special chemo drugs

Question 1

hydroxyurea: mechanism, non-cancer use, toxicity

Answer 1

inhibits ribonucleotide reductase. decreases DNA synthesis. S phase specific.
used for melanoma, CML, and SICKLE CELL DISEASE (increases HbF).
tox: bone marrow suppression and GI upset

Question 2

tamoxifen. similar drugs, mechanism , use, toxicity

Answer 2

also raloxifene.
these are SERMs. receptor antogonists in breast and agonists in bone. block the binding of estrogen to ER positive cells.
used for breast cancer treatment (tamoxifen only), and prevention. raloxifene also used to prevent osteoporosis. toxicities: tamoxifen is a partial agonist of the endometrium, so there is a risk of endometrial cancer. this is NOT true of raloxifene (it is an endometrial antagonist)

Question 3

trastuzumab: mechanism, use, toxicity

Answer 3

aka herceptin
monoclonal ab against HER2, a tyrosine kinase receptor. helps kill breast cancer cells that overexpress HER2 through inhibition of HER-2 initiated cellular signaling and ab dependent cytotoxicity.
used for HER2 positive gastric cancer and breast cancer.
toxicity: cardiotoxic

Question 4

imatinib: mechanism, use, toxicity

Answer 4

tyrosine-kinase inhibitor of Bcr-Abl (CML) and c-kit (common in GI stromal tumors).
toxicity is very minimal (fluid retention)

Question 5

rituximab: mechanism, use, toxicity

Answer 5

monoclonal ab against CD20, which is found on most B cell neoplasms. also used for RA.
incr. risk of progressive multifocal leukoencephalopathy

Question 6

vermurafenib

Answer 6

inhibitor of forms of the B-raf kinase with a V600E mutiation. used for metastatic melanoma.

Question 7

Bevacizumab

Answer 7

ab against VEGF that inhibits angiogenesis. used for solid tumors. can cause hemorrhage and impaired wound healing.