Pharamacology of GI Tumor Flashcards
What are options to treating someone with esophageal cancer?
- surgery with chemo
- antineoplastic drugs
5- fluorouracil
oxaliplatin
paclitaxel
irinotecan, epirubicin
ramicirumab: VEGF receptor 2 monoclonal antibody
Gastric adenocarcinomas can be treated with what antineoplastic drugs?
- 2 drug combination regimens are preferred for first-line therapy.
5-flurouracil or a taxane agent plus a platinum agent
- A three-drug combo of:
docetaxel plus cisplatin and 5-fluorouracil
What is the Marsden Regimen?
chemotherapy regimen for treatment of gastric cancer made up of the drugs:
epirubicin, cisplatin and 5-flurouracil (3wks) 6 cycles
What is capecitabine hydrolyzed by to become the prodrug 5-FU?
thymidine phosphorylase
What regimen is widely used for treatment of metastatic colorectal cancer?
capecitabine/oxaliplatin (XELOX)
but also used for pancreatic, gastroesophageal cancer.
ADR of capecitabine.
diarrhea, hand-foot syndrome, myelosupression, nausea vomiting
Are alkylating drugs cell cycle specific or cell cycle Nono specific?
cell cycle non specific
Use of Oxaliplatin?
advanced pancreatic and colon cancer
What is a major ADR of using oxaliplatin?
cold- related peripheral neuropathy
Mechanism of action of Doxocrubicin and epirubicin?
- Anthracycline category
- Intercalate between DNA base pairs
- Super oxide and radical actionàDNA strands breaks
- Block topoisomerase II
What are the side effects of Doxorubicin and Epirubicin?
BMS, N+V, mucositis, diarrhea, red-orange color urine
- Dose dependent cardiotoxicity;
- Acute cardiac arrhythmia
- Chronic dilated cardiomyopathy and CHF >Due to free radicals.
Indications for Doxorubicin?
ALL: bladder, breast, ovarian, lung,, soft tissue, and thyroid ca
myeloma, neuroblastoma
What drug should you never combine Doxorubicin and Epirubicin with? Why?
Tranztuzimab because it may precipitate cardiac failure
MOA of Imatinib?
- Imatinib : Inhibitor of the tyrosine kinase domain of the Bcr-Abl oncoprotein and other receptor tyrosine kinases
Indication for Imatinib?
CML, Gastrointestinal stromal tumor( GIST)
ADR for Imatinib?
Nausea ,vomiting ,Fluid retention with ankle and periorbital edema, diarrhea, CHF.
FOLFOX acronym for the chemotherapy regimen used to treat colorectal cancer stands for what drugs?
FOL- Folinic acid(leucovorin)
F- Fluorouracil (5-FU)
OX- Oxaliplatin
Another name for Leucovorin?
folonic acid
What is the main purpose of using folinic acid in chemotherapy regimens?
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).
Does leucovorin have many side effects on its own?
no
When Leucovorin is given in combination with fluorouracil will it increase or decrease the side effects of the drug?
it will increase it
How does combination of leucovorin with fluorouracil aid in making fluorouracil a more ideal chemotherapeutic agent?
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.
Name 5 possible side effects of FOLFOX regimen?
- 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
How can the activation of the EGFR pathway lead to development of cellular drug resistance?
Pathway inhibits the cytotoxic activity of various anti-cancer agents through suppression of key apoptotic mechanisms
