GI Cancer Pharm

Question 1

Anal cancer therapy

Answer 1

Cisplatin + 5-FU + Mitomycin

Question 2

Colorectal cancer therapy

Answer 2

FOLFOX or FOLFIRI (F-5U + Leucovorin + oxaplatin)

Question 3

Esophageal cancer therapy

Answer 3

Cisplatin + F-5U/Cisplatin + Vinblastine

Taxane is second-line

Question 4

Gastric cancer therapy

Answer 4

Test everyone for HER2
Trastuzumab always if positive

5-FU + Cisplatin standard

Glutamic acid to balance HCl deficiency

Question 5

GI Carcinoid tumor therapy

Answer 5

Octreotide (somatostatin inhibitor) inhibits serotonin causing inc. intestinal absorption and less gastric acid secretion
Treat for ~12 months because tachyphylaxis

IFN-alpha inhibits disease progression and provides relief

Question 6

IFN-alpha side effects

Answer 6

Alopecia
Anorexia
Fatigue
Fever
FLU-like 
Myelosuppression

Question 7

GI stromal tumors therapy

Answer 7

NOT cytotoxic therapy
TKIs!
Imatinib is first line for difficult ones
Sunitinib malate is even stronger and for worse cases

Question 8

Pancreatic cancer therapy

Answer 8

Enzyme replacement for malnutrition
Gemcitabine or F-5U
Erlotinib or FOLFIRINOX (leuco-irino-oxiplatin)

Question 9

Liver cancer therapy

Answer 9

TACE: trans-catheter arterial chemoembolization: doxo injected while hepatic arterial branch feeding tumor is occluded

Sorafenib: standard of care for advanced HCC