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PHM703 Heme/Onc/Crit Care > Exam 3 - Colorectal Cancer > Flashcards

Exam 3 - Colorectal Cancer Flashcards

1
Q

List risk factors for colorectal cancer?

A

PMH of polyps, IBD (IC, CD), family history, genetics (FAP, HNPCC/Lynch syndrome), smoking, heavy alcohol use (decreases folic acid stores), physical inactivity

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2
Q

List socieconomic/age risk factors for colorectal cancer?

A

diabetes, obesity, diet (high in red/processed meats), increasing age, race

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3
Q

List signs/symptoms of colorectal cancer?

A

bright red or dark blood in stool, change in bowel habits, abdominal discomfort, N/V

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4
Q

What is the MOA of leucovorin (folinic acid)?

A

stabilizes fdUMP binding to thymidylate synthase

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5
Q

What is the MoA of capecitabine (Xeloda)?

A

prodrug of 5-FU

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6
Q

What is the MoA of 5-fluorouracil?

A

inhibits thymidylate synthase

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7
Q

What are AEs of capecitabine (Xeloda)?

A

renal impairment dose adjustments, hyperbilirubinemia, diarrhea, Hand-foot syndrome, mucositis

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8
Q

What is a CI for capecitabine (Xeloda)?

A

dihydropyrimidine dehydrogenase (DPD) deficiency

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9
Q

What is the MoA of oxaliplatin (Eloxatin)?

A

platinum analog, non cell-cycle specific alkylating agent

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10
Q

What are AEs of oxaliplatin (Eloxatin)?

A

peripheral neuropathy, cold intolerance/sensitivity, myelosuppression

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11
Q

What are treatments for oxaliplatin-induced neuropathy? (3)

A

eating/drinking at room temp, GABA analogues, SNRIs (duloxetine)

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12
Q

What is the MoA of irinotecan (Camptosar)?

A

topoisomerase-1 inhibitor

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13
Q

What are AEs of irinotecan (Camptosar)?

A

DIARRHEA, fatigue, alopecia, myelosupression (neutropenia)

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14
Q

What are treatments for acute phase irinotecan-induced diarrhea?

A

atropine, diphenoxylate/atropine

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15
Q

What is treatment for delayed phase irinotecan-induced diarrhea?

A

loperamide

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16
Q

What is the MOA of bevacizumab (Avastin)?

A

recombinant, humanized MoAb to VEGF-A

17
Q

What is the MOA of Ziv-aflibercept (Zaltrap)?

A

fusion protein that inhibits VEGF-A/B

18
Q

What are AEs of bevacizumab (Avastin)?

A

HTN, delayed wound healing, proteinuria, hemorrhage (epistaxis), VTE

19
Q

What is a CI for bevacizumab (Avastin)?

A

uncontrolled HTN

20
Q

What is the MOA of ramucirumab (Cyramza)?

A

VEGF-R2 inhibitor

21
Q

What are AEs of ramucirumab (Cyramza)?

A

similar to other VEGF inhibitors

22
Q

List EGFR inhibitors? (2)

A

cetuximab (Erbitux), panitumumab (Vectibux)

23
Q

What are AEs of EGFR inhibitors?

A

infusion-related reactions, hypomagnesemia, paronchyia, aceniform rash

24
Q

What is the MOA of regorafenib (Stivarga)?

A

multikinase inhibitor

25
Q

What are AEs of regorafenib (Stivarga)?

A

fatigue, weight loss, diarrhea, hand-foot syndrome, HTN, infection

26
Q

List anti-HER2 therapies?

A

trastuzumab + pertuzumab or lapatinib

27
Q

What is the MOA of trifluridine + tipiracil (Lonsurf)?

A

interferes with DNA synthesis and inhibits cell proliferation by incorporation into DNA

28
Q

What are AEs of trifluridine + tipiracil (Lonsurf)?

A

myelosuppression, anemia, fatigue, N/V/D

29
Q

List immunotherapy options for colorectal cancers? (2)

A

nivolumab (Opdivo), pembrolizumab (Keytruda)

30
Q

What are AEs of nivolumab (Opdivo) and pembrolizumab (Keytruda)? (6)

A

rash, colitis, hepatitis, nephritis, pneumonitis, thyroid disorders

31
Q

What are treatments used for a BRAF mutation? (2)

A

cetuximab (Erbitux), encorafenib (Braftovi)

32
Q

What is treatment for Stage I colorectal cancer?

A

surveillance

33
Q

What is treatment for Stage II colorectal cancer?

A

surgery and consider adjuvant therapy in high risk (FOLFOX, CapeOX, capecitabine, 5-FU/leucovorin)

34
Q

What is treatment for Stage III colorectal cancers?

A

surgery with chemotherapy (FOLFOX, CapeOX (preferred); capecitabine, 5-FU/leucovorin)

35
Q

What is the duration of FOLFOX therapy in high risk Stage III colorectal cancers? Low risk?

A

6 months; 3-6 months

36
Q

What should NOT be used in Stage III colorectal cancers? (2)

A

targeted therapies, irinotecan

37
Q

What is treatment for Stage IV colorectal cancers?

A

chemotherapy (FOLFOX or FOLFIRI or CapeOx with additional drugs depending on cytogenetics)

PHM703 Heme/Onc/Crit Care (18 decks)

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