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Block 4: SD 2 Week 11 > Pharamacology of GI Tumor > Flashcards

Pharamacology of GI Tumor Flashcards

1
Q

What are options to treating someone with esophageal cancer?

A
  1. surgery with chemo
  2. antineoplastic drugs

5- fluorouracil
oxaliplatin
paclitaxel
irinotecan, epirubicin
ramicirumab: VEGF receptor 2 monoclonal antibody

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2
Q

Gastric adenocarcinomas can be treated with what antineoplastic drugs?

A
  1. 2 drug combination regimens are preferred for first-line therapy.

5-flurouracil or a taxane agent plus a platinum agent

  1. A three-drug combo of:
    docetaxel plus cisplatin and 5-fluorouracil
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3
Q

What is the Marsden Regimen?

A

chemotherapy regimen for treatment of gastric cancer made up of the drugs:

epirubicin, cisplatin and 5-flurouracil (3wks) 6 cycles

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4
Q

What is capecitabine hydrolyzed by to become the prodrug 5-FU?

A

thymidine phosphorylase

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5
Q

What regimen is widely used for treatment of metastatic colorectal cancer?

A

capecitabine/oxaliplatin (XELOX)

but also used for pancreatic, gastroesophageal cancer.

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6
Q

ADR of capecitabine.

A

diarrhea, hand-foot syndrome, myelosupression, nausea vomiting

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7
Q

Are alkylating drugs cell cycle specific or cell cycle Nono specific?

A

cell cycle non specific

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8
Q

Use of Oxaliplatin?

A

advanced pancreatic and colon cancer

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9
Q

What is a major ADR of using oxaliplatin?

A

cold- related peripheral neuropathy

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10
Q

Mechanism of action of Doxocrubicin and epirubicin?

A
  1. Anthracycline category
  2. Intercalate between DNA base pairs
  3. Super oxide and radical actionàDNA strands breaks
  4. Block topoisomerase II
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11
Q

What are the side effects of Doxorubicin and Epirubicin?

A

BMS, N+V, mucositis, diarrhea, red-orange color urine

  • Dose dependent cardiotoxicity;
  • Acute cardiac arrhythmia
  • Chronic dilated cardiomyopathy and CHF >Due to free radicals.
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12
Q

Indications for Doxorubicin?

A

ALL: bladder, breast, ovarian, lung,, soft tissue, and thyroid ca
myeloma, neuroblastoma

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13
Q

What drug should you never combine Doxorubicin and Epirubicin with? Why?

A

Tranztuzimab because it may precipitate cardiac failure

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14
Q

MOA of Imatinib?

A
  • Imatinib : Inhibitor of the tyrosine kinase domain of the Bcr-Abl oncoprotein and other receptor tyrosine kinases
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15
Q

Indication for Imatinib?

A

CML, Gastrointestinal stromal tumor( GIST)

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16
Q

ADR for Imatinib?

A

Nausea ,vomiting ,Fluid retention with ankle and periorbital edema, diarrhea, CHF.

17
Q

FOLFOX acronym for the chemotherapy regimen used to treat colorectal cancer stands for what drugs?

A

FOL- Folinic acid(leucovorin)
F- Fluorouracil (5-FU)
OX- Oxaliplatin

18
Q

Another name for Leucovorin?

A

folonic acid

19
Q

What is the main purpose of using folinic acid in chemotherapy regimens?

A

not a chemotherapy drug itself, however it is used in addition to chemotherapy drugs to either:

  • enhance anti cancer effects (i.e with fluorouracil)
  • help prevent or lessen side effects (i.e. with methotrexate).
20
Q

Does leucovorin have many side effects on its own?

A

no

21
Q

When Leucovorin is given in combination with fluorouracil will it increase or decrease the side effects of the drug?

A

it will increase it

22
Q

How does combination of leucovorin with fluorouracil aid in making fluorouracil a more ideal chemotherapeutic agent?

A

Fluorouracil when given alone stays in the body for only a short time.

In combination with Leucovorin,

Leucovorin enhances binding of fluorouracil to an enzyme inside of cancer cells. As a result fluorouracil may stay in the cancer cell longer and exert its anti cancer effect on the cells.

23
Q

Name 5 possible side effects of FOLFOX regimen?

A
  • Hair loss
  • Redness, pain or peeling of palms and soles
  • Rash, increased risk of sunburn, itching
  • Diarrhea, nausea, vomiting, constipation, loss of appetite
  • Difficulty swallowing, Sores in mouth, Heartburn
  • Infection, especially when white blood cell count is low
  • Anemia which may require a blood transfusion
  • Bruising, bleeding, Headache, Tiredness
  • Numbness, tingling or pain, “pins and needles” of the hands, feet, arms and legs
  • Tingling or a loss of feeling in your hands, feet, nose, or tightness in throat or jaw, or difficulty swallowing or breathing which may be made worse by exposure to cold
  • Cough, Fever, Chest pain
  • Allergic reaction which may cause rash, low blood pressure, wheezing, shortness of breath, swelling
    of the face or throat
  • Change in voice
  • Confusion, dizziness
  • Muscle weakness
  • Inability to move shoulder or turn head
  • Blurred vision, watering eyes
24
Q

How can the activation of the EGFR pathway lead to development of cellular drug resistance?

A

Pathway inhibits the cytotoxic activity of various anti-cancer agents through suppression of key apoptotic mechanisms

25
Q

What does EGFR stand for?

A

epidermal growth factor receptor

26
Q

What’re the drugs we discussed that are considered growth factor receptor inhibitors?

A

Cetuximab, Panitumumab

27
Q

Uses of Cetuximab and Panitumumab?

A

colorectal cancer

28
Q

ADR of Cetuximab and Panitumumab?

A

Infusion reaction, skin rash ,hypomagnesemia, fatigue, interstitial lung disease.

29
Q

MOA of Cetuximab and Panitumumab?

A

Binds to EGFR and inhibits binding of epidermal growth factor and downstream signaling , enhances response to chemotherapy

Finally causing inhibition of tumor growth and increases apoptosis.

30
Q

What does VEGF stand for?

A

vascular endothelial growth factor

31
Q

MOA of Bevacizumab?

A

Inhibits binding of Vascular endothelial growth factor- A (VEGF-A) to VEGFR leading to inhibition of VEGF signaling; inhibits tumor vascular permeability and inhibits vascularization of tumor

32
Q

Indication for BEvacizumab?

A

colorectal cancer

33
Q

ADR Bevacizumab

A

Hypertension, infusion reaction, arterial thromboembolic events, gastrointestinal perforation, Bleeding complication, proteinuria

34
Q

What is an indication for Dostarlimab?

A

rectal cancer

35
Q

MOA of Dostarlimab?

A

“Dostarlimab works by unlocking the body’s natural immune system to fight cancer. When we give immunotherapy like [with] dostarlimab, it ramps up the immune system so that it sees cancer and gets rid of it,

36
Q

Be able to reproduce slide on GI cancers and treatment of choice.

A

Block 4: SD 2 Week 11 (4 decks)

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