Final: Anticancer PKPD Flashcards
Carcinomas are derived from _____
Epithelial Cells
Sarcomas are derived from ______
Connective Tissue
Lymphomas are derived from ____.
Lymphatic Tissue
Leukemia are derived from _____
Blood forming elements.
_____ is chemotherapy given before surgical procedure to remove a tumor.
Neoadjuvant
______ is chemotherapy given to destroy left over cells which may be present after tumor is removed.
Adjuvant Therapy
_____ therapy includes TKIs and antibody mediated therapy.
Targetted Thearpy
Anticancer agents have a ____ therapeutic window with _____ interindividual variability.
Narrow
Wide (2-10 fold)
_____ plots are used to measure duration-free survival plots for anti-cancer agents.
Kaplan Meier
when paclitaxel is maintained above a Cp of _____ for _____ it has superior surivial according to one study covered in class.
0.1 for 15+ hours.
Describe the interaction between 5-FU and Leucovorin.
Positive PD Interaction: Leucovorin enhances 5-FU by inhibiting thymidylate synthetase activity.
Describe the interaction between platinum agents (cisplatin, carboplatin) and taxanes (paclitaxel and docetaxel).
When paclitaxel is followed by carboplatin, there is a decrease in the platinum adducts in the patients DNA. This leads to a reduction in off-target effects, and the ant-tumor activity of carboplatin.
Which PK indices are used for anticancer agents commonly.
- AUC
- Css
- Cmax
- Exposure time above threshold.
What is the problem with BSA Dose Optimization?
Simply because a patient has a higher BSA, does not mean they have larger organs as well.
Carboplatin is priori dose adjusted based on _____ and _____.
Renal Function as it is 75% cleared by the kidney.
Toxicity (Thrombocytopenia) —> monitor AUC. –> Can predict change in platelet counts.
Should we adjust doses simply because of age?
No, it is better to adjust based on individual physiology instead.
For obese patients, what should we cap BSA at for calculations.
2.2 m^2
Should we adjust complete priori dose adjustments based on pharmacogenomics for anticancer agents?
Yes
How does 5-Fluorouracil under go priori based dose adjustment?
Pharmacogenomic Based
Patients with a deficiency of DPD should receive lower doses of this drug.
How does 6-mercaptopurine under go priori based dose adjustment?
Based on the functional staus of thiopurine methyltransferase (TPMT) –> patients may clear this drug differently.
m/m = low CL
m/wt = mid CL
wt/wt= high CL (most common)
How is population PK used for anti-cancer drugs?
Sets to identify covariates in PD. If co-variate is clinically significant then modify the dose.
How does Dose-Limited Sampling Method work?
Sample at specific time points during the first course of therapy, then AUC can be adjusted using predictive models created by co-variate correlation to achieve target AUC.
What is the limitation of LSM?
Needs to be applied to the same drug at the same dose, administration, and duration.
How should methotrexate be monitored?
24-48 hours after start. Should be measured in 48 hour intervals.
If Methotrexate levels are greater than 1 uM, then _____ blank should be used.
Leucovorin—> MTX levels are monitored every 48 hours afterwards and Leucovorin levels are adjusted until MTX is <1.
