GI cancer drugs

Question 1

bevacizumab moa

Answer 1

anti-VEGF

Question 2

bevacizumab adverse effects

Answer 2

bleeding, GI perforation, wound dehiscence, HTN

Question 3

cetuximab moa

Answer 3

anti-EGFR

Question 4

cetuximab adverse effects

Answer 4

cardiac arrest, respiratory arrest, and sudden death; acne form rash in 80%

Question 5

erlotinib moa

Answer 5

EGFR tyrosine kinase inhibitor

Question 6

erlotinib adverse effects

Answer 6

Bleeding, elevated LFTs, ocular toxicity, interstitial lung disease

Question 7

glutamic acid moa

Answer 7

nutritional supplement; used to counterbalance deficiencies of HCl in the gastric juice

Question 8

imatinib moa

Answer 8

KIT tyrosine kinase inhibitor

Question 9

imatinib adverse effects

Answer 9

CHF in some patients, neurologic toxicity, GI toxicity

Question 10

leucovorin moa

Answer 10

reduced folate; synergies with 5-FU

Question 11

methysergide moa

Answer 11

serotonin inhibitor in the GI tract, causing vasoconstriction; used for migraines

Question 12

octreotide moa

Answer 12

somatostatin analog; reduces duodenal bicarb and amylase, gastric acidity, inhibition of GB contractility and bile secretion, meal induced increases in SMA and portal flow.

Question 13

octreotide adverse effects

Answer 13

inhibition of insulin and glucagon. dose related diarrhea

Question 14

sorafenib moa

Answer 14

oral multikinase inhibitor targeting serine/threonine and receptor tyrosine kinases in both tumor and vasculature:
Raf, VEGFR 2&3, PDGFR-beta, KIT, FLT-3, and RET

Question 15

sorafenib adverse effects

Answer 15

hand-food skin reaction characterized by redness, pain, swelling, or blisters on the palms of the hands or soles of the feet, generally in first 6 weeks of treatment

Question 16

sunitinib moa

Answer 16

inhibitor of >80 RTKs including PDGFR alpha and beta, VEGFR1,2,3, KIT, FLT-3, CSF-1R, and RET

Question 17

sunitinib adverse effects

Answer 17

thrombocytopenia and bleeding, QT prolongation, sometimes fatal GI complications including perforation

Question 18

trastuzumab moa

Answer 18

HER-2/neu antibody, causing HER2 downregulation, leading to accumulation of CDK inhibitor p27, causing cell cycle arrest; also inhibits HER2 cleavage mediated by metalloproteases, which may correlate with the clinical activity

Question 19

trastuzumab adverse effects

Answer 19

LVEF dysfunction and cardiomyopathy, severe infusion-related reactions including anaphylaxis, angioedema, and pulmonary toxicity; pulmonary toxicity is worse in patients with interstitial lung disease