Drugs for Lung Cancer Flashcards
When is bevacizumab not recommended?
squamous cell carcinomas because it can lead to severe bleeding and increased cavitation.
Also when there is hemoptysis or brain metastases
What mutations can render erlotinib inneffective?
KRAS mutations because the proliferative pathway remains active downstream of the drug blockade
Which mutations are more common in non-smokers?
EGFR, EML4-ALK, and hMSH2
What is treatment for SCLC?
etoposide and cisplatin or carboplatin. Surgery is typically not an option because of early metastisis
What is treatment for NSCLC?
cisplatin AND paclitaxel, gemcitabine, docetaxel.
If EGFR positive use erlotinb. Bevacizumab for those with non-squamous histo or hemoptysis.
What is MOA of carboplatin?
forms DNA intrastrand crosslinks and adducts
What is MOA of cisplatin?
forms DNA intrastrand crosslinks and adducts
What is MOA of cyclophosphamide?
pro-drug of active alkylating moiety
What is MOA of doxorubicin?
intercalator, free radical generator, topo II inhibitor
What is MOA of etoposide?
DNA topo II complex stabilizer
What is MOA of gemcitabine?
DNA polymerase inhibitor via incorporation of triphosphate form during DNA synthesis
What is MOA of ifosfamide?
intra and inter-strand cross linker
What is MOA of irnotecan?
DNA-topo I complex stabilizer
What is MOA of paclitaxel?
microtubule stabilizer inhibition depolymerization
What is MOA of pemetrexed?
DHFR inhbitor
What is MOA of topotecan?
DNA topo I complex stabilizer
What is MOA of vincristine?
microtubule inhibitor, tubules disintegrate int spiral aggregates/ protofilaments.
What is MOA of vinorelbine?
microtubule inhibitor, tubules disintegrate int spiral aggregates/ protofilaments.
What are main adverse effects of carboplatin?
platinum allergies, myelosuppression, anemia, increased hepatic enzymes, BUN and creatinine.
What are main adverse effects of cisplatin?
platinum allergies, nephrotoxicity, myelosuppression and ototoxicity
What are main adverse effects of cyclophosphamide?
anemia, renal compromise, hemorrhagic cstitis, pulmonary fibrosis
What are main adverse effects of doxorubicin?
myelosuppression, CHF, hepatic disease
What are main adverse effects of etoposide?
myelosuppression, hematologic toxicity, alopecia
What are main adverse effects of gemcitabine?
arthralgia, fatigue, peripheral neuropathy
What are main adverse effects of ifosfamide?
alopecia, neurotoxicity, hematuria renal failure
What are main adverse effects of irinotecan?
myelosuppression, diarrhea, asthenia
What are main adverse effects of paclitaxel?
taxane hypersensitivity, myalgia and arthalgia
What are main adverse effects of pemetrexed?
GI toxicity. Elevated LFTs and creatinine. Can’t combine with cisplatin because of GI toxicity
What are main adverse effects of topotecan?
GI toxicity, hyperbilirubinemia
What are main adverse effects of vinblastine?
neuropathic toxicity, neutropenia
What are main adverse effects of vinorelbine?
myelosuppression, neuropathic toxicity, neutropenia.
What is MOA of erlotinib?
reversible inhibitor selective for EGFR
What are main adverse effects of erlotinib?
liver and kidney problems, corneal perforations and rash
