitumor antibiotic
  • IV
  • Ewing sarcoma, rhabdomyosarcoma, Wilms tumor, testicular cancer
  • myelosuppression, N/V/D, mucositis, anorexia, alopecia
44
Q

What is the classification, route of administration, indication, and possible side effects of Mitomycin-C (Mutamycin)?

A
  • Antitumor antibiotic
  • IV
  • anal, bladder, breast, esophageal, head and neck, lung, pancreatic, and stomach cancer
  • myelosuppression, N/V/D, mucositis, anorexia, pulmonary and/or renal toxicity, alopecia
45
Q

What is the classification, route of administration, indication, and possible side effects of Daunorubicin (Daunomycin)?

A
  • Anthracycline antitumor antibiotics
  • IV
  • ALL, AML, APL
  • myelosuppression, N/V/D, mucositis, anorexia, hyperuremia, cardiotoxicity, alopecia, red urine, hyperpigmentation
46
Q

What is the classification, route of administration, indication, and possible side effects of Doxorubicin (Adriamycin)?

A
  • Anthracycline antitumor antibiotic
  • IV
  • breast, liver, lung, ovarian, prostate, and stomach cancers, NHL, MM, ALL, AML, SCC of head and neck, sarcomas
  • myelosuppression, N/V/D, mucositis, anorexia, cardiotoxicity, hand-foot syndrome, hyperpigmentation, alopecia, red-orange urine
47
Q

What is the classification, route of administration, indication, and possible side effects of Doxorubicin liposomal (Doxil)?

A
  • Anthracycline antitumor antibiotic
  • IV
  • AIDS-related Kaposi sarcoma, breast and ovarian cancers, and other solid tumors
  • myelosuppression, N/V/D, mucositis, cardiotoxicity, hand-foot syndrome, hyperpigmentation, alopecia, red-orange urine, infusion reaction
48
Q

What is the classification, route of administration, indication, and possible side effects of Epirubicin (Ellence)?

A
  • Anthracycline antitumor antibiotic
  • IV
  • breast cancer
  • myelosuppression, N/V/D, mucositis, cardiotoxicity, skin rash, alopecia, red-orange urine
49
Q

What is the classification, route of administration, indication, and possible side effects of Idarubicin (Idamycin)?

A
  • Anthracycline antitumor antibiotic
  • IV
  • AML, ALL, CML, MDS
  • myelosuppression, N/V/D, mucositis, cardiotoxicity, alopecia, hand-foot syndrome, elevated liver enzymes, red urine
50
Q

What is the mechanism of action for Epipodophyllotoxins?

A

Damage the cell prior to mitosis, late S and G2 phase, inhibits topoisomerase II

51
Q

What is the classification, route of administration, indication, and possible side effects of Etoposide (Vepesid, VP-16)?

A
  • Epipodophyllotoxin
  • IV, oral
  • bladder, lung, prostate, stomach, and uterine cancers, HD, NHL, germ cell cancer (testicular)
  • myelosuppression, N/V/D, mucositis, anorexia, metallic taste during infusion, hypersensitivity reaction, alopecia, orthostatic hypertension, yellowing of skin or eyes
52
Q

What is the classification, route of administration, indication, and possible side effects of Teniposide (Vumon, VM-26)?

A
  • Epipodophyllotoxins
  • IV
  • childhood ALL
  • myelosuppression, N/V, hypotension, pulmonary toxicity
53
Q

What is the mechanism of action for Taxanes?

A

Active in the mitosis phase; antimicrotubule agents, which lead to inhibition of mitosis and cell division

54
Q

What is the classification, route of administration, indication, and possible side effects of Paclitaxel (Taxol)?

A
  • Taxane
  • IV
  • bladder, breast, esophagus, head and neck, lung, ovarian, pancreatic, and prostate cancers
  • myelosuppression, swelling of feet and ankles, N/V/D, mucositis, peripheral neuropathy, hypersensitivity reaction, alopecia, arthralgia, myalgia
55
Q

What is the classification, route of administration, indication, and possible side effects of Docetaxel (Taxotere)?

A
  • Taxane
  • IV
  • bladder, breast, head and neck, lung, ovarian, pancreatic, prostate, and stomach cancers, sarcomas
  • myelosuppression, N/V/D, mucositis, peripheral neuropathy, fluid retention, skin and nail changes, hypersensitivity reaction, alopecia
56
Q

What is the classification, route of administration, indication, and possible side effects of Paclitaxel protein bound (Abraxane)?

