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Oncology > Colon Cancer > Flashcards

Colon Cancer Flashcards

1
Q

What is the class of 5-Fluorouracil?

A

Antimetabolite

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2
Q

What is the MOA of 5-Fluorouracil?

A
  • Prodrug metabolized to 5-fluorouridine-5’-triphosphate (FUTP) and 5-fluorodeoxyuridine-5’-monophosphate (FdUMP)
  • FUTP incorporated in RNA—impairs protein synthesis
  • FdUMP binds to thymidylate synthase (TS) in presence of methylenetetrahydrofolate (CH2-THF), reducing rate of DNA synthesis
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3
Q

What are the adverse effects of 5-Fluorouracil?

A
  • Alopecia
  • Hand-foot syndrome
  • Nausea/vomiting – low emetogenicity
  • Mucositis/stomatitis
  • Myelosuppression – neutropenia, thrombocytopenia, anemia
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4
Q

What is the class of Leucovorin?

A

Folinic acid

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5
Q

What is the MOA of Leucovorin?

A
  • Reduced form of folinic acid enhances inhibition of thymidylate synthase
  • Increases the effects of 5FU
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6
Q

What are the side effects of Leucovorin?

A
  • Rash/pruritis
  • Nausea/diarrhea
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7
Q

What is the class of Oxaplatin?

A

Alkylating agent

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8
Q

What is the MOA of Oxaplatin?

A

Binds to DNA, forms crosslinks

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9
Q

What are the side effects of Oxaplatin?

A
  • Neuropathy (76%)—acute and persistent
  • Nausea/vomiting (65%)—highly emetogenic
  • Diarrhea (46%)
  • Fatigue (41%)
  • Myelosuppression—anemia (64%), thrombocytopenia (30%)
  • Elevated AST (36%)/ALT (54%)
  • Hypersensitivity reactions
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10
Q

Acute Oxaplatin-Induced Neuropathy

A
  • Onset: hours to days
  • Resolution: within 2 weeks
  • Frequently recurs with further dosing
  • Symptoms: Paresthesia/dysesthesia/hypoesthesia in the hands, feet, perioral area, or throat
  • Exposure to cold temperatures or cold objects can precipitate or exacerbate symptoms
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11
Q

Persistent Oxaplatin-Induced Neuropathy

A
  • Paresthesia, dysesthesia, hypoesthesia, and possibly proprioception
  • May occur without prior acute neuropathy
  • Longer than 2 weeks
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12
Q

What is the administration and monitoring of Oxaplatin?

A

Administration: IV infusion over 2-6 hours

Monitoring:
-CBC w/ differential
-Liver function tests
-Serum creatinine
-Signs/symptoms of neuropathy
-Signs/symptoms of hypersensitivity

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13
Q

What is the class of Irinotecan?

A

Topoisomerase I inhibitor

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14
Q

What is the MOA of Irinotecan?

A

Prevents repair of single-stranded breaks by binding to the topoisomerase 1-DNA complex

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15
Q

What are the side effects of Irinotecan?

A
  • Diarrhea (90%)—acute (50%) vs. late (85%)
  • Nausea/vomiting—highly emetogenic
  • Myelosuppression—anemia (60-90%), neutropenia (30-96%), anemia (60-97%)
  • Alopecia (46-72%)
  • Electrolyte abnormalities (hypocalcemia, hyponatremia)
  • Fever (45%)
  • Mucositis (30%)
  • Elevated bilirubin (84%)
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16
Q

What is the administration of Irinotecan?

A

IV infusion over 90 minutes

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17
Q

What is the class of Capecitabine?

A

Antimetabolite

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18
Q

What is the MOA of Capecitabine?

A

Oral prodrug of 5-FU

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19
Q

What are the side effects of Capecitabine?

