Others

Question 1

Cisplatin, carboplatin

Answer 1

Cross-link DNA

use: testicular, bladder, ovary, and lung carcinomas
toxicity: nephrotoxicity and acoustic nerve damage. Prevent nephrotoxicity with amifostine (free radical scavenger) and chloride diuresis.

Question 2

Hydroyurea

Answer 2

inhibits ribonucleotide redcutase –> decrease DNA synthesis (S-phase specific)
Use: melanoma, CML, sickle cell disease (increase HbF)
Toxicity: bone marrow suppression, GI upset;

Question 3

Prednisone

Answer 3

May trigger apoptosis. May even work on non-dividing cells;
Use: most commonly used glucocorticoid in cancer chemotherapy; used in CLL, Hodgkin’s lymphoma (part of MOPP); also an immunosuppressant used in autoimmune disorders
toxicity: Cushing-like symptoms (puffy face, buffalo hump, stria; cataracts, immunosuppression, acne, osteoperosis, hypertension, peptic ulcers, psychosis, hypocalcemia, hypokalemia, hypernatremia, hyperglycemia, fluid retention

Question 4

Tamoxifen, raloxifene

Answer 4

SERMs - receptor antagonists in breast and agonists in bone; block the binding of estrogen to estrogen receptor-positive cells;
Use: breast cancer; prevent osteoperosis
Toxicity: Tamoxifen - increase risk of endometrial carcinoma via partial agonist effects; “hot flashes”
Raloxifene - no increase in endometrial carcinoma because its an endometrial antagonist;
DVT, stroke

Question 5

Tratuzumab (Herceptin)

Answer 5

Monoclonal antibody against HER-2 (erb-B2), a tyrosine kinase. Helps kill breast cancer cells that overexpress HER-2, possibly through antibody-dependent cytotoxicity;
Use: metastatic breast cancer
Toxicity: cardiotoxicity

Question 6

Imatinib (Gleevec)

Answer 6

Philadelphia chromosome bcr-abl tyrosinse kinase inhibitor
Use: CML, GI Stromal tumors
toxicity: fluid retention

Question 7

Rituximab

Answer 7

Monoclonal antibody against CD20, which is found on most B-cell neoplams
Use: NHL, RA (with MTX), CLL