Chemotherapy

Question 1

Meclorethamine

Answer 1

Used for Hodgkin’s Disease

Question 2

Cylophosphamide and Ifosfamide

Answer 2

Cyclophosphamide: acute and chronic lymphocytic leukemia, non-Hodgkin’s Lymphoma, breast, lung and ovarian cancers.

Ifosfamide: sarcoma and testicular cancer

Can cause hemorrhagic cystitis.

Question 3

Carmustine and Lomustine

Answer 3

Can cross the BBB. Used for brain tumors.

Can cause pulmonary fibrosis.

Question 4

Decarbazine and Temozolomide

Answer 4

Decarbazine: Hodgkin’s Disease and malignant melanoma

Temozolomide: malignant gliomas. Standard agent in combination with radiation therapy.

Question 5

Cisplatin, Carboplatin and Oxaliplatin

Answer 5

Cisplatin: testicular, ovarian, cervical and bladder cancers.

• nephro and ototoxic
• can cause neuropathy

Carboplatin: ovarian cancer

Oxaliplatin: gastric and colorectal cancer
-peripheral sensory neuropathy

Question 6

Methotrexate

Answer 6

Inhibits dihydrofolate reductase.

Used for ALL and choriocarcinoma

Can pair with leucovarin to minimize toxicity.

Renal toxic: can crystallize in the urine at high doses.

Hepatotoxic: fibrosis or cirrhosis

Question 7

5-flurouracil

Answer 7

5-FdUMP: prevents thymidine synthesis

5-FdUTP: interferes with RNA function

Question 8

Cytarabine:

Answer 8

Ara-CMP –> Ara-CTP: competes with dCT, causes premature DNA chain termination.

Most effective treatment for AML. Also used for ALL and CML.

Question 9

Gemcitabine

Answer 9

dFdCDP: inhibits ribonucleotide reductase

dFdCTP: leads to termination of DNA synthesis

First line treatment for Pancreatic Cancer.

Question 10

6-mercaptopurine

Answer 10

1. Inhibits purine synthesis
2. Blocks formation of AMP and xanthinylic acid from iosinic acid.
3. Incorporated into DNA and RNA, resulting in inhibition of DNA and RNA synthesis.

Used to maintain remission in ALL.

Hepatotoxic with prolonged use.

Decrease dose when simultaneously using allopurinol (inhibits xanthine oxidase, which inhibits 6-MP).

Question 11

Dactinomycin

Answer 11

Intercalates between G-C base pairs of DNA, interfering with DNA-dependent RNA polymerase, casing inhibition of DNA transcription.

Used mainly for pediatric tumors: Wilm’s tumor, rhabdomyosarcoma and Ewing’s sarcoma.

Question 12

Daunorubicin, Doxorubicin, Epirubicin and Idarubicin.

Answer 12

Daunorubicin/Idarubicin: AML

Doxorubicin: sarcomas, breast and lung carcinomas, malignant lymphomas.

Epirubicin: metastatic breast cancer and gastric cancer.

Question 13

Bleomycin

Answer 13

Used for testicular tumors.

Pulmonary/cutaneous toxicity.

Question 14

Vinblastine and Vincristine

Answer 14

Block ability of tubulin to polymerize into microtubules.

Vinblastine: testicular tumors and Hodgkin’s

Vincristine: Hodgkin’s and non-Hodgkin’s.

Question 15

Paclitaxel and Docetaxel

Answer 15

Prevent depolymerization of microtubules.

Question 16

Etoposide and Teniposide

Answer 16

Inhibit topisomerase II.

Teniposide: ALL

Question 17

Irinotecan and Topotecan

Answer 17

Inhibit topoisomerase I.

Irinotecan: advanced colorectal cancer.

Topotecan: ovarian and small cell lung cancer.

Question 18

Prednisone and Dexamethasone

Answer 18

Glucocorticoids have cytotoxic effects on lymphocytes by inhibiting mitosis.

Prednisone: ALL and lots of other shit.

Dexamethasone: used in conjunction with radiation therapy to reduce edema related to brain and spinal cord tumors.

Question 19

Tamoxifen

Answer 19

Competes with estradiol for binding to ER.

Used for ER-positive breast cancer.

Question 20

Fulvestrant

Answer 20

Inhibits dimierization of ER and increases its degradation.

Question 21

Aminoglutethamide:and Anastrozole

Answer 21

1st and 3rd generation. Used for breast cancer, the latter in post-menopausal women.