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Gynecologic Oncology > Chemotherapy and Biologic Therapy > Flashcards

Chemotherapy and Biologic Therapy Flashcards

1
Q

Components of Drug Effect with Chemotherapy

A

Drug Concentration x Duration of Exposure

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2
Q

How is Dosage Calculated for chemotherapy?

A

Milligrams per meter squared of body surface area

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3
Q

Definition of Area Under the Curve

A

attenuate doses based on functional or induced impairment of body systems

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4
Q

Definition of Complete response to Chemotherapy treatment

A

Disappearance of all evidence of tumor

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5
Q

Definition of Partial response to chemotherapy treatment

A

a 50% reduction in the cross product of measurable lesions and absence of any new disease

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6
Q

Definition of Cell Cycle Specific Chemo agents

A

Depend on proliferative capacity of cells and phase of cells.

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7
Q

Chemotherapy agents that work in DNA synthesis (S) phase

A

Antimetabolites: Methotrexate, Gemcitabine

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8
Q

Chemotherapy agents that work in the mitotic phase (M) phase

A

Alkaloids: Taxanes, Topotecan, Etoposide, Vincristine

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9
Q

Definition of Cell Cycle non specific Chemo agents

A

acts in all phases of the cell cycle, not dependent on proliferative capacity

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10
Q

Classes of cycle non specific chemo agents

A

Platinum agents, Antibiotics, Alkylating agents

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11
Q

Common Platinum agents

A

Cisplatin, carboplatin

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12
Q

Antibiotics used in Chemotherapy regimens

A

Doxorubicin, Bleomycin

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13
Q

Common Alkylating agents

A

Cyclophosphamide, Ifosfamide

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14
Q

Methotrexate: Mechanism of action

A

Active during S phase, Combines with dihydrofolate reductase. Inhibits conversion of di-hydrofolate to tetrahydrofolate

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15
Q

Methotrexate: Toxicities

A

Mucositis, Myelosupression, Liver and renal impairment

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16
Q

Methotrexate: Uses

A

GTN, Breast cancer`

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17
Q

Gemcitabine: Mechanism of action

A

Active during S phase

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18
Q

Gemcitabine: Toxicities

A

Myelosupression

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19
Q

Gemcitabine: Uses

A

Ovarian Cancer

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20
Q

Paclitaxel: Mechanism of action

A

Active in M phase. Stabilization of micro tubular aparatus, cells die in metaphase arrest

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21
Q

Paclitaxel: Toxicities

A

Hypersensitivity reaction, Dysrhythmias, alopecia, neuropathy, myelosupression

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22
Q

Paclitaxel: Dose limiting toxicity

A

Myelosupression

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23
Q

Vincristine: Mechanism of action

A

Active in M phase: Inhibits polymerization of tubulin

24
Q

Vincristine: Toxicities

A

Neuropathy, Alopecia

25
Q

Vinblastine: Mechanism of action

A

Active in M phase: Inhibits polymerization of tubulin

26
Q

Vinblastine: Toxicities

A

Myelosupression

27
Q

Cyclophosphamide and Ifosfamide: Mechanism of Action

A

Alkylating agent, reactive species bind to DNA, Cross link DNA, produce breaks in DNA chains and Interfere with base pairing

28
Q

Cyclophosphamide and Ifosfamide: Toxicities

A

Increased risk of second malignancy, premature gonadal failure, hemorrhagic cystitis, CNS confusion (Ifosphamide)

29
Q

Cisplatin: Mechanism of action

A

Platinum Drug, mechanism similar to alkylating agent. reactive species bind to DNA, Cross link DNA, produce breaks in DNA chains and Interfere with base pairing

30
Q

Cisplatin: Toxicities

A

Emetogenic, Neuropathy, Nephropathy

31
Q

Carboplatin: Mechanism of action

A

Platinum drug, Forms adducts/complexes with DNA, causes single and double strand breaks

32
Q

Carboplatin: Toxicities

A

More marrow Supressive, less emetogenic, neurotoxic and nephrotoxic

33
Q

Doxorubicin: mechanism of action

A

Antibiotic. Direct DNA intercalation, Free radical formation

34
Q

Doxorubicin: Toxicities

A

Mucositis, Myelosupression, Cardiomyopathy

35
Q

Doxil: Mechanism of action

A

liposomal pegylated Doxirubicin. Direct DNA intercalation, Free radical formation

36
Q

Doxil: Toxicities

A

Mucositis, Myelosupression, Cardiomyopathy, Palmar plantar erythrodysesthesia (peeling from sking on palmar and platar surfaces)

37
Q

Bleomycin: Mechanism of action

A

Antibiotic. Forms complexes with DNA, breaking DNA helix

38
Q

Bleomycin: Toxicities

A

Pneumonitis, pulmonary fibrosis

39
Q

Bevacizumab (Avastin): Mechanism of action

A

Antivascular. Inhibit new blood vessel formation, regression of tumor microvessels, normalization of tumor vascularity.

40
Q

Bevacizumab (Avastin): Toxicities

A

Hypertension, Proteinuria, Bowel perforation

41
Q

Olaparib: Mechanism of action

A

PARP Inhibitor. used for treatment and maintenance. Binds PARP enzyme to prevent single stranded DNA repair

42
Q

Olaparib: Toxicities

A

Nausea, vomiting, dyspepsia, diarrhea

43
Q

Rucaparib: Mechanism of action

A

PARP inhibitor. used for treatement and maintenance. same mechanism as olaparib. BRCA mutation enhanced effect

44
Q

Rucaparib: Toxicities

A

Fatigue, anemia

45
Q

Niraparib: Mechanism of action

A

PARP inhibitor. used only for maintenance. Same mechanism as olaparib.

46
Q

Niraparib: Toxicities

A

rarely causes AML/MDS

47
Q

Pembrolizumab: Mechanism of action

A

Anti-PDL1 monoclonal antibody. Inhibits programmed cell death activity by binding to PD1 receptor on T cells, induces antitumor response and reverses T cell supression

48
Q

Pembrolizumab: Toxicities

A

Fatigue, rash, endocrine/metabolic disorders

49
Q

Pebrolizumab: Uses in Uterine cancer

A

MSI +/high tumor, dMMR positive tumor

50
Q

Pembolizumab: Uses in Cervical cancer

A

PDL1 positive tumor, CPS > 1 tumor

51
Q

Chemotherapy treatment: Epithelial Ovarian Cancer

A

Primary - Taxanes, platinums (Carboplatin, Paclitaxol)

Secondary - Doxorubicin, Topetecan, Gemcitabine, Olaparib, Pembro

52
Q

Chemotherapy Treatment: Germ Cell Ovarian Cancer

A

BEP - Bleomycin, Etoposide, Cisplatin

VAC - Vinblastine, Actinomycin-D, Cyclophosphamide

53
Q

Chemotherapy Treatment: Uterine Cancer

A

Primary - Taxanes, Platinums (Carboplatin, Paclitaxol

Secondary - Doxorubicin, Ifosphamide, megace, Pembro

54
Q

Chemotherapy Treatment: Cervico-Vaginal

A

Primary - Cisplatin + Radiation

Secondary- Carbotaxol, carboplatin/cisplatin, Bevacizumab, Pembro

55
Q

Chemotherapy Treatment: GTN

A

MAC - Methotrexate, Actinomycin-D, Cyclophosphamide

EMACO - Methotrexate, Actinomycin-D, Cyclophosphamide, Etoposide, Vincristine

Gynecologic Oncology (11 decks)

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