Targeted Therapy for Cancer

Question 1

T or F. Targeted therapy can destroy tumors, which is why patients are at a high risk of tumor lysis syndrome.

Answer 1

F - Target therapy can only prevent tumor from growing

Question 2

Tyrosine kinase inhibitors block the TK site on a __________ receptor to prevent signaling. These agents all end in “-…..”

Answer 2

Growth factor

ib.

Question 3

Monoclonal Antibodies work by binding to the __________ receptors. These drugs end in “-…”

Answer 3

Extracellular proteins - growth factor receptors

“Ab”

Question 4

Immune Modulating Agents (IMIDs) both __________ and ________ the immune system.

Answer 4

inhibit and stimulate

Question 5

Mammalian target of rapamycin (MTOR) works by inhibiting what process in the body?

Answer 5

Intracellular signal transduction pathway - identified in T-cells and targeted for immune suppression,

Question 6

T or F. Targeting chemotherapy are cytotoxic.

Answer 6

F - Cytostatic - only inhibit growth signals

Question 7

Cytostatic chemo is typically dosed _______.
Oral agents are given ______.
Drugs with a longer half life can be given __________.

Answer 7

Continuously.
Daily
IV weekly

Question 8

How do cytostatic chemo drugs differ from cytotoxic in how they are dosed?

Answer 8

Cytostatic - dosed to maximum effect

Cytotoxic - dosed to maximum toxicity tolerated

Question 9

Which is more toxic - targeted therapy or cytotoxic?

Answer 9

Cytotoxic - because targeted therapy isn’t dosed to maximum tolerated toxicity

Question 10

Where are the side effects going to be seen when using cytostatic chemo?
Why?
What are the side effects?

Answer 10

• Cells that use the signaling pathway - skin
• Chemo inhibits Epidermal Growth Factor Receptors (EGFR) - dermatologic toxicity
• Acne like rash, paronchia, dry skin, conjunctivitis, dry inflamed eyes

Question 11

Managing toxicity and counseling the importance of _________ is paramount to optimize the outcomes of the targeting agents.

Answer 11

compliance

Question 12

What are the 2 cautions that need to be kept in mind with targeted therapy?

Answer 12

1. Drug interactions - many are metabolized and can effect metabolism of other drugs
2. Changes in liver or renal function

Question 13

What is another AE of using targeted therapy? (other than skin) Why?

Answer 13

Chemo inhibits Vascular Endothelial Growth Factor Receptors - prevents angiogenesis
Leads to increased risk of cardiac issues:
Increased bleeding
Thrombosis (increased exposure to collagen/tissue factor)
HTN

Question 14

Be able to write out 8 differences between cytotoxic and cytostatic:
MOA:
Route and dosing regimen:
Maximum dose is based on:
How toxic?
Is compliance an issue?
Drug-drug interactions?
AEs:

Answer 14

Cytotoxic/Cytostatic
kills/static
IV and pulsatile/ Oral and IV and given daily
max dose based on toxicity/efficacy
Very toxic/less toxic
Compliance NOT an issue/yes issue
Rarely have DI/yes drug interactions
Hair loss, N/V / skin toxicity/cardiac issues from VEGF