Heme onc Flashcards
ras
protooncogene; lung, colon, pancreas, bladder
n-myc
protooncogene; neuroblastoma, small cell cancer of the lung
ERB-B1
protooncogene; squamous cell carcinoma of the lung
ERB-B2
protooncogene; breast, ovarian cancer
TGF- alpha
protooncogene; astrocytoma, HCC
sis
protooncogene; astrocytoma, osteosarcoma
abl
protooncogene; CML, ALL
BRCA 1,2
anti-oncogene; breast, ovarian cancer
NF-1
antioncogene; neuroblastoma, neurofibramatosis 1, sarcoma
APC
antioncogene; colon (familial adenomatous polyposis)
DCC
antioncogene; colon
p53
antioncogene; most cancers, li-fraumeni
RB
antioncogene; retinoblastoma, osteosarcoma
WT-1
Wilm’s tumor
Azathioprine, 6-mercaptopurine, 6-thioguanine
Antimetabolite: Purine analog, decrease purine synthesis, activated by HGPRT; immunosuppresant, RA, IBD, SLE; used to wean off steriod therapy; myelosuppression, GI, liver, metabolized by xanthine oxidase, so increased toxicity with allopurinol
Cladribine
Antimetabolite: Purine analog; hairy cell leukemia; myelosuppression, nephrotoxicity, neurotoxicity
Cytarabine
Antimetabolite: Pyrimidine analog/inhibition of DNA polymerase; leukemias (AML), lymphomas; pancytopenia
5-FU
Antimetabolite: Pyrimidine analog (activated by 5F-dUMP), inhibits thymidylate synthase, lowers dTMP, lowers DNA synthesis; colon cancer, pancreatic cancer, BCC (topical); myelosuppression (not reversible with leucovorin)
Methotrexate
Antimetabolite: FA analog, competitve inhibitor of DHF, lowers dTMP, lowers DNA synthesis; cancers ((leukemia, ALL esp), lymphoma, choriocarcinoma, sarcoma), non-cancer (ectopic, abortion, RA, IBD, psoriasis, vasculitis); myelosuppression (reversible with leucovorin), hepatotoxicity, mucositis, pulmonary fibrosis
Bleomycin
Antitumor antibiotic: Induces free radical formation that breaks DNA strands; testicular cancer, Hodgkin lymphoma; pulmonary fibrosis, skin hyperpigmentation, mucositis, minimal myelosuppression
Dactinomycin
Antitumor antibiotic: Intercalates in DNA; children’s tumors (wilms, ewing, rhabdomyosarcoma); myelosuppression
Doxorubicin, daunorubicin
Antitumor antibiotic: generates free radicals, intercalate in DNA; solid tumor, leukemia, lymphoma; cardiotoxicity (DCM) - can be prevented with dexrazosane the iron chelator, myelosuppression, alopecia
Busulfan
Alkylating agent: cross-links DNA; CML. Also used to ablate BM before BM transplantation; severe myelosuppression, pulmonary fibrosis, hyperpignmentation
Cyclophosphamide
Alylating agent: cross-link DNA at guanine N-7 (requires liver bioactivation); solid tumor, leukemia, lymphoma; myelosuppression, hemorrhagic cystitis (partially prevented with mesna)
Nitrosoureas
Alkylating agent: cross-link DNA, can cross BBB, requires bioactivation; brain tumor (inc GBM); CNX toxicity (convulsion, dizziness, ataxia)
Paclitaxel
Microtubule inhibitor: hyperstabilize polymerized microtubules in M phase so that mitotic spindle cannot break down and anaphase cannot occur; ovarian and breast carcinomas; myelosuppression, alopecia, hypersensitivity reactions
Vincristine, vinblastine
Microtubule inhibitor: vinca alkaloids that bind beta-tubulin and inhibit polymerization into microtubules - prevent mitotic spinde formation (arrest M-phase); solid tumors, leukemias, Hodgkin (vinblast), non-Hodgkin (vincristine); Vincristine (neurotoxicity), vinblastine (BM suppression)
Cisplatin
Cross-link DNA; testicular, bladder, ovary, lung carcinoma; nephrotoxicity (prevent with amifostine (free radical scavenger and saline diuresis), ototoxicity
Etoposide, teniposide
Inhibits topoisomerase II, increases DNA degradation; testicular and small cell lung cancer, leukemias, lymphomas; myelosuppression, GI upset, alopecia
Irinotecan, topotecan
Inhibit topoisomerase I, prevent DNA unwinding and replication; irinotecan = colon cancer, topotecan = ovarian and small cell lung cancer; severe myelosuppression, diarrhea
Hydroxyurea
Inhibit ribonucleotide reductase, inhibit DNA synthesis in the S phase; melanoma, CML, SCD; severe myelosuppression, GI upset
Prednisone, prenisolone
Bind intracytoplasmic receptor; CLL, non-Hodgkin lymphoma; Cushing-like symptoms
Bevacizumab
Monoclonal anti-VEGF antibody, inhibits angiogenesis; colon cancer, RCC; hemorrhage, blood clots, impaired wound healing
Erlotinib
EGFR tyrosine kinase inhibitor; non-small cell lung carcinoma; rash
Imatinib
Tyrosine kinase inhibitor of BCR-ABL and c-kit; CML, GI stromal tumors; fluid retention
Rituximab
Anti-Cd20 monoclonal antibody; Non-Hodgkin lymphoma, CLL, IBD, RA; risk of PML
Tamoxifen, raloxifene
Selective estrogen receptor modulators (antagonist at breast, agonist at bone); tamoxifen = breast cancer, raloxifene = osteoporosis; tamoxifen - endometrial cancer, hot flashes
Trastuzumab (Herceptin)
Her2 (tyrosine kinase receptor) monoclonal antibody; inhibition of Her2-initiated cellular signalling and antibody-dependent cytotoxicity; Her2 positive breast cancer and gastric cancer; cardiotoxicity
Vemurafenib
Small molecule inhibitor of BRAF oncogene positive melanoma; metastatic melanoma