A
  • Taxane
  • IV
  • breast and pancreatic cancer, NSCLC
  • myelosuppression, N/V/D, mucositis, arthralgia, myalgia, peripheral neuropathy, alopecia, swelling of feet and ankles, eye problems
57
Q

What is the mechanism of action for Vinca alkaloids?

A

Bind to protein tubulin, disrupt mitotic spindle formation, and prevent cell division in the mitosis phase

58
Q

What is the classification, route of administration, indication, and possible side effects of Vincristine (Oncovin)?

A
  • Vinca alkaloid
  • IV
  • ALL, AML, HD, NHL, rhabdomyosarcoma, neuroblastoma, Ewing sarcoma, Wilms tumor, brain and thyroid cancers
  • myelosuppression, peripheral neuropathy, N/C, abdominal cramps, taste changes, mucositis, SIADH, hypersensitivity reaction, jaw pain, alopecia
59
Q

What is the classification, route of administration, indication, and possible side effects of Vinblastine (Velban)?

A
  • Vinca alkaloid
  • IV
  • bladder, breast, testicular, head and neck, and lung cancers, HD, NHL, sarcomas, blood disorders
  • myelosuppression, constipation, mucositis, stomatitis, taste changes, hypertension, alopecia, jaw pain
60
Q

What is the classification, route of administration, indication, and possible side effects of Vinorelbine (Navelbine)?

A
  • Vinca alkaloid
  • IV
  • breast and ovarian cancer, NSCLC, HD
  • myelosuppression, N/V/C, stomatitis, anorexia, transient elevations in LFTs, alopecia
61
Q

What is the mechanism of action for monoclonal antibodies?

A

Target specific receptors on the outside of tumor cells which then activate pathways inside the cell to disrupt cell functions and cause apoptosis

62
Q

What is the mechanism of action for protein-targeted agents?

A

Use small molecules that penetrate malignant cell membranes to interact with specific areas of the target proteins, which induces apoptosis

63
Q

What is the mechanism of action for angiogenesis inhibitors (antiangiogenesis therapy)?

A

Hinder formation of new blood vessels in primary and metastatic tumors, preventing their growth, invasion, and spread

64
Q

What is immunotherapy?

A

Treatment to boost or restore the ability of the immune system to fight cancer, infection, and other diseases by inducing, enhancing, or suppressing an individual’s own immune response

65
Q

What is the target, route of administration, indication, and possible side effects of the monoclonal antibody Ibritumomab tiuxetan (Zevalin)?

A
  • CD20
  • IV
  • NHL, follicular lymphoma
  • myelosuppression, asthenia, infections, N/V (generally mild), possible infusion reaction, cough, dyspnea, sinusitis
66
Q

What is the target, route of administration, indication, and possible side effects of the monoclonal antibody Rituximab (Rituxan)?

A
  • CD20
  • IV
  • NHL, chronic lymphocytic leukemia (CLL)
  • myelosuppression, N/V (generally mild), TLS, possible infusion reaction, skin reaction
67
Q

What is the target, route of administration, indication, and possible side effects of the monoclonal antibody Alemtuzuab (Campath)?

A
  • CD52
  • IV
  • chronic lymphocytic leukemia (CLL)
  • myelosuppression, N/V, possible infusion reaction
68
Q

What is the target, route of administration, indication, and possible side effects of the monoclonal antibody Pertuzumab (Perjeta)?

A
  • ERBB2 (aka HER2)
  • IV
  • ERBB2 + breast cancer
  • myelosuppression, N/V/D, possible infusion reaction, rash
69
Q

What is the target, route of administration, indication, and possible side effects of the monoclonal antibody Trastuzumab (Herceptin)?

A
  • ERBB2 (aka HER2)
  • IV
  • ERBB2 + breast cancer, gastric cancer
  • myelosuppression (rarely), N/V/D (generally mild), cardiotoxicity, possible infusion reaction, pulmonary toxicity
70
Q

What is the target, route of administration, indication, and possible side effects of the monoclonal antibody Ado-trastuzumab emtansine (Kadcyla)?

A
  • ERBB2 (aka HER2)
  • IV
  • ERBB2+ metastatic breast cancer
  • myelosuppression, nausea, peripheral neuropathy, possible infusion reaction, increased liver enzymes, decreased serum potassium
71
Q

What is the target, route of administration, indication, and possible side effects of the monoclonal antibody Cetuximan (Erbitux)?

A
  • EGFR
  • IV
  • metastatic colorectal cancer, NSCLC, SCC of head and neck, squamous cell skin cancer
  • N/V/D, anorexia, pulmonary toxicity, hypomagnesemia, possible infusion reaction, skin rash, pruritus
72
Q

What is the target, route of administration, indication, and possible side effects of the monoclonal antibody Panitumumab (Vectibix)?

