Chemotherapy Flashcards

1
Q

What are the objectives of chemotherapy?

A
  • cure
  • decrease tumor size, reduce symptoms (palliative)
  • adjuvant
  • neoadjuvant
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2
Q

What is adjuvant chemotherapy?

A

Chemotherapy is given after definitive therapy (surgery, radiation)

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3
Q

Why is adjuvant therapy given?

A

To eliminate remaining disease

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4
Q

What is neoadjuvant chemotherapy?

A

Chemotherapy given before definitive therapy (surgery, radiation)

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5
Q

Why is neoadjuvant therapy given?

A

Decrease the tumor burden before definitive therapy

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6
Q

How is response to chemotherapy defined?

A
  • complete response (CR): 100% clearance
  • partial response (PR): >50% reduction
  • stable disease: tumor size neither grows nor shrinks <25% change in size
  • progression or no response: > 25% increase in tumor size or appearance of new lesions
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7
Q

How is response rate (RR) defined?

A

Response rate (RR) = complete response (CR) + partial response (PR)

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8
Q

Classification of chemotherapeutic agents?

A
  • alkylating agents
  • antitumor antibiotics
  • anti metabolites
  • mitotic inhibitors
  • topoisomerase inhibitors
  • enzymes
  • protein tyrosine kinase inhibitors
  • hormones
  • biological response modifiers
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9
Q

MOA of alkylating agents?

A

Inhibit dna replication by causing cross-linking and abnormal base pairing of dna strands

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10
Q

Alkylating agents are Classified as?

A

Phase non-specific agents

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11
Q

Examples of alkylating agents:

A

Cyclophosphamide

Ifosfamide

Carmustine

Lomustine

Cisplatin

Busulfan

Chlorambucil

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12
Q

MOA of antitumor antibodies?

A

Inhibits dna synthesis by sliding between base pairs

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13
Q

Antitumor antibodies are classified as?

A

Phase non-specific agents

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14
Q

Examples of antitumor antibodies:

A

Doxorubicin

Bleomycin

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15
Q

MOA of antimetabolites?

A

Inhibit dna synthesis by acting as false substitutions in the production of nucleic acids

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16
Q

Antimetabolites are classified as?

A

S-phase specific agents

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17
Q

Examples of antimetabolites?

A

Methotrexate

6-mercaptopurine

5-fluorouracil

Cytarabine

Azacitidine

Capecitabine

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18
Q

MOA of mitotic inhibitors?

A

Inhibit cell division by preventing microtubule formation

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19
Q

Mitotic inhibitors are also known as?

A

Taxanes

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20
Q

Mitotic inhibitors are classified as?

A

M-phase specific

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21
Q

Examples of mitotic inhibitors?

A

Vincristine

Vinblastine

Paclitaxel

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22
Q

MOA of topoisomerase inhibitors?

A

Inhibit topoisomerase enzyme necessary for dna replication and rna transcription

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23
Q

Topoisomerase inhibitors are classified as?

A

G2-specific agents

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24
Q

Examples of topoisomerase inhibitors?

A

Topotecan

Irinotecan

Etoposide

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25
Q

Example of enzyme based chemotherapeutic agents?

A

Asparaginase

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26
Q

Asparaginase is classified as?

A

G1-specific agent

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27
Q

Example of protein tyrosine kinase inhibitors?

A

Imatinib mesylate

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28
Q

MOA of imatinib mesylate?

A

Selective tyrosine kinase inhibitor that causes apoptosis

29
Q

Examples of hormonal chemotherapeutic agents?

A

Adrenocorticoids (dexamethasone, prednisone)

Estrogens (estradiol, dirthylstbestrol)

Antiestrogen (tamoxifen)

Aromatase inhibitor (anastrazole)

Androgens (testosterone)

Antiandrogens (flutamide)

30
Q

Examples of adrenocorticoids?

A

Dexamethasone

Prednisone

31
Q

Examples of estrogen

A

Estradiol

Diethylstilbestrol

32
Q

Antiestrogen?

