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GI > PHARM: GI Tumors > Flashcards

PHARM: GI Tumors Flashcards

1
Q

Targeted therapy for Colorectal cancer.

A

Bevacizumab

Cetuximab

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2
Q

Targeted therapy for Gastric cancer.

A

Glutamic Acid

Trastuzumab

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3
Q

Targeted therapy for GI carcinoid tumor.

A

Methysergie

Octreotide

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4
Q

Targeted therapy for GIST.

A

Imatinib

Sunitinib

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5
Q

Targeted therapy for pancreatic cancer.

A

Erlotinib

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6
Q

Targeted therapy for Liver Cancer

A

Sorafenib

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7
Q

MOA: Her-2 neu Antibody; HER2 is downregulated, CDK-p27 accumulates and cell cycle arrest occurs. Inhibits constitutive HER2 cleavage/shedding mediated by metalloproteases (may correlate with clinical activity)

A

Trastuzumab

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8
Q

MOA: rhu-MAb of VEGF

A

Bevacizumab

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9
Q

MOA: Inhibitor of many RTKs like PDGFR-alpha and –beta, VEGFR, KIT, FLT3, CSR-1R, RET

A

Sunitinib

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10
Q

MOA: rh/mMAb of EGFR

A

Cetuzimab

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11
Q

MOA: Oral multi-kinase inhibitor targeting serine/threonine and receptor TK in both tumor and vasculature. Target examples: Raf, VEGF, PDGFR-beta, Kit, FLT-3, RET

A

Sorafenib

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12
Q

MOA: EGFR-TKI

A

Erlotinib

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13
Q

MOA: SS analog; reduces duodenal HCO3-, amylase, gastric acidity and inhibits gallbladder contrations and bile secretion as well as meal-induced increases in SMA and portal venous flow

A

Octreotide

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14
Q

MOA: Nutritional supplement; used to counterbalance deficiencies of HCl in gastric juice

A

Glutamic Acid

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15
Q

MOA: Serotonin inhibitor in GI tract

A

Methysergide

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16
Q

MOA: Oral TKI as adjuvant treatment following complete resection of Kit (CD117) positive GIST

A

Imatinib

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17
Q

MOA: Reduced folate; synergizes with 5-FU

A

Levucovorin

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18
Q

TOXICITY: Diarrhea and dehydration

A

Leucovorin

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19
Q

TOXICITY: Bleeding, GI perforation, wound dehiscence, HTN, Hypersensiivity

A

Bebacizumab

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20
Q

TOXICITY: GI toxicities (pain, bloating, N/V, constipation, stomatitis, dyspepsia) common. CHF. Neurologic toxicity, fluid retention, edema.

A

Imatinib

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21
Q

TOXICITY: GI toxicity (N/V, diarrhea) prolonged bleeding, elevated LFTs, ocular toxicities; rarely interstitial lung disease

A

Erlotinib

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22
Q

TOXICITY: Monitor blood glucose because drug inhibits insulin and glucagon. Dose related diarrhea (so give with methysergide)

A

octreotide

23
Q

TOXICITY: LVEF dysfunction and cardiomyopathy. Severe infusion-related reactions including anaphylaxis, angioedema, and pulmonary toxicity (worse in patients w/ COPD, asthma, respiratory insufficiency)

A

Trastuzumab

24
Q

TOXICITY: Cardiac arrest, respiratory arrest, and/or sudden death; infusion reactions. Acneiform rash common (76-88%), severe in
up to 17% of patients

A

Cetuzimab

25
Q

TOXICITY: Hand-foot skin reaction characterized by redness, pain, swelling or blisters on the palms of the hands or soles of the feet. Generally appears in first 6 weeks of treatment.

A

Sorafenib

26
Q

TOXICITY: Thrombocytopenia and bleeding. QT prolongation (sometimes fatal), GI complications including GI perforation.

A

Sunitinib

27
Q

What drug is also a Vasoconstrictor of large and small arteries; used for migraine therapy?

A

methysergide

28
Q

Which cancer has the following treatment plan: Radiation therapy (70% 5YS even if used alone); Radiation + Cisplatin, 5-FU, Mitomycin leads to improved outcomes?

A

anal cancer

29
Q

What are folfox and folfiri used for?

A

colorectal cancer

30
Q

What is folfox?

A

5-FU + Leucovorin + oxaplatin

31
Q

What is folfiri?

A

5-FU + Leucovorin + irinotecan

32
Q

How can you tell that a patient with esophageal cancer has invasion to muscularis propria and metastasis?

A

dysphagia

33
Q

How may EBV viral infection lead to gastric cancer?

A

DNA methylation, miss-match repair

34
Q

How may microsatellite instability lead to gastric cancer?

A

DNA miss-match repair

35
Q

If a gastric cancer is HER2 positive, what drug is added to the 5-FU and cisplatin?

A

Trastuzumab

36
Q

Why is glutamic acid given with gastric cancer?

A

ancillary agent that is employed as a gastric acidifier to counterbalance deficiencies of HCl in gastric juice

37
Q

What type of tumors are rare malignancies arising from cells linking the endocrine and CNS?

A

GI carcinoid tumors

38
Q

TRUE or FALSE: GI carcinoid tumors are highly responsive to treatments.

A

FALSE: no protocol has shown objective tumor response rate of > 15%

39
Q

Why can octreotide only be given for 1 year?

A

tachyphylaxis (not as bad with long-acting formulations) and/or disease progression

40
Q

Why do you give methysergide in GI carcinoid treatment?

A

serotonin antagonist used to inhibit diarrhea arising from serotonin effects in the GI tract

41
Q

What drug used to treat GI carcinoid tumors inhibits disease progression and provides symptom relief in 75% of patients?

A

INF-alpha

42
Q

What is the problem with INF-alpha?

A

Toxicity is severe (alopecia, anorexia, fatigue, weight loss, fever, flu-like syndrome, myelosuppression)

43
Q

What type of tumors are 80% KIT-mutants?

A

GI stromal tumors

44
Q

Why is treatment with cytotoxic chemotherapy futile in GIST?

A

P-gp overexpression pumps the drug out

45
Q

What is the first line treatment for unresectable, metastatic, or recurrent GIST?

A

Imatinib mesylate

46
Q

What is the problem with imatinib?

A

majority of patients eventually develop imatinib resistance due to secondary mutations in a separate portion of the KIT-coding sequence

47
Q

What treatment of pancreatic cancer alleviates the malabsorption caused by exocrine insufficiency (that leads to malnutrition)?

A

pancreatic enzyme replacement

48
Q

What is FOLFIRINOX and what cancer is it used in?

A

Pancreatic cancer

leucovorin + fluorouracil + irinotecan + oxiplatin

49
Q

What is the synergistic combination used in pancreatic cancer?

A

5-FU/Folinic Acid (Leucovorin)

50
Q

For what type of cancer is TACE used?

A

liver cancer

51
Q

What does TACE stand for?

A

trans-catheter arterial chemoembolization)-

52
Q

What is injected in TACE?

A

doxorubicin

53
Q

How does TACE spare normal tissue and minimizes dispersion of drug away from the tumor site?

A

Super-selective catheterization of segmental arteries feeding tumor

GI (21 decks)

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