Drugs to Treat Ovarian and Bladder Cancer Flashcards
What is the most important risk factor for Epithelial Ovarian Carcinoma?
Cancer in a 1st degree relative
For Ovarian Cancer limited to the ovary and peritoneum, what drug can be administered intraperitoneally?
- advantages?
- *High Volume Cisplatin Instillation**
- allows for high drug concentration without systemic toxicity
What Drugs (4 or 5 of them) are used in treatment of ovarian cancer? \*\*What drug should be included for more advanced cancers?
Platinum Drug + Cyclophosphamide or Doxorubicin or Paclitaxel
More advanced cancers require Paclitaxel
What is the most common presenting symptom in bladder cancer?
Hematuria
BCG
- Administration
- MOA
- Indication
BCG (Bacillus-Calmette-Guerin)
ADMINISTRATION
Intravesicular
MOA
Binding to Urothelial cells attracts APCs that present cancer cell antigens to Lymphocytes, NK cells, ect that will learn to recognize cancer cell antigens
INDICATION
Bladder Cancer
What abnormal histology might be seen in bladder cancer if it has been treated with BCG?
**Could see granulomas in the bladder of someone treated with BCG for bladder cancer**
Carboplatin
- MOA
- AEs
MOA:
- Forms DNA intrAstrand crosslinks and adducts
AE:
- Allergic (platinum) rxns, dose-related myelo-suppression, cumulative anemia, BLOOD DYSCRASIA, N/V.
- Increased Hepatic Enzymes, BUN and Creatinine
- Oto/Nephro/Neurotoxic, but not to the extent of cisplatin
*Indicated for the treatment of bladder cancer
Cisplatin
- MOA
- AEs
Cisplatin:
- forms DNA intrAstrand crosslinks and adducts
AEs:
- Allegeric (platinum) rxns, Dose-related SEVERE (dose-limiting) nephrotoxicity, myelosuppression, N/V.
- OTOTOXICY, Nephropathy
Indicated for tx of bladder CA
Cyclophosphamide
- MOA
- AEs
Cyclophosphamide
MOA:
- Pro-drug of active alkylating moiety
Indication:
- Renal Compromise, HEMORRHAGIC CYSTITIS (give mesna), Amenorrhea, infertitlity, Pulmonary Fibrosis
Doxorubicin
MOA
AEs
Doxorubicin
MOA
- Intercalator, free radical generator, topo II inhibitor (etoposide is also a topo II inhibitor, the tecans inhibit topo I)
AEs
- myelosuppression, CHF (dilated cardiomyopathy), Hepatic disease, secondary malignancy, extravasational necrosis
Mitomycin C
- MOA
- AEs
Mitomycin C
MOA
- Mono and Bi-functional alkylating agent
AEs
- Pancytopenia, CHEMICAL CYSTITIS (along with cyclophosphamide), Contact dermititis, PALMAR and PLANTAR erythema IF contact made with sol’n DIRECTLY or IN URINE
Paclitaxel
MOA
AEs
MOA
Stabilizes microtubues and prevents the cell from exiting M-phase
AEs
Neuropathy
Thiotepa
- MOA
- AEs
Thiotepa
MOA
- Polyfunctional alkylator with loss of aziridine (alkylator) moeity
AEs
- Dysuria, Urinary Retention, Chemical/Hemorrhagic Cystitis, Renal Dysfunctoin
What drug are often administered intravesicularly in bladder cancer?
Mitomycin C
Thiotepa
BCG
What 3 drugs used to treat bladder CA cause hemorrhagic cystitis?
Cyclophosphamide
Mitomycin C
Thiotepa
What drug that is commonly administered intravesicularly is likely to have systemic effects despite the route of administration?
- Why?
Thiotepa is a LOW MW drug and thus can diffuse through urothelial tissue and have systemic effects
NOTE - all of these drugs damage the integrity of the bladder to some extent giving them a greater chance of going systemic
NOTE - all of these drugs damage the integrity of the bladder to some extent giving them a greater chance of going systemic
What two drugs used to treat bladder cancer have the potential to cause pulmonary fibrosis and unproductive cought?
- what unique side effect could differentiate these two?
Both Mitomycin C and Cyclophosphamide could do this.
Mitomycin C has the unique effect of cause erythema when it comes into contact with skin
