Platinum Derivatives, Procarbazine, Asparaginase, Retinoids

Question 1

Cisplatin, Carboplatin

Answer 1

• Platinum derivatives. Non-phase specific. Mofa similar to Alkylating agents -> reactive complex that cross link DNA.
  • Cisplatin: Solid tumors (testicular, ovarian). Severe persisting vomiting, Doselimiting nephrotoxicity, ototocixity.
  • Carboplatin: Used when nephrotoxicity/ototoxicity is a problem. Doselimiting Myelotoxicity.

Question 2

Procarbazine

Answer 2

• Alkylating agent, inhibiting DNA synthesis.
• Hodkings Lymphoma
• AE: Neurotoxicity, mutagenic & teratogenic, Disulfiram-like reaction, inhibits MAO.

Question 3

Asparaginase

Answer 3

Crisantaspase.

• Hydrolyzes blood asparagine, deprive tumor of nutrients.
• ALL, as it looses ability to synthesize asparagine and need it exogenously.
• AE: hypersensitivity, coagulation abnormalities, Hepatotoxicity, seizures&coma (ammonia toxicity)

Question 4

Retinoids

Answer 4

• related to Vit. A, cause differentiation and prevent cell growth. Also activated tumor suppressor genes
• APL (translocation 15,17 -> abnormal retinoid receptor), high staged neuroblastoma.
• 1st gen: Retinol, Retinal, Tretinoin
• 2nd gen: Acitretin
• 3rd gen: Tazarotene
• AE: dry skin/eyes, myalgia, papilledema, Alopecia
• CI in pregnancy