A
  • Nausea/vomiting—moderately emetogenic
  • Diarrhea (47-57%)
  • Mucositis (25%)
  • Hand-foot syndrome (54-60%)
  • Myelosuppression—anemia (72%), neutropenia (26%), thrombocytopenia (24%)
  • Elevated bilirubin (22-48%)
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20
Q

What are the monitoring parameters of Capecitabine?

A
  • CBC w/ differential
  • Liver function tests
  • Renal function tests
  • Diarrhea
  • Hand-foot syndrome

Drug interaction: May increase levels of phenytoin and warfarin

21
Q

What are the classes of Trifluridine and Tipiracil?

A

Antimetabolite (pyrimidine analog)

22
Q

What is the MOA of Trifluridine and Tipiracil?

A
  • Trifluridine is incorporated into DNA and interferes w/ DNA synthesis
  • Tipiracil prevents rapid degradation of trifluridine, allowing increased exposure
23
Q

What are the adverse effects of Trifluridine and Tipiracil?

A
  • Fatigue (<= 52%)
  • GI: Nausea (48%), decreased appetite (39%), diarrhea (32%), vomiting (28%), abdominal pain (21%)
  • Heme: Hgb (77%), WBC (67%), platelets (42%)
  • Weakness (<= 52%)
  • Fever (19%)
24
Q

What is the dosing of trifluridine?

A

35 mg/m2 twice daily on days 1 to 5 and days 8 to 12 of a 28-day cycle

25
Q

What is the administration and monitoring parameters of Trifluridine and Tipiracil?

A

Administration: Orally twice daily within 1 hour of completion of morning and evening meals

Monitoring:
-Complete blood counts prior to each cycle and on day 15 of each cycle (more frequently if necessary)
-Signs/symptoms of gastrointestinal toxicity

26
Q

What is the class of Bevacizumab?

A

Recombinant humanized monoclonal antibody

27
Q

What is the target of Bevacizumab?

28
Q

What is the class of Cetuximab?

A

Murine-human chimeric monoclonal antibody

29
Q

What is the target and CRC marker of Cetuximab?

A
  • EGFR
  • KRAS wild type
30
Q

What is the class of Panitumumab?

A

Fully human IgG2 monoclonal antibody

31
Q

What is the target and CRC marker of Panitumumab?

A
  • EGFR
  • KRAS wild-type
32
Q

What is the class of Ziv-Aflibercept?

A

VEGF inhibitor

33
Q

What is the target of Ziv-Aflibercept?

A
  • VEGF (acts as a decoy VEGF receptor)
34
Q

What is the class of Ramucirumab?

A

Monoclonal antibody

35
Q

What is the target of Ramucirumab?

36
Q

What is the class of Pembrolizumab?

A

Immune checkpoint inhibitor

37
Q

What is the target and CRC marker of Pembrolizumab?

38
Q

What is the class of Nivolumab?

A

Immune checkpoint inhibitor

39
Q

What is the target and CRC marker of Nivolumab?

40
Q

What is the class of Ipilimumab?

A

Immune checkpoint inhibitor

41
Q

What is the target and CRC marker of Ipilimumab?

A
  • CTLA-4
  • MSI-H
42
Q

What is the class of dostarlimab-gxly?

A

Immune checkpoint inhibitor

43
Q

What is the target and CRC marker of Dostarlimab-gxly?

A
  • PD1
  • Deficient mismatch repair (dMMR)
44
Q

What is the target of Regorafenib?

45
Q

What is the target and CRC marker for Encorafenib?

A
  • BRAF inhibitor
  • BRAF V600E mutation
46
Q

What is the target and CRC marker for Trastuzumab?

A
  • HER2
  • HER2+ tumors
47
Q

What is the target and CRC marker for Lapatinib?

A
  • HER2
  • HER2+ tumors
48
Q

What is the target and CRC marker for Tucatinib?

A
  • HER2
  • HER2+ tumors
49
Q

What is the target and CRC marker for Pertuzumab?

A
  • HER2
  • HER2+ tumors

Oncology (14 decks)

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