phase B drugs

Question 1

Bevacizumab dose

Answer 1

5-10mg Qw2, 10-15 mg Qw3

Question 2

Bevacizumab indication

Answer 2

mets CRC, NSCLC, GBM, Ovarian, Cervical, Renal , HCC

Question 3

A black box warning for bevacizumab

Answer 3

Arterial thromboembolism, fatal hemorrhage, wound dehiscence, GIT perforation

Question 4

Atezolizumab indication

Answer 4

advanced or metastatic urothelial carcinoma: following platinum, not eligible for platinum,
NSCLC: progression following platinum
NSCLS with PDL1>50%
Breast cancer TNBC, with nab paclitaxel
Extensive SCLC
metastatic melanoma

Question 5

Atezolizumab dose

Answer 5

840 mg iv 2 wkly, 1200mg 3 wkly, 1680 mg 4 wkly

Question 6

common side effect of atezolizumab

Answer 6

immune mediated adverse reaction: common being
- pneumonitis
- hepatitis
-colitis
-hypophysitis
- pancreatitis
- neurological disorder
-adrenal and thyroid disorder

Question 7

Relugolix mechanism of action

Answer 7

GnRh antagonist

Question 8

relugolix dose

Answer 8

360mg on first day of treatment followed by 120mg taken once daily

Question 9

common side effect of relugolix

Answer 9

hot flush
glucosed increased
TG increased
AST, ALT increased
constipation
diarrhea

Question 10

Tamoxifen side effect?

Answer 10

Menopausal symptoms fluid retention, peripheral edema, tumor flare I headache, lethargy, skin rash, pruritus, thromboembolic complication, endometrial hyperplasia

Question 11

Drug causing neutropenia

Answer 11

Alkylating agents
• Chlorambucil
• Cyclophosphamide • Ifosfamide
• Melphalan
• Mechlorethamine • Carmustine
• Lomustine
• Streptozocin

Anthracyclines
• Doxorubicin
• Daunorubicin • Epirubicin
Cytarabine
Platinum analogs • Cisplatin
• Carboplatin • Oxaliplatin
Methotrexate, 5-FU

Question 12

Osimertinib side effect

Answer 12

Skin toxicity
Diarrhea is most common GI toxicity
Pulmonary toxicity in the form of ILD
QTC prolongation
Cardiomyopathy and CHF
Fatigue, anorexia, and reduced appetite.

Question 13

Capecitabine dosage

Answer 13

Dosage:
During radiation therapy: 825 mg/m2 bid through out the entire course of radiation therapy D1-5
Xelox: capecitabine 1000mg/m2 po bid on days 1-14
Mono therapy: 1000-1250 mg/m2
On TNBC: breast: 1250mg/m2 on days 1-14, repeat cycle every 21 days.

Question 14

Capecitabine side effect

Answer 14

Diarrhea is dose limiting observed up to 55% of patients
Hand foot syndrome
Nausea and omitting
Elevation in serum bilirubin
Myelosuppression
Neurological toxicity
Cardiac symptoms: ECG changes, serum enzyme elevation
Tear duct stenosis, acute and chronic conjunctivitis.

Question 15

Nivolumab dose

Answer 15

For unresectable melanoma: 240mg iv every 2 weeks or 480 mg iv every 4 weeks
NSCLC: 240mg iv every 2 weeks or 480 mg iv every 4 weeks

Question 16

Pembrolizumab dose

Answer 16

Melanoma/SCLC/NSCLC: 200 mg iv every 3 weeks or 400 mg iv every 6 weeks

Question 17

Rituximab dose

Answer 17

375 mg/m2

Question 18

What are the points to monitor during rituximab administration

Answer 18

Monitor for infusion related events. Including fever, chills, urticaria, flushing, fatigue, headache, bronchospasm, rhinitis, dyspnea, angioedema, nausea, and or hypotension.
Monitor for tumor lysis syndrome. Especially in patients with high number of circulating cells (>25000/mm3) or high tumor burdens. Characterized by hyperkalemia, hyperuricemia, hyperphosphatemia, hypocalcemia, and renal insufficiency etc. usually occurs within the first 12-24 hours of treatment

Question 19

Indication of pembrolizumab

Answer 19

Metastatic melanoma
Metastatic NSCLC
Non squamous NSCLC
Recurrent or metastatic head and neck cancer
Pediatric patient with refractory classical Hodgkin lymphoma
Refractory primary mediastinal large B cell lymphoma
Locally advanced or metastatic urothelial cancer
Unresectable or metastatic MSI-H or dMMR CRC
Gastric or gastroesophageal junction adenocarcinoma
Locally advanced or metastatic squamous cell cancer of the esophagus
Recurrent or metastatic cervical cancer
Hepatocellular carcinoma who have previously been treated with sorafenib
MCC

Question 20

Imatinib dose

Answer 20

Start with 400 mg once daily, than if progression give 800 mg. In case of exon 9kit mutation start with 800 mg

Question 21

Things to monitor during imatinib

Answer 21

Weight, cbc, lft, rft
Echo 3 mnthly
Avoid komla, malta, kamranga, batabilebu
Asses for depression, suicide
Screen for hepatitis

Question 22

List of light sensitive drugs

Answer 22

Cisplatin,dacarbazine, doxorubicin, vinblastine,vincristine

Question 23

side effect of nivolumab

Answer 23

• significant immune mediated adverse reactions
  permanently discontinued in case of
• any life threatening or grade 4 toxicity
  grade 3 or 4 pneumonitis
  grade 4 colitis
  SGOT/SGPT >5 of upper level of normal
  serum creatinine >6 X ULN
  any severe or grade 3 toxicity that recurs

Question 24

indication of nivolumab

Answer 24

1. adjuvant treatment of melanoma with lymph node involvement following complete surgical resection
   metastatic NSCLC
   recurrent NSCLC with no EGFR/ALK mutation
   resistant SCLC
   advanced renal cell cancer
   advanced or metastatic urothelial carcinoma
   single agent or in combination with ipilimumab for hepatocellular carcinoma

Question 25

Trastazumab dose

Answer 25

loading dose of 4mg/kg iv over 90 minutes followed by maintenance dose of 2mg/kg iv on a weekly basis.
another alternative schedule is:
8mg/kg iv administered over 30-90 minutes followed by maintenance dose of 6mg/kg iv every 3 weeks

Question 26

indication of trastazumab

Answer 26

metastatic breast cancer: first line therapy in combination iwth paclitaxel with HER3 positive
metastatic breast cancer second and third line therapy
early stage breast cancer FDA approved for adjuvant therapy of node positive , Her 2 positive
metastatic gastric and gastro esophageal junction adenocarcinoma