A

Tamoxifen

33
Q

Aromatase inhibitor?

A

Anastrazole

34
Q

Androgen?

A

Testosterone

35
Q

Antiandrogen?

A

Flutamide

36
Q

MOA of biological response modifiers?

A

Alter of enhance the patient’s immune system to fight cancer

37
Q

Examples of biological response modifiers?

A

Cytokines

Monoclonal antibodies

38
Q

Function of monoclonal antibodies in cancer treatment?

A
  • identify cancer-specific antigens and help target cytotoxic therapy to the tumor cells
  • inhibit angiogenesis (inhibiting blood supply) to the tumor by inhibiting vascular endothelial growth factor (VEGF)
39
Q

Examples of monoclonal antibodies that help target cytotoxic therapy to tumor cells?

A

Suffix -ab

40
Q

Example of monoclonal antibody that inhibits VEGF?

A

Bevacizumab

41
Q

G1-phase specific agents?

A

Asparaginase

Prednisone

Cortisone

42
Q

S-phase specific agents?

A

Antimetabolites

43
Q

G2-phase specific?

A

Topoisomerase inhibitors

Topotecan, irinotecan, etoposide

44
Q

Phase non-specific agents?

A

Alkylating agents

Antitumor antibiotics

45
Q

M-phase specific agents?

A

Mitotic inhibitors (taxanes)

46
Q

Which chemotherapeutic agents cause alopecia?

A

Doxorubicin

Cyclophosphamide

Paclitaxel

Doctor ruby’s head was a cycle when she packed her taxes

47
Q

Which chemotherapeutic agents cause gi toxicity (diarrhea)?

A

Irinotecan

Fluorouracil

48
Q

Which chemotherapeutic agent causes gi toxicity (constipation)?

A

Vincristine

49
Q

Solution for tumor lysis syndrome?

A

IV hydration

Alkalinizing urine by decreasing uric acid

50
Q

Cause of hypercalcemia in cancer patients?

A

Release of parathyroid hormone related protein from tumor cells

51
Q

Solution for hypercalcemia?

A

Hydration with normal saline

52
Q

Which chemotherapeutic agent causes chills and fever?

A

Bleomycin

Cytarabine

Monoclonal antibodies

IL-2

53
Q

Which chemotherapeutic agents cause pulmonary toxicity?

A

Bleomycin

Busulfan

54
Q

Cardiac toxicity?

A

Doxorubicin

Daunorubicin

55
Q

Cardioprotective agent against doxorubicin?

A

Dexrazoxane

56
Q

Hypersensitivity reaction?

A

Asparaginase

Cisplatin

Etoposide

Paclitaxel

57
Q

Hemorrhagic cystitis?

A

Cyclophosphamide

Ifosfasmide

58
Q

Cause of hemorrhagic cystitis? Solution?

A

Acrolein (toxic metabolite)

Mesna (binds to it)

59
Q

Renal toxicity?

A

Cisplatin

Methotrexate

Ifosfamide

60
Q

Hepatotoxicity?

A

Mercaptopurine

Asparaginase

Methotrexate

Cytarabine

61
Q

Secondary malignancies?

A

Cyclophosphamide

Etoposide

62
Q

Infertility?

A

Cyclophosphamide

Chlorambucil

63
Q

Adverse effects of cyclophosphamide?

A

Alopecia

Hemorrhagic cystitis

Secondary malignancies

Infertility

64
Q

Adv effect of cisplatin?

A

Ototoxicity

Nephrotoxicity

Nausea and vomiting

65
Q

Adv effect of cytarabine?

A

Chemical conjunctivitis

66
Q

Which agents cause cardio toxicity?

A

Doxorubicin

Daunorubicin

67
Q

Pulmonary toxicity?

A

Bleomycin

Busulfan

68
Q

Hemorrhagic cystitis?

A

Cyclophosphamide

Ifosfamide

69
Q

Diarrhea?

A

Irinotecan