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NAPLEX Review > Oncology Common Cancer Types and Treatment > Flashcards

Oncology Common Cancer Types and Treatment Flashcards

1
Q

What is the difference between complete response and partial response?

A

Complete - treatment destroyed all known tumor cells

Partial - at least 30% of the tumor was eliminated

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2
Q

What is neoadjuvant therapy

A

Radiation or chemo given before surgery to shrink tumor

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3
Q

What is the most common primary therapy for cancer?

A

Surgery

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4
Q

What is adjuvant therapy?

A

radiation and/or chemo given after surgery in attempt to eradicate residual disease

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5
Q

What do BRCA1 and BRCA2 genes do?

A

Suppress tumor growth

Mutations prevent cell repair and cause drastic increase in breast cancer incidence

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6
Q

What is Klinefelter Syndrome and what cancer does it cause a high incidence of?

A

When a male has one Y and two or more X chromosomes
Causes men to be infertile and produce more estrogen
Higher risk of breast cancer

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7
Q

What hormonal therapy is used in pre and post menopausal women with breast cancer?

A

Pre - Tamoxifen (first line)

Post - Aromatase inhibitor (anastrozole nad letrozole); tamoxifen second line

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8
Q

What SERM is used for breast cancer prophylaxis, not treatment?

A

Raloxifene

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9
Q

What cancer medications are SERMs? What cancers are they used in?

A

Tamoxifen
Fulvestrant
Breast

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10
Q

SERM BBW, CI, SE

A

BBW: increased risk of uterine or endometrial cancer and thromboembolic events
CI: pregnancy (tamoxifen)
SE: hot flashes/night sweats, vaginal bleeding/spotting, decreased bone density, supplement with calcium/vitamin D with tamoxifen

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11
Q

What medications are aromatase inhibitors

A

Anastrozole (Arimidex)
Letrozole
Exemestane

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12
Q

Aromatase SE, CI

A

CI: pregnancy
SE: hot flashes/night sweats, arthralgia/myalgia, osteoporosis, higher risk of CVD

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13
Q

What medication are cyclin-dependent kinasae (CKD4/6) inhibitors

A

Palbociclib
Abemaciclib
Ribociclib

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14
Q

Aromatase inhibitor MOA

A

inhibits conversion of androgens to estrogens

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15
Q

CDK4/6 MOA

A

inhibits downstream signalling of tumor growth

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16
Q

What PSA level indicates prostate cancer?

A

> 10

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17
Q

What medications are hormonal therapies used for prostate cancer? What if hormonal therapy does not work?

A

Androgen deprivation therapy
GnRH agonist +/- antiandrogen
GnRH antagonist

Castration resistant - use chemo

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18
Q

What medications are GnRH agonists?

A

Leuprolide
Goserelin

aka LHRH agonists

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19
Q

GnRH agonist MOA

A

stimulate production of GnRH (and consequently testosterone) then stop production through negative feedback

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20
Q

GnRH agonist SE and notes

A

SE: hot flashes, impotence, gynecomastia, bone pain
Note: tumor flare - can given with antiandrogen for several weeks

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21
Q

What medications are GnRH antagonist

A

Degarelix

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22
Q

GnRH antagonist SE and notes

A

SE: osteoporosis risk - consider Ca and Vit D supplementation
Note - no tumor flare

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23
Q

What medications are antiandrogens?

A

First generation: bicalutamide, flutamide, nilutamide

Second gen: Apalutamide, darolutamide, enzalutamide

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24
Q

What medications are androgen biosynthesis inhibitors?

A

Abiraterone

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25
Q

Abiraterone (Zytiga) MOA

A

interferes with specific CYP-17 enzyme to decrease testosterone production
***MUST be taken with prednisone to prevent hyperaldosteronism

26
Q

BSA calculation

A

Square root of:
Ht (cm) x Wt (kg)
————————-
3600

27
Q

What metabolite of cyclophosphamide and ifosfamide causes hemorrhagic cystitis?

A

acrolein

28
Q

What chemo medications are alkylating agents?

