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Clinical Medicine Heme/Onc > Chemotherapy in Hematology-Oncology > Flashcards

Chemotherapy in Hematology-Oncology Flashcards

1
Q

Problems with cancer?

A
  • Surrounding anatomy is compromised
  • Hormone synthesis is affected
  • Cancer required increased blood flow; necrosis occurs when growth of cancer exceeds growth of vasculature
  • Malnutrition
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2
Q

Cancer treatment?

A

Based on primary site (bone cancer as a result of breast cancer is treated as breast cancer)

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3
Q

Does staging change throughout treatment?

A

NO

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4
Q

Cure rate of chemotherapy

A

10-15% of cancers

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5
Q

Cancers which respond favorably and have curative potential with chemo?

A
  • Choriocarcinoma
  • ALL
  • Hodgkin disease
  • Burkitt’s lymphoma
  • Wilm’s tumor
  • Testicular cancer
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6
Q

Adjuvant?

A

Used after surgery to kill any remaining cancer cells that may be undetectable

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7
Q

Neoadjuvant?

A

Chemotherapy given prior to surgery to shrink tumor

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8
Q

Palliative?

A

Relieves symptoms but is not expected to reduce cancer

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9
Q

Induction?

A

Chemotherapy given to induce remission

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10
Q

Consolidation?

A

Also called intensification, goal is to sustain remission

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11
Q

Maintenance?

A

Low dose chemotherapy to prolong remission

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12
Q

Classes affecting M phase?

A
  • Vinca alkaloids
  • Taxanes
  • Antimicrotubule inhibitor
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13
Q

Classes affecting S phase?

A
  • Antimetabolites

- Epipodophyllotoxin (Topoisomerase II inhibitors)

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14
Q

Classes affecting G2 phase?

A
  • Antitumor antibiotics

- Epipodophyllotoxin (Topoisomerase II inhibitors)

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15
Q

Meds causing pulmonary fibrosis?

A
  • Bleomycin (CCS)

- Busulfan (CCNS)

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16
Q

Meds causing peripheral neuropathy

A
  • Taxanes

- Platinum analogs (cisplatin)

17
Q

Secondary cancers that respond well to treatment?

A

Topoisomerase II inhibitors

  • etoposide
  • teniposide
  • mitoxantrone
18
Q

Secondary cancers that DO NOT respond well to treatment?

A

Alkylating agents/platinum analogs

  • mechlorethamine
  • chlorambucil
  • cyclophosphamide
  • melphalan
  • lomustine
  • carmustine
  • busulfan
  • cisplatin
  • carboplatin
19
Q

Where can chemo drugs be found?

A

In bodily fluids!

  • Disposable gloves
  • Everything should be washed separate
20
Q

Glucocorticoids?

A

Commonly used in leukemias and lymphomas along with other agents

  • prednisone
  • dexamethasone
21
Q

Estrogen and androgen antagonists?

A
  • Tamoxifen blocks estrogen in estrogen dependent breast cancer
  • Flutamide blocks androgens in prostate cancer
22
Q

Gonadoropin releasing hormone analogs?

A

Used in prostate cancers

  • leuprolide
  • goserelin
23
Q

Aromatase inhibitors?

A

Important for the conversion of androgen to estrogen

  • anastrozole
  • letrozole
24
Q

Interferons?

A
  • Naturally occurring endogenous glycoproteins that are antiviral and antineoplastic
  • Fatigue and flu-like symptoms are a problem
25
Q

Tyrosine kinase inhibitors?

A
  • Imatinib (Gleevec) began the revolution
  • Once a day ORAL medication
  • Effectiveness of Gleevec depends on whether patient is in accelerated phase, chronic phase, or blastic phase (worse prognosis)
  • Target BCR-ABL tyrosine kinase inhibitor
26
Q

Bevacizumab side effects?

A
  • Arterial thromboembolic events (MI/stroke) in 4%
  • HTN
  • Bowel perforation
27
Q

EGFR inhibitors?

A
  • Acneiform rash

- The worse the rash, the better the treatment is working!

28
Q

Increased risk of squamous cell carcinoma of skin?

A
  • vemurafenib

- dabrafenib

29
Q

Non-hodgkin Lymphoma?

A
  • CHOP and R-CHOP
  • Monoclonal antibodies
  • Interferon
  • Immunomodulators
30
Q

Hodgkin disease?

A
  • ABVD
  • Stanford V
  • BEACOPP
  • Monoclonal antibodies
31
Q

ALL?

A
  • Tyrosine kinase inhibitors

- Effective in patients with Philadelphia chromosome

32
Q

CLL?

A

Just recognize there are a lot of drugs

33
Q

AML?

A

Cytarabine and antracyclines are the most commonly used

34
Q

CML?

A
  • Gleevec has changed the world of CML treatment
  • Tyrosine kinase inhibitors are the mainstay of treatment for CML due to the presence of the BCR-ABL oncogene
  • If the leukemia produces the T315I mutation that prevents TKIs from being effective, omacetaxine may be used
35
Q

Multiple Myeloma?

A

LOTS OF REGIMENS
Also:
Bisphosphonates
Interferon

36
Q

Ewing’s Sarcoma?

A

Alternate between two combinations given every 2-3 weeks for about 14-15 cycles

  • VAdriaC
  • IE

Clinical Medicine Heme/Onc (11 decks)

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