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This stuff right here Flashcards

1
Q

High Emetic Risk Drugs

A 
Streptozosin
Mechlorethamine
Darcarbazine
Cyclophosphamide >1.5gm/m2
Carboplatin AUC >6
Cisplatin
Doxorubicin + Cyclophosphamide
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2
Q

High Risk Antiemesis Combo regimen

A

5HT3 + NK + Steroid (and/or Benzo)

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3
Q

Antiemesis Rescue Tx

A

Something not already in use; D2A common for breakthrough

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4
Q

Febrile Neutropenia Empiric Coverage

A

Antipseudomonal Beta-Lactam (cephalosporin)

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5
Q

When to use gCSF

A

When patient is becoming neutropenic (>20% risk)

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6
Q

What to do as secondary prophylaxis if pt has history of Febrile Neutropenia and/or previous gCSF use

A

Add gCSF, if previously used then Reduce chemo or change Tx

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7
Q

What labs/levels are high risk for TLS?

A

Uric Acid (>8) Potassium >6; Phosphorous >6.5 and Calcium <7 or >14

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8
Q

Tx for Uric Acid abnormalities in TLS

A

Allopurinol (also can be used prophylaxis)

Rasburicase

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9
Q

Tx for Hyperkalemia in TLS

A 
Regular Insulin in D50W (if BG <250)
Nebulized Albuterol + Sodium Bicarbonate
Furosemide
SPS (sodium exchange)
Patiromer (Ca exchange)
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10
Q

Tx for Hyperphosphatemia if no Hypercalcemia

A

Calcium Carbonate
Calcium Acetate
Aluminum Hydroxide

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11
Q

Tx for Hyperphosphatemia if Hypercalcemia

A 
Renagel
Renvela
Lanthanum Carbonate
Ferric CItrate
Sucroferric Oxyhydride
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12
Q

Tx for Hypercalcemia

A

Hydrate First
Bisphosphanates
Calcitonin
* if refractory w/ Bisphosphanates may add denosumab

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13
Q

Strongest Mutation correlated with Breast Cancer

A

BRCA (1 and 2)

- also at higher risk for ovarian/prostate

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14
Q

Breast Cancer Tx if ER/PR (+) and HER-2 (+/-)

A

Hormone Tx

  • Tamoxifen or LHRH (premenopausal)
  • Aromatase inhibitor (postmenopausal)
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15
Q

Breast Cancer Tx if ER/PR (-) and HER2 (+)

A

Trastuzumab +/- (Carboplatin + Docetaxel)

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16
Q

Breast Cancer Tx if ER/PR (-) and HER2 (-)

A

Cyclophosphamide + Doxorubin + Taxane

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17
Q

Breast Cancer Emetogenic Regimen

A

Fosaprepitant + Dexmethasone + Ondansetron
PRN prochloperazine and Ativan
+ Olanzapine if refractory

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18
Q

Breat Cancer Trastuzumab adjunctive

A

Pentuzumab ( only w/ Trastuzumab)

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19
Q

Neratinib

A

Used in HER2 (+)
TKI; prevents formation of HER2 epitopes
Diarrhea major side effect

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20
Q

Lapatinib

A

Used in HER2 (+)

TKI; inhibits EGFR & HER2;

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21
Q

Pablociclib

A

Used in HER2(-) ER/PR (+)
Cyclin Depende Kinase inhibitor
Inhibits CDK4/6 by blocking retinoblastoma hyperphosphorylation

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22
Q

Androgen Deprivation Therapy Options

A
  1. Oriechiectomy (Castration)

2. Medical Androgen Deprivation (Chem Cast)

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23
Q

LHRH Agonist Place in therapy

A

Suppresses LH an FSH/Testosterone Production
Leuprolide
Goreselin
Triptorelin
- See initial disease flare up to 2 weeks; Use anti-androgens prior to Tx for 1-2wks

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24
Q

LHRH Antagonists

A

Use if high tumor burden
Binds to GNRH receptor in pituitary, directly suppresses androgen production
Degarelix agent of choice

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25
Q

AntiAndrogens

A

Used in combo w/ LHRH for androgen deprivation

Bicalutamide agent of choice

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26
Q

Abiraterone

A

Androgen Biosynthesis inhibitor binds CYP17, blocking androgen synthesis in testes, adrenal and tumors
Significant DDIs: 3A4, 2C8, 2D6, 1A2

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27
Q

Chemo Tx in Prostate Cancer

A

used if metastazing

- Docetaxel or Cabazitaxel

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28
Q

Enzalutamide

A

Pure androgen blocker,
More Hormonal side effects than bicalutamide
Decreases seizure threshold

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29
Q

Limited Stage SCLC Tx

A

Cisplatin + Etoposide (EP) and Radiation

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30
Q

Extensive Stage SCLC Tx

A

Etoposide + Cisplatin
Etoposide + Carboplatin
Cisplatin + Irinotecan (Asians?)

