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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
Example of enzyme based chemotherapeutic agents?
Asparaginase
26
Asparaginase is classified as?
G1-specific agent
27
Example of protein tyrosine kinase inhibitors?
Imatinib mesylate
28
MOA of imatinib mesylate?
Selective tyrosine kinase inhibitor that causes apoptosis
29
Examples of hormonal chemotherapeutic agents?
Adrenocorticoids (dexamethasone, prednisone) Estrogens (estradiol, dirthylstbestrol) Antiestrogen (tamoxifen) Aromatase inhibitor (anastrazole) Androgens (testosterone) Antiandrogens (flutamide)
30
Examples of adrenocorticoids?
Dexamethasone Prednisone
31
Examples of estrogen
Estradiol Diethylstilbestrol
32
Antiestrogen?
Tamoxifen
33
Aromatase inhibitor?
Anastrazole
34
Androgen?
Testosterone
35
Antiandrogen?
Flutamide
36
MOA of biological response modifiers?
Alter of enhance the patient’s immune system to fight cancer
37
Examples of biological response modifiers?
Cytokines Monoclonal antibodies
38
Function of monoclonal antibodies in cancer treatment?
- 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
Examples of monoclonal antibodies that help target cytotoxic therapy to tumor cells?
Suffix -ab
40
Example of monoclonal antibody that inhibits VEGF?
Bevacizumab
41
G1-phase specific agents?
Asparaginase Prednisone Cortisone
42
S-phase specific agents?
Antimetabolites
43
G2-phase specific?
Topoisomerase inhibitors | Topotecan, irinotecan, etoposide
44
Phase non-specific agents?
Alkylating agents Antitumor antibiotics
45
M-phase specific agents?
Mitotic inhibitors (taxanes)
46
Which chemotherapeutic agents cause alopecia?
Doxorubicin Cyclophosphamide Paclitaxel Doctor ruby’s head was a cycle when she packed her taxes
47
Which chemotherapeutic agents cause gi toxicity (diarrhea)?
Irinotecan Fluorouracil
48
Which chemotherapeutic agent causes gi toxicity (constipation)?
Vincristine
49
Solution for tumor lysis syndrome?
IV hydration Alkalinizing urine by decreasing uric acid
50
Cause of hypercalcemia in cancer patients?
Release of parathyroid hormone related protein from tumor cells
51
Solution for hypercalcemia?
Hydration with normal saline
52
Which chemotherapeutic agent causes chills and fever?
Bleomycin Cytarabine Monoclonal antibodies IL-2
53
Which chemotherapeutic agents cause pulmonary toxicity?
Bleomycin Busulfan
54
Cardiac toxicity?
Doxorubicin Daunorubicin
55
Cardioprotective agent against doxorubicin?
Dexrazoxane
56
Hypersensitivity reaction?
Asparaginase Cisplatin Etoposide Paclitaxel
57
Hemorrhagic cystitis?
Cyclophosphamide Ifosfasmide
58
Cause of hemorrhagic cystitis? Solution?
Acrolein (toxic metabolite) Mesna (binds to it)
59
Renal toxicity?
Cisplatin Methotrexate Ifosfamide
60
Hepatotoxicity?
Mercaptopurine Asparaginase Methotrexate Cytarabine
61
Secondary malignancies?
Cyclophosphamide Etoposide
62
Infertility?
Cyclophosphamide Chlorambucil
63
Adverse effects of cyclophosphamide?
Alopecia Hemorrhagic cystitis Secondary malignancies Infertility
64
Adv effect of cisplatin?
Ototoxicity Nephrotoxicity Nausea and vomiting
65
Adv effect of cytarabine?
Chemical conjunctivitis
66
Which agents cause cardio toxicity?
Doxorubicin Daunorubicin
67
Pulmonary toxicity?
Bleomycin Busulfan
68
Hemorrhagic cystitis?
Cyclophosphamide Ifosfamide
69
Diarrhea?
Irinotecan

Cancer Chemotherapy (2 decks)

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