Chemo Drugs 2

Question 1

Imatinib

• Mech
• Target+Fxn (2)
• Disease
• Special

Answer 1

TK Inhibitor

• Catalytic clef on ABL-binds and prevents fusion to resul tin in cytogenetic remission
• Inhibits PDGFR and cKIT

CML (9,22 Philly Chrom)

Mutations in cleft limit ability of Imatinib to bind

Question 2

ATRA

• Same mech @
• Target/Mech
• Disease
• Special

Answer 2

Arsenic

Displaces PML-RAR (15;17) fusion protein-get differentation and death of these cells

Acute promyelocytic leukemia

ATRA Syndrome-occurs shortly after iniation

• High neutrophil count
• Capillary leak-pulm edemia=resp failure
• renal failure
• trx with steroids, chemo, or sup care

Question 3

Rituximab

• Mech
• Target
• Disease
• Special

Answer 3

Chimeric monoclonal Ab-immune activation

CD20 pre B and mature B cells

B cell malignancies (primary trx B cell NHL)

Also widely used in autoimmune diseases

Question 4

Crizotinib

• Mech
• Target
• Disease

Answer 4

TK inhibitor

ALK, ROS1, HGFR

Anaplastic large T cell lymphoma

Question 5

Thalidominde

• Disease
• Special

Answer 5

Multiple myeloma

Teratogenic-focomelia

Question 6

Trastuzumab

• aka
• target
• mech (2)
• tox

Answer 6

Herceptin

HER2-R

Prevents dimerization which would result in proliferation signals
Ab depnendt cellualr cytotox

cardiac tox

Question 7

Cetuximab

• mech
• target
• Special

Answer 7

Chimeric monoclonal Ab

EGFR

Resitance with K-RAS and BRAF mutations

Question 8

Erlotinib

• Mech
• Target

Answer 8

TK inhibitor

EGF-R activating mutations

Question 9

Bevacizumab

• Target
• Mech
• Tox (4)

Answer 9

VEGFR

Inhibits VEGFR (which induces prolferation…)

Pulm hemorrhage-high risk in pts with squamous cell cancer
HTN
Proteinuria
100k cost

Question 10

Vemurafinib

• Mech
• Target
• Disease
• Tox
• Special

Answer 10

Small molecule RAF inhibitor

V600 BRAF mutation (activates EGFR and AKT)

Melanoma, NHL, Hairy Cell Leukemia

Causes other skin cancers (need to give MEK inhibitor)

REsistance in colon cancer with V600E mutation

Question 11

Bortezomib

• Target
• Disease
• Tox (2)

Answer 11

Proteosome Inhibitor (Ab?)

Primary trx for multiple myeloma

Neuropathy
Myelosupression

Question 12

Nivolumab

• Target
• Mech
• Disease
• Tox

Answer 12

PD-L1 inhibitor

PD-1-R-inhibits interaction with tumor PD-L1 which usually inhibits cell death by hiding from immume regulaation and antitumor responmse

HL

Immune mediated pneumonitis, colitis, hepatitis, endocrinopathies
Fatiue, rash, MSK pain, pruritis

Question 13

Do chemo man again

Answer 13

suh dude