Chemotherapy deck that isn’t 200 notecards

Question 1

First-line treatment of NSCLC

Answer 1

Pemetrexed + Cisplatin

Question 2

4 First-line therapy options for metastatic colorectal cancer

Answer 2

Irinotecan + 5-FU + leucovorin [Ziv-aflibercept added if progression observed w/oxaliplatin-based therapy]

Irinotecan + Oxaliplatin + Cetuximab

Oxaliplatin + Capecitabine [XELOX regimen]

Bevacizumab + any IV fluoropyrimidine-containing regimen (5-FU, capecitabine, etc.)

Question 3

2 First-line therapy options for chronic phase CML

Answer 3

Nilotinib

Imatinib

Question 4

First-line treatment for metastatic NSCLC in patients with EGFR mutations and in patients that are refractory to at least one prior chemotherapy regimen

Answer 4

Erlotinib

Question 5

First-line tx of metastatic NSCLC with EGFR mutations

Answer 5

Afatinib

Question 6

First-line treatment for metastatic colorectal cancer in combination with any IV fluoropyrimidine-containing regimen

Answer 6

Bevacizumab

Question 7

Irreversibly blocks dihydrofolate reductase, thus inhibiting synthesis of THF

Causes folate deficiency and subsequent megaloblastic anemia, pulmonary fibrosis, hepatoxicity

Answer 7

Methotrexate

Question 8

Drug that can reverse the toxic effects of MTX

Answer 8

Leucovorin (folinic acid)

Question 9

Cytotoxic pyrimidine analog that complexes with THF and inhibits thymidylate synthase, blocking thymidine production and increasing levels of dUMP

active against many solid tumors

Associated with diarrhea, cutaneous complications like photosensitivity and hyperpigmentation

Answer 9

5-FU

Question 10

Cytotoxic purine analog activated by HGPRT; blocks synthesis of IMP leading to decreased purine synthesis

Treats hematologic malignancies like ALL

May cause pancreatitis or hepatitis — increased risk in those on xanthine oxidase inhibitors

Answer 10

6-mercaptopurine

Question 11

Cytotoxic purine analog that treats hairy cell leukemia

Answer 11

Cladribine

Question 12

Cytotoxic pyrimiding analog that is only active against hematologic malignancies like AML, NHL, etc.

Answer 12

Cytarabine

Question 13

Cytotoxic pyrimidine analog that is active against both hematologic and solid malignancies

Answer 13

Gemcitabine

Question 14

Cytotoxic alkylating agent activated by hepatic CYP450

AEs include hemorrhagic cystitis, increased risk of bladder cancer, hyponatremia d/t SIADH, and infertility + premature menopause

Answer 14

Cyclophosphamide

Question 15

Cytotoxic alkylating agent given prior to bone marrow transplant

AEs include lung toxicity — acute lung injury, interstitial fibrosis, alveolar hemorrhage, as well as hyperpigmentation rxn

Answer 15

Busulfan

Question 16

Highly lipophilic chemotherapeutic drugs that cross BBB so they are used to treat brain tumors like glioblastoma multiforme

AEs include neurotoxicity — convulsions, dizziness, ataxia

Answer 16

Nitrosoureas — Carmustine, streptozocin

Question 17

Cytotoxic platinum analogs that form crosslinks in DNA; treat various solid malignancies

AEs include ototoxicity (sensorineural loss, tinnitus), neurotoxicity (peripheral neuropathy), acute kidney injury, myelosuppression, immunosuppression, and increased risk of infection

Answer 17

Cisplatin
Carboplatin
Oxaliplatin

Note: ototoxicity, neurotoxicity, and nephrotoxicity are higher risk with cisplatin; myelosuppression etc. is higher risk with carboplatin

Question 18

Binds DNA and produces free radicals causing single and double stranded breaks — blocking G2 of cell cycle

AEs include pulmonary toxicity — pneumonitis, pulmonary infiltrates; skin rash/exfoliation/hyperpigmentation

Answer 18

Bleomycin

Question 19

Produce free radicals that intercalate in DNA — blocking DNA and RNA synthesis

AEs include CARDIOTOXICITY (prevented by dexrazoxane)

Answer 19

Anthracyclines: Doxorubicin, Daunorubicin

Question 20

Topoisomerase II inhibitor leading to dsDNA breaks as well as inhibition of re-ligation of DNA; blocks G2 and S phases

Answer 20

Etoposide

Question 21

Topoisomerase I inhibitors that lead to single stranded DNA nicks

AEs include severe diarrhea

Answer 21

Topotecan

Irinotecan

Question 22

Natural chemotherapeutics that inhibit microtubule production and mitotic spindle assembly; block M phase of cell cycle

AEs include neurotoxicity (peripheral sensory neuropathy) and autonomic dysfunction — paralytic ileus, constipation

Answer 22

Vinca alkaloids — Vincristine, vinblastine

[AEs more common with vincristine, except myelosuppression is more common with vinblastine]

Question 23

Natural chemotherapeutics that enhance microtubule production and prevent their degradation —> improper mitotic spindle function

AEs include neurotoxicity — peripheral sensory neuropathy

Answer 23

Taxanes: paclitaxel

Question 24

Blocks tyrosine kinase domain of BCR/ABL fusion protein in CML
as well as c-kit tyrosine kinase in GI stromal tumors

AEs include fluid retention — ankle and periorbital edema

Answer 24

Imatinib

Question 25

Blocks EGFR tyrosine kinase; treats solid tumors with EGFR overexpression (e.g., NSCLC)

AEs include papulopustular acneiform rash and diarrhea

Answer 25

Erlotinib

Question 26

Inhibit VEGFR tyrosine kinase; treat cancer w/VEGFR overexpression (RCC)

AEs include hyperkeratosis and skin rash, increased risk of hemorrhage

Answer 26

Sunitinib

Sorafenib

Question 27

Chimeric monoclonal Ab that binds EGFR RTK; treats solid tumors

AEs include infusion reaction, serum sickness, papulopustular acneiform rash

Answer 27

Cetuximab

Question 28

Binds VEGF and inhibits growth of blood vessels in tumors; treats metastatic tumors

AEs include bleeding, thrombotic events, and GI perforation

Answer 28

Bevacizumab

Question 29

Hand-foot syndrome is painful erythema and swelling of hands and feet associated what what class of chemotherapeutics?

Answer 29

Antimetabolites (i.e., pemetrexed)

Question 30

What are the immune checkpoint inhibitors

Answer 30

Nivolumab, pembrolizumab (PD-1 inhibitors; tx melanoma, NSCLC, HL)

Atezolizumab, avelumab, durvalumab (PD-L1 inhibitors; tx bladder cancer, NSCLC, Merkel cell skin cancer)