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31
Q

Extensive SCLC Single Agent Tx

A 
Topotecan
Irinotecan
Gemcitabine
Paclitaxel
Docetaxel
Vinorebine
Etoposide
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32
Q

Extensive SCLC 2nd line Combo

A

Cyclphosphamide + Doxorubicin + Vincrisitine (CAV)
Nivolumab or Ipilumumab
Combos increase toxicity

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33
Q

Mutation free NSCLC SCC

A

Platinum Doublet (No pemetrexed)

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34
Q

Mutation Free NSCLC LCC

A

Platinum Doublet with Pemetrexed
Carboplatin + Paclitaxel + Bevacizumab
Carboplatin + Pemtrexed + Pembroluzumab

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35
Q

EGFR Mutation NSCLC

A

Afatinib, Erlotnib, getfitinib

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36
Q

ALK Mutation NSCLC

A

Alectinib, Crizotinib, Ceritnib

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37
Q

ROS1 Mutation NSCLC

A

Crizotinib

Ceritnib

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38
Q

BRAF v600 Mutation NSCLC

A

Dabrafenib + Trametinib

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39
Q

PD-li Mutation NSCLC

A

Pembrolizumab

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40
Q

Gynecologic Malgnancies Stage Ic-III Tx

A

Platinum/Taxan Combo (IV or IP)
(Ic = OV)
(III = IP)
NO Oxaliplatin

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41
Q

Calvert Equation

A

Dose = AUC x (GFR +25)
Max GFR = 125
Used for Carboplatin Dosing

42
Q

Plt Resistant Recurrent Gyne Malig Tx

A

Single agent (non platinum) +/- Bevacizumab

43
Q

Recurrent Gyne malig Tx (plt sensitive)

A

Platinum doublet +/- Bevacizumab

44
Q

Recurrent (>2) gyne malig tx

A

Parp Inhibitors
Olaparib
Rucaparib
Niraparib

45
Q

Colon Cancer Stage III Category 1 tx

A

FOLFOX

or CAPEOX

46
Q

Colon Cancer Stage IV Tx

A

FOLFIRI (inc mortality except in stage IV)
FOLFOX
CAPEOX

47
Q

Colon Cancer Tx w/ KRAS/NRAS wild type

A

Cetuximab

Panitimumab

48
Q

Colon Cancer EGFR inhibitor Major Toxicity

A

Skin Toxicity

  • Papulopoustular Skin Rash
  • Xenosis
  • Fissures
  • Alopecia
49
Q

Non-Mismatch Repair Deficient Colon Cancer Tx

A

Nivolumab

Pembrolizumab

50
Q

ALL Induction Tx

A

Vincristine + Prednisone + Daunorubucin + L-Aasparaginase

51
Q

ALL CNS Chemo Tx

A

Intrathecal Chemo

  • Methotrexate
  • Cytarabine
52
Q

ALL Consolidation Tx

A

Non-universal combo tx

Daunorubicin, Vincristine, Prednisone, Asparaginase, Methotrexate, Cytaraine, Doxorubicin, Mercaptopurine, Thioguanine

53
Q

ALL maintenance Tx

A

Decreasing doses of

  • Mercaptopurine
  • Methotrexate
  • Vincristine
  • Prednisone
54
Q

ALL w/ Philadelphia Mut Tx

A

BCR-ABL Tyrosine Kinase Inhibitors

- Dasatninb, Imatinib, Nilotinib

55
Q

ALL Salvage Tx for anti-CD19

A

Blinatumomab

Tisagenlecleucel

56
Q

ALL Salvage Tx for anti CD22

A

Inotuzumab

57
Q

Blinatumomab MoA

A

CD-19 dicted CD3 T-cell engager, forms cytolytic synapse between cytotoxic T cell and cancer target B-cell. Mediates the production of cytolytic proteins, release of inflammatory cytokines and proliferation of T cells, resulting in lysis of CD 19 + cells

58
Q

ALL CNS prophylaxis measures

A

Do not do with Kids (mental Retardation alert)

59
Q

AML/ANLL Induction Tx

A

Anthracycline x 3 days Cytarabine x7 days (3 and 7)

60
Q

AML/ANLL Consolidation Tx

A

high doses of Cytarabine

61
Q

APL Induction Tx

A

Tretinoin PO + Arsenic (low risk)

Anthracycline +/- Cytarabine (High Risk)

62
Q

Pre AHSCT Tx

A

Busulfan and Cyclophosphamide

63
Q

CLL Chemo Immuno Tx

A

Fludarabine + Cyclophosphamide + Rituximab (FCR)
Pentostatin + Cyclophosphadmie + Rituximab (PCR)
Bendamustine + Rituximab (BR)

64
Q

CLL P13-K Delta inhibitor Tx

A

Idelalisib

65
Q

CLL Bruton’s Tyrosine Kinase Inhibitor

A

Ibrutinib

66
Q

CLL Selective BCL02 inhibitor

A

Venetoclax

67
Q

CLL tx w/ adjuvant Chlorambucil

A

Ofatumumab

Obinutuzumab

68
Q

CLL CD52 inhibitor

A

Alemtuzumab

69
Q

HSV/VZV Infection Prophylaxis

A

Acyclovir/Valacyclovir

70
Q

PCP infection prophylaxis

A

SMX/TMP
Dapson
Atovaquone
Pentamidine

71
Q

Hepatitis B Infection Prophylaxis

A

Entecavir, Tenofovir and Lamivudine

72
Q

CMV Infection Prophylaxis

A

Serial PCRs

Valganciclovir

73
Q

Hypogammaglobulinemia Tx

A

IV Ig

74
Q

Autoimmune Hemolytic Anemia Tx

A

High dose steroids
Rituximab
Alemtuzumab

75
Q

Immune Thrombocytopenia

A

High Dose steroids
IV Ig, Rituximab, Rho Ig, Immunosuppressants
Romiplostim, Eltrombopag

76
Q

Richter Syndrome Tx

A

Combination Chemo

77
Q

CML Acute Frontline Tx

A

Hydroxyurea

TLS prophylaxis w/ Allopurinol

78
Q

CML Primary Tx

A

Imatinib, Dastatinib or Nilotinib

D or N if high risk

79
Q

CML Tx after TKI failure

A

Bosutinib
Ponatinib
Omacetaxine

80
Q

MM Clinical Manifestation

A 
CRAB
Calcium elevation
Renal Insufficiecy
Anemia
Bone Disease
81
Q

MM low/Int Induction Tx

A

VRD

Bortezomib, Lenalidomide and Dexamethasone

82
Q

MM High risk Induction Tx

A

KRD

Carfilzomib, Lenalidomide and Dexamethasone

83
Q

MM Elder/Frail Tx

A

RD

Lenalidomide and Dexamethasone

84
Q

Immunomodulators used in MM

A

Lenalidomide

Thalidomide

85
Q

Immunomodulator ADRs

A

Teratogenicity
VTE
Myelosuppression
Peripheral Neuropathy

86
Q

Proteasome inhibitors and target

A

Bortezomib (26S)
Carflizomib (20S)
Ixasomib (20s, reversible)

87
Q

MM Maintenance Tx

A

Lenalidomide or Bortezomib

88
Q

MM Salvage Tx

A

Daratumumab

Elotuzumab

89
Q

Osteo Support in MM

A

Bisphosphonates
Pamidronate
Zoledronic Acid

90
Q

Elotuzumab MoA

A

(SLAMF7) Direction activation of NK cells

91
Q

Daratumumab target

A

(CD38)

92
Q

“B Symptoms”

A

Fever
Drenching Night Sweats
Weight Loss >10% Body weight

93
Q

Hodgkin Chemo Tx Standards

A

ABVD
Stanford V
BEACOPP

94
Q

ABVD

A 
ABVD
Doxorubicin
Bleomycin
Vinblastine
Dacarbazine
95
Q

Stanford V

A 
Doxorubicin
Vinblastine
Mechlorethamine
Vincristine
Bleomycin
Etoposide
Prednisone
96
Q

BEACOPP

A 
Bleomycin
Etoposide
Doxorubicin
Cyclophosphamide
Vincristine
Procarbazine
Prednisone
97
Q

Hodgkin Salvage Tx

A

AutoSCT –> Brentuximab, Nivolumab, Prembrolizumab

98
Q

Non-Hodgkin Diffuse Large C CEll Tx

A

RCHOP or R-Bendamustine
Rituximab, Cyclphosphamide, Doxorubicin, Vincristine, Prednisone
Rituximab + Bendamustine

99
Q

Non-Hodgkin Follicular Tx

A

Bendamustine + Rituximab

Bendamustine + Obintuzumab

100
Q

Burkitts Lymphoma Tx

A

RCHOP

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