Lung Cancer Drugs

Question 1

What is crizotinib

Answer 1

Oral ALK receptor inhibitor

Question 2

When would you use crizotinib

Answer 2

First line treatment of adults with anaplastic lymphoma kinase (ALK) +ve advanced NSCLC

Question 3

Side effects of crizotinib

Answer 3

Visual problems (blurred, photophobia, Diplopia) 
N&v
Diarrhoea 
Oedema (face and general)
Neuropathy 
Neutropenia 
Interstitial lung disease

Question 4

Chemo for advanced/metastatic NSCLC with no EGFR/ALK mutation

Answer 4

Cisplatin and pemetrexed 4-6 cycles then pemetrexed maintenance

Question 5

Three options for treating advanced or metastatic lung cancer with EGFR mutation

Answer 5

Gefitinib
Erlotinib
Afatinib

Question 6

Sign effects of the oral tyrosine kinase inhibits (erlotinib, gefitinib, afatinib)

Answer 6

Diarrhoea 
Skin reactions (acne) 
Paronychia
Hepatotoxicity 
Stomatitis

Question 7

Monoclonal antibody used in NSCLC and when is it used

Answer 7

Pembrolizumab –> metastatic NSCLC whose tumours express PD-L1 with no EGFR or ALK tumour mutations

Question 8

MOA of pembrolizumab

Answer 8

Binds PD-1 receptor preventing binding with Luganda PD-1 and PD-2 –> potentiates activation of T-cell immune response

Question 9

Side effects of pembrolizumab

Answer 9

Fatigue 
Cough
Arthralgia 
Diarrhoea 
Immune mediated adverse reactions - pneumonitis, colitis, hepatitis