Pharmacology Of Lung Cancer

Question 1

Small cell lung cancer facts

Answer 1

Oat cell carcinomas

Centrally located

Staging:

1) limited stage = goal is cure w/ chemo and surgery used
- survival = <40%

2) extensive stage = goal is palliative care w/ chemo and whole brain radiation if brain Mets are present
- survival = <5%

Question 2

SCLC treatment options

Answer 2

Both stages are treated with cisplatin and etoposide

For extensive stage, can sub etoposide out with irinotecan if desired

• both treatments have 4-6 cycles use*

Question 3

NSCLC facts

Answer 3

3 different histology:

1) adenocarcinomas
- 40% prevalence
- located peripherally and in bronchial epithelium
- metastasis easily

2) squamous cell
- 30% prevalence
- located in basal cells of bronchial epithelium
- Centrally located
- dont metastasizes often
- high smoking prevalence

3) large cell
- 15% prevalence
- located peripherally and in nodules
- metastasize easily

Question 4

NSCLC chemotherapy treatment

Answer 4

First line is cisplatin or caroboplatin in combination with one of the following

1) a Taxane (paclitaxel /docetaxel)
2) a vinca alkaloid (Vinorelbine/ Vinblastine)
3) a topoisomerase inhibitor (irinotecan/ etoposide)

Question 5

Difference between DNA topoisomerase 1 and 2 inhibtors

Answer 5

1 = single strand breaks only
- irinotecan and topotecan

2 = double strand breaks only

• etopooside
• teniposdie

both prevent supercoiling in DNA strands

Toposiomerase 1 ADRs:

• alopecia
• diarrhea
• note delayed diarrhea can be fatal if not monitored due to severe electrolyte imbalances *

Topoisomerase 2 ADRs:

• mucositis
• infertility
• chemo induced menopause

Question 6

Types of novel biological therapy targets in SCLC and NSCLC

Answer 6

SCLC
- ALK-tyrosine kinase (7% frequency)

NSCLC

• Epidermial growth factor receptor (EGFR) (10-50% frequency)
• K-RAS receptors (10-30% frequency)