Chemo therapy targeted therapies.

Question 1

What are your VEGF inhibitors (CI)?

What are your HER2 inhibitors and warnings?

What are the EGFR inhibitors?

Answer 1

Bevacizumab(Avastin), Ramucirumab (Cyramza). Impairs wound healing so do not administer for 28 days before or after surgery. Severe fatal bleeding/GI perforation warnings.

Trastuzumab (Herceptin), Pertuzumab, Ado-Trastuzumab Emtansine (Kadcyla). Monitor LVEF (using echocardiogram or MUGA scan), They are NOT interchangeable.

Cetuximab (Erbitux), Panitumumab (Vectibix). Test for EGFR positive expression as this has better response rates, KRAS wild type to use. Rash from an EGFR indicates they will have a good response. Avoid sunlight, use sunscreen. Topical steroids, antibiotics.

Question 2

What to know about Rituximab (Rituxan)?

What to know about Blinatumomab (Blincyto)?

What are your PD-1 inhibitors?

Answer 2

Premedicate with diphenhydramine, acetaminophen, steroid. CD20 positive to use.

Neurotoxicity, Cytokine release syndrome watch out.

Pembrolizumab (Keytruda), Nivolumab (Opdivo).

Question 3

What is your CTLA-4 inhibitor?

What to know about Imatinib (Gleevec)?

What are used in melanoma?

Answer 3

Ipilimumab (Yervoy).

Used in CML, BCR-ABL inhibitor. Must be philadelphia chromosome positive to use(BCR-ABL). Watch for fluid retention.

BRAF inhibitors. BRAF V600E or V600K mutation positive. New malignancies.

Question 4

What are the MEK 1 and 2 inhibitors?

What is used in NSCLC, EGFR inhibitors?

What drugs must be ALK positive?

Answer 4

Trametinib, Cobimetinib.

EGFR mutation positive, Acneiform rash, dry skin, rash indicates a better response, avoid sunlight and use sunscreen, use topical steroids and antibiotics prophylactically to avoid damage.

Crizotinib, Ceritinib, Alectinib.

Question 5

What drugs must be HER2?

What oral agents are teratogenic?

Answer 5

Lapatinib, Neratinib.

Thalidomide, Pomalidomide, and lenalidomide.