Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IHO Week 1 > Millikan IHO Week 2 > Flashcards

Millikan IHO Week 2 Flashcards

1
Q

Human Oncology Trials: Phase 1 Goals

A

to define a dose (and schedule) tolerable for human patients and ‘optimized’ by some criteria for toxicity and/or efficacy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Human Oncology Trials: Phase 2 Goals

A

to define an anti-cancer effect in some defined group of patients-a ‘disease state’ (hypothesis generating)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Human Oncology Trials: Phase 3 Goals

A

to formally compare some ‘novel’ treatment (or therapeutic strategy) with an existing standard (hypothesis testing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how the body affects the drug

A

pharmacokinetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how the drug affects the body

A

pharmacodynamics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Phase 1 Clinical Trials

A

aims to define ‘dose limiting toxicity’ for a particular schedule of 1 or more agents; typically less than 40 patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Toxicity of Events: Grade 1

A

No physiologic or clinical consquence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Toxicity of Events: Grade 2

A

Physiologically Relevant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Toxicity of Events: Grade 3

A

Events are potentially associated with major morbidity (hospitalization, intensive treatment, etc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Toxicity of Events: Grade 4

A

Events are life threatening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Phase 2 Clinical Trials

A

Scientific and statistical goal is to define the rate of ‘benefit’ in a defined population; uses a quick response marker, 30-60 patients; includes available info about prognostic factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What do the following have in common: low albumin, high ferritin, high platelets, elevated crp, esr, elevated beta 2 microglubulin, elevated IL6, age, particular genetic lesions

A

Prognostic Factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Phase 3 Clinical Trials

A

scientific and statistical goal to formally compare 2 or more tx or strategies using a definitive end-point such as survival time; 300-1200 patients; needs to be pass ‘lucky you’ ethical test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

alkyator, nitrogen mustard; small molecule; breast cancer, lymphomas, immunosuppression, stem cell mobilization; $1,050

A

Cyclophosphamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

alkyator, nitrogen mustard; small molecule; lymphomas; $10,300/month

A

Bendamustine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

alkyator, nitrogen mustard; small molecule; brain cancer

A

Temozolomide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

alkyator, nitrogen mustard; small molecule; germ cell tumors, bladder cancer

A

Cisplatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

alkyator, nitrogen mustard; small molecule; epithelial malignancies, second-line treatment of lymphoma

A

Carboplatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

single most important cytoxic drug ever discovered; acrolein metabolite (bladder cancer); good TI unforseen ALDH; ESPECIALLY 5q- (myelodysplasia)

A

Cyclophosphamide

20
Q

germ cell tumor tumors in pre-transplant salvage regimens for lymphoma and sarcoma; electrolyte wasting, CNS toxicity,

A

Ifosfamide

21
Q

MESNa

A

Mercapto-EthylSulphonic Acid, Na salt; protects bladder from acrolein

22
Q

3 Downsides of Cyclophosphamide

A

-hemorrhagic cystitis, bladder cancer, myelodysplasia

23
Q

Name the 3 Platinums

A

cisplatin (nephrotoxic), carboplatin(safe, less effective), oxaliplatin (safe, less effective)

24
Q

3 Consequences of DNA Adducts

A

-inhibition of transcription, inhibition of DNA replication, induction of apoptosis

25
Q

8 Resistance Mechanisms

A

reduced platium uptake, increased efflux, intracellular detox by glutathione, increased DNA repair, decreased mismatch repair, defective apoptosis, modulation of signaling pathways, presence of quiescent non-cycling cells

26
Q

germ cell tumors, NOT VERY MYELOSUPPRESSIVE, damage to the 8th nerve and long sensory nerves, kidney damage (irreversible), n/v

A

Cisplatin

27
Q

solid tumors and salvage lymphoma regimens, not as active as ciplatin except for = in lung, gyn and breast cancers, less neurotoxic/emetogenic and nephrotoxic, quite myelosuppressive, causing throbocytopenia

A

Carboplatin

28
Q

GI cancers, cold intolerance/neuropathy, uncommon for patients to tolerate more than about 8 cycles of tx including oxaliplatin

A

Oxiplatin

29
Q

important in sarcoma and hodgkin lymphoma; methylates N7 and O6 on GUANINE and N3 on adenine

A

Dacarbazine

30
Q

prodrug for MTIC, important in CNS tumors, expression of Methylguanine Methyltransferase predicts poor response

A

Temozolomide

31
Q

4 Clinically Important Facts about non-classical alkylators

A
  1. used for gliomas 2. profound hematologic stem cell toxicity makes them useful for bone marrow transplant conditioning regimens 3. carbazines are vessicants, emetogenic & not used 4. dacarbazine-related prodrug for glioma: MGMT or MMR deficient-> methylation doesn’t work
32
Q

Antimetabolite, anti-fol, small molecules, many cancers

A

Methotrexate

33
Q

Antimetabolite, pyrimidine analog, small molecules, GI cancers

A

5-Fluorouracil

34
Q

Antimetabolite, pyrimidine analog, small molecules, pancreas cancer, bladder cancer, widely used in second line setting

A

Gemcitabine

35
Q

Antimetabolite, pyrimidine analog, small molecules, AML, second-line lymphoma

A

Cytarabine

36
Q

blocks dihydrofolate reductase which impairs DNA synthesis by depleting Thymidine

A

Methotrexate

37
Q

Do NOT give methotrexate to patients with what

A

anasarca, ascites, large pleural effusions or impaired renal function b/c it is myelosuppressive

38
Q

Methotrexate antidote

A

reduced folates in the form of leucovorin

39
Q

dose limiting toxicity of methotrexate

A

stomatitis

40
Q

Most of the efficacy of methotrexate versus the toxicity

A

DNA dysfunction (effect) versus RNA dysfunction (toxicity)

41
Q

dose limiting toxicity of 5-FU

A

infusion is GI, stomatitis, diarrhea odynophage and hand/foot syndrome and actinic recall

42
Q

5 FU antidote

A

uridine tri-acetate

43
Q

broad spectrum, syndergistic with DNA damaging agents, self potentiating, interactive with platinum drugs/radiotherapy, SAFE IN RENAL PTS., rarely causes alopecia

A

Gemcitabine

44
Q

important for AML and various lymphomas, intrathecally

A

Ara-C

45
Q

remarkably active against hairy cell leukemia, some use in autoimmune ds, active in many other B cell malignancies

A

Cladribine (2-CdA)

46
Q

immunosuppressive class (used for cancer also)

A

purine analogs

47
Q

allowed for first successful kidney transplant

A

azathioprine

IHO Week 1 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions