Testicular Cancer Drugs

Question 1

Tx for organ confined dz

Answer 1

Orchiectomy

Question 2

Tx for mets to lymph and abd

Answer 2

Adjunctive radiotherapy and/or chemo

Question 3

Mechanisms of cisplatin resistance

Answer 3

1. Affect pre-binding processes
2. Increase DNA damage repair
3. Impair signal transmission
4. Stimulate pro-survival signaling

Question 4

bleomycin MOA

Answer 4

DNA strand breakage

Question 5

cisplatin/carboplatin MOA

Answer 5

DNA damage and oxidative stress

Question 6

etoposide MOA

Answer 6

stabilizes topo II –> strand breakage

Question 7

ifosfamide MOA

Answer 7

alkylating agent

Question 8

paclitaxel MOA

Answer 8

microtubule stabilization

Question 9

vinblastine MOA

Answer 9

microtubule destruction

Question 10

mesna and amifostine significance

Answer 10

protect against hemorrhagic cystitis caused by ifosfamide

Question 11

bleomycin toxicity

Answer 11

pulmonary fibrosis

skin toxicity

Question 12

cisplatin toxicity

Answer 12

renal and ototoxicity

Question 13

carboplatin toxicity

Answer 13

thrombocytopenia

Question 14

etoposide toxicity

Answer 14

leukopenia

Question 15

ifosfamide toxicity

Answer 15

hemorrhagic cystitis

myelosuppression

Question 16

paclitaxel toxicity

Answer 16

bone marrow suppression

peripheral neuropathy

Question 17

vinblastine toxicity

Answer 17

peripheral neuropathy

Question 18

MOA of cisplatin causing renal and ototoxicity

Answer 18

accumulates in renal and cochlear cells via OCT2 transport and causes inflammation and generation of ROS
OCT is downregulated in tumor cells, so blocking it could reduce these sx

Question 19

MOA of bleomycin causing pulmonary fibrosis

Answer 19

stimulates Nalp3 inflammasome –> production of ROS, IL1B, and TGF-B –> inflammation and fibrosis