Overview of Antineoplastics

Question 1

What ADR is associated with Cisplatin?

Answer 1

Nephrotoxicity

Question 2

What are the clinical indications for the use of Trastuzumab?

Answer 2

Breast & gastric cancers expressing HER2

Question 3

What anticancer drugs are associated with neurotoxic effects?

Answer 3

Paclitaxel (peripheral neuropathy), Vincristine, Cytarabine, Oxaliplatin (peripheral neuropathy)

Question 4

What anticancer drugs act primarily on the M phase of the cell cycle?

Answer 4

Vincristine & Paclitaxel

Question 5

What anticancer drug is known to have adverse effects on the heart and could lead to irreversible CHF?

Answer 5

Doxorubicin

Question 6

Peripheral neuropathy is an ADR associated with what anticancer drug?

Answer 6

Oxaliplatin

Question 7

True/False. Starting cancer treatment after symptoms present always results in death.

Answer 7

True. Treatment must be started early and before direct symptoms begin for effective treatment.

Question 8

What unique ADRs are associated with Bleomycin?

Answer 8

Skin pigmentation on the hands, pulmonary pneumonitis

Question 9

What is the MOA for the aromatse inhibitors used in the treatment of advanced breast cancer?

Answer 9

Letrozole & Anastrozole - inhibits estrogen formation from testosterone

Question 10

What is the MOA of Doxorubicin?

Answer 10

Inhibits topoisomerase II and causes formation of free radicals

Question 11

What common toxicities are associated with nearly all antineoplastics?

Answer 11

Bone marrow suppression, GI damage, skin damage, loss of hair, sterility, nausea/vomiting

Question 12

What anticancer drug is used to treat prostate cancer and inhibits FSH/LH secretion?

Answer 12

Leuprolide

Question 13

Bleomycin is a cell cycle-specific anticancer drug that causes DNA strand breaks. In what phase of the cell cycle does it act?

Answer 13

G2 phase

Question 14

What strategy is utilized with Cyclophosphamide to prevent its unique ADR?

Answer 14

Pre-hydration with mensa disulfide to prevent hemorrhagic cystitis

Question 15

To what class of anticancer drugs does Meclorethamine belong?

Answer 15

Alkylating Agent

Question 16

What is the MOA of vincristine?

Answer 16

Acts during M phase of the cell cycle to prevent microtubule formation

Question 17

What is the most common method of antineoplastic resistance?

Answer 17

Increased P-gp function and drug efflux

Question 18

What is the MOA of Bortezomib?

Answer 18

Inhibits 26S proteasome degradation

Question 19

What ADRs are associated with Paclitaxel?

Answer 19

Neutropenia, peripheral neuropathy

Question 20

True/False. Chemotherapy should not be begun until after surgery to remove a solid tumor.

Answer 20

False. Neoadjuvant chemotherapy is begun before surgery to shrink the tumor and improve results.

Question 21

What anticancer drugs inhibit topoisomerase II?

Answer 21

Etoposide & Teniposide

Question 22

What anticancer drug inhibits the DNA polymerase and is known to cause neurotoxicity?

Answer 22

Cytarabine

Question 23

What aromatase inhibitors are used in the treatment of advanced breast cancer?

Answer 23

Letrozole & Anastrozole

Question 24

Hemorrhagic cystitis is a severe ADR associated with what antineoplastic drug?

Answer 24

Cyclophosphamide

Question 25

What anticancer drug cross-links DNA strands and has wide use with solid tumors?

Answer 25

Cisplatin

Question 26

What plant alkaloid anticancer drug is associated with neurotoxicity?

Answer 26

Vincristine & Paclitaxel (peripheral neuropathy)

Question 27

What small organic molecule inhibits the ABL portion of the tyrosine kinase?

Answer 27

Imatinib mesylate

Question 28

What is the MOA for the anticancer drug that may cause neutropenia and peripheral neuropathy as an ADR?

Answer 28

Paclitaxel - prevents polymerization of the mitotic spindle

Question 29

What anticancer drug crosses the BBB and is used to treat CNS tumors and meningeal leukemia?

Answer 29

Carmustine

Question 30

What is the MOA of Oxaliplatin?

Answer 30

Causes intrastrand crosslinks of DNA

Question 31

What is the MOA of Methotrexate?

Answer 31

Inhibits the dihydrofolate reductase required to activate folic acid

Question 32

What drug is administered to prevent the unique ADR of Doxorubicin?

Answer 32

Dexrazoxane chelates Fe to prevent free radical formation that causes cardiac toxicity with Doxorubicin use

Question 33

True/False. Leucovorin prevents toxicity with both Methotrexate & 5-FU.

Answer 33

False. Leucovorin prevents Methotrexate nephrotoxicity, but enhances the anticancer effects of 5-FU.

Question 34

Methotrexate and 5-FU both ultimately lead to the inhibition of the thymidylate synthase. What is the effect of this inhibition?

Answer 34

Inhibition of RNA & DNA synthesis

Question 35

What is the function of Leucovirin?

Answer 35

Folate analog that acts as a rescue drug to prevent Methotrexate nephrotoxicity

Question 36

Alkylating agents are (cell cycle specific/non-specific) anticancer drugs?

Answer 36

Cell cycle non-specific

Question 37

Topoisomerase inhibitors are cell cycle-specific. At what phase of the cell cycle do they act?

Answer 37

S phase

Question 38

What ADR is associated with Cytarabine?

Answer 38

Neurotoxicity

Question 39

How do the MOAs of Methotrexate and 5-Fluorouracil differ?

Answer 39

Methotrexate inhibits the dihrydrofolate reductase. This ultimately leads to the inhibition of the thymidylate synthase. 5-FU directly inhibits the thymidylate synthase.

Question 40

What Cyclophosphamide metabolite is responsible for causing hemorrhagic cystitis?

Answer 40

Acrolein