A
  • EGFR
  • IV
  • colorectal cancer
  • possible infusion reaction, acneiform skin rash, pruritis pulmonary toxicity, hypomagnesemia, diarrhea, malaise
73
Q

What is the target, route of administration, indication, and possible side effects of the monoclonal antibody Denosumab (Xgeva)0?

A
  • RANKL
  • IV
  • bone metastasis, giant cell tumor of the bone
  • N/V/D, hypocalcemia, risk for osteonecrosis of the jaw
74
Q

What is the target, route of administration, indication, and possible side effects of the monoclonal antibody Denosumab (Prolia)?

A
  • RANKL
  • IV
  • osteoporosis with high risk of fracture
  • N/V/D, hypocalcemia, risk for osteonecrosis of the jaw
75
Q

What is the target, route of administration, indication, and possible side effects of the monoclonal antibody Ipilimumab (Yervoy)?

A
  • PD-1/PD-L1
  • IV
  • melanoma
  • anemia, N/V/D, rash, pruritis, pulmonary symptoms
76
Q

What is the target, route of administration, indication, and possible side effects of the monoclonal antibody Nivolumab (Opdivo)?

A
  • PD-1/PD-L1
  • IV
  • melanoma, NSCLC, renal cell cancer
  • myelosuppression, colitis, N/V/C, hyponatremia, hypokalemia, hypomagnesemia, pruritus, pulmonary symptoms, pneumonia
77
Q

What is the target, route of administration, indication, and possible side effects of the monoclonal antibody Pembrolizumab (Keytruda)?

A
  • PD-1
  • IV
  • melanoma, NSCLC, SCC of head and neck, endometrial cancer
  • anemia, nausea, hyperglycemia, hyponatremia, hypoalbuminemia, pruritus, pulmonary symptoms, increased liver enzymes
78
Q

What is the drug class and indication for the protein-targeted agent Erlotinib (Tarceva)?

A
  • tyrosine kinase inhibitor
  • locally advanced or metastatic NSCLC or pancreatic cancer
79
Q

What is the drug class and indication for the protein-targeted agent Gefitinib (Iressa)?

A
  • tyrosine kinase inhibitor
  • refractory NSCLC
80
Q

What is the drug class and indication for the protein-targeted agent Imatinib (Gleevec)?

A
  • tyrosine kinase inhibitor
  • Ph+ CML, gastrointestinal stromal tumor (GIST), MDS, refractory Ph+ ALL
81
Q

What is the drug class and indication for the protein-targeted agent Sorafenib (Nexavar)?

A
  • tyrosine kinase inhibitor
  • renal cell, thyroid, and hepatocellular cancer
82
Q

What is the drug class and indication for the protein-targeted agent Sunitinib (Sutent)?

A
  • tyrosine kinase inhibitor
  • GIST, renal cell cancer, PNET
83
Q

What is the drug class and indication for the protein-targeted agent Crizotinib (Xalkori)?

A
  • tyrosine kinase inhibitor
  • ALK+ or ROS1+ NSCLC
84
Q

What is the drug class and indication for the protein-targeted agent Dasatinib (Syprcel)?

A
  • tyrosine kinase inhibitor
  • Ph+ CML, Ph+ ALL
85
Q

What is the mechanism of action for tyrosine kinase inhibitors?

A

Inhibit several receptor tyrosine kinases, which are involved in tumor growth, angiogenesis, and metastasis

86
Q

What is the drug class and indication for the protein-targeted agent Temsirolimus (Torisel)?

A
  • mTOR inhibitor
  • renal cell cancer
87
Q

What is the drug class and indication for the protein-targeted agent Everolimus (Affinitor)?

A
  • mTOR inhibitor
  • renal cell cancer, PNET, ER+ advanced breast cancer
88
Q

What is the mechanism of action for mTOR inhibitors?

A

Block angiogenesis by preventing the release of VEGF and PDGF, thus blocking tumor cell proliferation and causing cell death

89
Q

What is the drug class and indication for the protein-targeted agent Bortezomib (Velcade)?

A
  • proteasome inhibitor
  • MM, mantel cell lymphoma
90
Q

What is the mechanism of action for proteasome inhibitors?

A

Inhibit breakdown of intracellular proteins and disrupt the proteasome pathway

91
Q

What is the drug class and indication for the protein-targeted agent Vemurafenib (Zelboraf)?