A

Cyclophosphamide, ifosfamide, carmustine, busulfan

29
Q

Alkylating agent BBW, SE

A

BBW: Hemorrhagic cystitis
SE: pulmonary toxicity

30
Q

What chemo medications are platinum-based compounds?

A

Cisplatin

Carboplatin

31
Q

What body fluid discoloration can doxorubicin cause?

A

Red urine, tears, sweat, and saliva

32
Q

What body fluid discoloration can mitoxantrone cause?

A

Blue urine and sclera

33
Q

What chemo medications are anthracyclines

A

Doxorubicin

Mitoxantrone

34
Q

What medications are topoisomerase I inhibitors

A

Irinotecan

Topotecan

35
Q

What medications are topoisomerase II inhibitors

A

Etoposide

Bleomycin

36
Q

What medications are vinca alkaloids

A

Vincristine

Vinblastine

37
Q

What chemo medication is fatal if administered intrathecally?

A

Vincristine

Must be administered in IV bag to prevent accidental intrathecal administration

38
Q

What chemo medications are taxanes?

A

Paclitaxel
Docetaxel
Cabazitaxel
Paclitaxel

39
Q

Why does docetaxel need to be premedicated with dexamethasone

A

To prevent severe fluid retention

40
Q

What chemo meds are pyrimidine analog antimetabolites?

A

Fluorouracil “5-FU”

Capecitabine (Xeloda)

41
Q

Pyrimidine analog antimetabolites CI adn SE

A

CI: CrCl <30
SE: hand-foot syndrome, diarrhea, mucositis

42
Q

What chemo meds are folate antimetabolites?

A

Methotrexate

43
Q

What is the methotrexate antidote?

A

Glucarpidase (Voraxaze)

44
Q

Methotrexate BBW, SE, and drug interactions

A

BBW: myelosuppression, renal damage, hepatotoxicity, GI toxicicty, teratogenicity
SE: Nephrotoxicity, hepatotoxicity, nausea, mucositis
Drug interactions: NSAIDs, salicylates

45
Q

Arsenic trioxide SE

A

QT prolongation

46
Q

What medications are mTOR inhibitors

A

Everolimus and temsirolimus

47
Q

mTOR inhibitor MOA

A

inhibit downstream regulation of vascular endothelial growth factor (VEGF) reducing cell growth, metabolism, proliferation and angiogenesis

48
Q

Everolimus SE

A

Mouth ulcers/stomatitis, rash, interstitial lung disease, peripheral edema, dislipidemia, increased BP

49
Q

What cancer medications are CAR T-cell gene therapies?

A

Axicabtagene ciloleucel

50
Q

What cancer medications are Immunomodulators?

A

Lenalidomide
Pomalidomide
Thalidomide

51
Q

Immunomodulator BBW

A

Fetal risk/pregnancy

52
Q

What cancer medications are protease inhibitors

A

Bortezomib and carfilzomib

53
Q

What medications are VEGF inhibitors?

A

Bevacizumab (Avastin)

Ramucirumab

54
Q

VEGF inhibitor BBW and SE

A

BBW: severe/fatal bleeding, GI perforation
SE: impaired wound healing, do not give 28 days before or after surgery

55
Q

HER2 inhibitor medications

A

Trastuzumab (Herceptin)

Pertuzumab

56
Q

EGFR inhibitor medications

A

Cetuximab

Panitumumab

57
Q

Leuocyte CD antigens medications

A

Rituximab

58
Q

PD-1 inhibitor medications

A

Pembrolizumab (Keytruda)
Nivolumab
Atezolizumab
Durvalumab

59
Q

CTLA-4 inhibitor medications

A

Ipilimumab

60
Q

Tyrosine kinase inhibitor (TKI) medications and common toxicities

A 
Lapatinib, neratinib, sorafenib, sunitinib
Hypothyroidism
QT prolongation
Rash
HTN
Hand-foot syndrome
Hepatic toxicity
Diarrhea

NAPLEX Review (79 decks)

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