A
  • BRAF inhibitor
  • melanoma
92
Q

What is the mechanism of action for BRAF inhibitors?

A

Target the mutant form of the BRAF protein

93
Q

What is the target, indication, and possible side effects of the angiogenesis inhibitor Bevacizumab (Avastin)?

A
  • VEGF
  • metastatic colorectal, breast, or renal cell cancer, NSCLC, glioblastoma
  • generalized weakness, pain, abdominal pain, N/V, reduced appetite, upper respiratory infection, low WBC count
94
Q

What is the target, indication, and possible side effects of the angiogenesis inhibitor Lenalidomide (Revlimide)?

A
  • Ubiquitin E3 ligase cereblon
  • MM, mantel cell lymphoma, MDS
  • N/V/C/D, rash, tiredness, fever, itching
95
Q

What is the target, indication, and possible side effects of the angiogenesis inhibitor Thalidomide (Thalomid)?

A
  • Ubiquitin E3 ligase cereblon
  • MM, renal cell cancer, glioblastoma multiforme
  • headache, dizziness, drowsiness, weakness, anxiety, agitation, confusion, tremors, muscle weakness, N/C, reduced appetite, edema, dyspnea, weight gain or loss, rash, dry skin
96
Q

What is the medication type, indication, and possible side effects of the hormonal agents Tamoxifen citrate (Novaldex) and Toremifene citrate (Fareston)?

A
  • Antiestrogen
  • breast cancer
  • menstrual symptoms (hot flashes, sweating, menstrual irregularities, mood changes…), fluid retention and peripheral edema, increased risk of endometrial changes and cancer, thromboembolic complications, skin changes/rash, joint aches, pains, weight gain
97
Q

What is the medication type, indication, and possible side effects of the hormonal agent Raloxifene (Evista)?

A
  • Antiestrogen
  • osteoporosis or post-menopausal women at risk for breast cancer
  • menstrual symptoms (hot flashes, sweating, menstrual irregularities, mood changes…), fluid retention and peripheral edema, increased risk of endometrial changes and cancer, thromboembolic complications, skin changes/rash, joint aches, pains, weight gain
98
Q

What is the medication type, indication, and possible side effects of the hormonal agents Anastrozole (Arimidex), Letrozole (Femara), and Exemestane (Aromasin)?

A
  • Aromatase inhibitor
  • breast cancer
  • hot flashes, arthralgias, N/V (generally mild), asthenia, thromboembolic events, high cholesterol (Letrozole), fever, malaise, myalgias, joint aches and pains
99
Q

What is the medication type, indication, and possible side effects of the hormonal agent Megestrol acetate (Megace)?

A
  • Progesterone
  • breast, endometrial, and renal cell cancers; prescribes as an appetite stimulant in cancer and HIV/AIDS
  • weight gain (fluid retention), thromboembolic events, N/V, menstrual bleeding, hot flashes, sweating, mood change, hyperglycemia
100
Q

What is the medication type, indication, and possible side effects of the hormonal agents Bicalutamide (Casodex) and Flutamide (Eulexin)?

A
  • Antiandrogen
  • prostate cancer
  • weight gain, hot flashes, fatigue, decreased libido, impotence, bone pain
101
Q

What is the medication type, indication, and possible side effects of the hormonal agent Leuprolide acetate (Lupron) and Goserelin (Zoladex)?

A
  • Luteinizing hormone-releasing hormone (LHRH) agonist
  • prostate and ovarian cancer
  • hot flashes, fatigue, decreased libido, impotence, bone pain, gynecomastia, headache, muscle weakness
102
Q

What are the three types of radiation therapy, and how do they work?

A
  1. External bean radiation therapy (EBRT): uses photons, electrons, and protons delivered from outside the body to treat a specific treatment field
  2. Brachytherapy: internal radiation therapy, uses sealed sources of radiation which are temporarily or permanently placed inside a body cavity, tissue or surface; designed to precisely deliver radiation and spare normal tissue
  3. Radiopharmaceutical therapy: uses unsealed sources of radiation to treat cancer systemically
103
Q

Describe interstitial brachytherapy placement. Which cancers is it used to treat?

A
  • A radioactive source is places into the tumor
  • breast, gynecological, head and neck, lung, prostate, rectal
104
Q

Describe intracavitary brachytherapy placement. Which cancers is it used to treat?

A
  • A radioactive source is placed directly into a surgical or body cavity (ex: vagina or uterus) near a tumor
  • gynecological, head and neck
105
Q

Describe contact brachytherapy placement. Which cancers is it used to treat?

A
  • A radioactive source is placed on an external surface
  • Skin