Tumors of GI system Flashcards
Drugs used for anal cancer
cisplatin, mitomycin, 5FU
Drugs used for CRC
bevacizumab, capecitabine, cetuximab, 5FU
Drugs used for esophageal cancer
Cisplatin, Docetaxel, 5FU
Drugs used for gastric cancer
cisplatin, docetaxel, 5FU, trastuzumab
Drugs used for GI carcinoid
octreotide, interferon
Drugs used for GIST
imatinib, sunitinib
Drugs used for pancreatic cancer
5FU, erlotinib, gemcitabine
Drugs used for liver cancer
5FU
What is 1st/2nd line therapy for esophageal cancer?
Cisplatin + 5FU. docetaxel is 2nd line
How should you determine gastic cancer therapy
Check Her2 status. If positive, trastuzumab should be added to 5FU/cisplatin therapy
How do you determine CRC therapy?
Capecitbine or 5FU + bevacizumab or cetuximab unless KRAS +
What drug is associated with tachyphylaxis?
octreotide- duration of treatment is 12 months usually
Treatment with conventional chemo is GIST is futile due to ____.
overexpression of P-gp
GIST can be categorized into what groups?
KIT-mutant (80%), KIT negative, PDGFRA-mutant, wild-type
MOA bevacizumab
rhuMAab-VEGF
Bevacizumab issues
bleeding, perforation, wound dehisence, HTN
Capecitabine MOA
5FU prodrug
Capecitabine issues
DPD deficiency prevents metabolic activation. CI in renal dysfunction. Adverse CV events. Neuro and heme toxicities
Cetuximab MOA
EGFR Ab
Cetuximab issues
Cardiac arrest, respiratory arrest, sudden death, acneiform, infusion rxn
Cisplatin MOA
DNA crosslinks and adducts
Cisplatin issues
ototoxicity, NEPHROTOXICITY, BMS
Docetaxel MOA
Stabilize microtubule
Docetaxel issues
Increased tx related morality in NSCLC; edema, neuropathy, CI in hepatic disease, DLT: neutropenia
Erlotinib MOA
EGFR-TKI
Erlotinib issues
GI tox, bleeding, LFTs, ocular toxicities, rarely ILD
5FU MOA
pyrimidine antimetabolite that inhibits TS and interferes with RNA synthesis and effects DNA
5Fu issues
DPD deficiency = enhanced neurotoxicity, severe heme tox and BMS
Gemcitabine MOA
DNA polymerase inhibitor, incorporates triphosphate
Gemcitabine issues
BMS, infection, sensory peripheral neuropathy, arthralagia, drowsiness, anorexia resolves in 2-3 days
imatinib MOA
TKI adjuvant with resection of KIT mutant GIST
Imatinib issues
GI tox, CHF, neuro tox, fluid retention, edema
Inf-a MOA
enzyme activation following cell surface receptor binding and TK activation
inf-a issues
neuropsychiatric events, FLS
Mitomycin MOA
alkylating agent
Mitomycin issues
BMS, thrombocytopenia, leukopenia, HUS
Octreotide MOA
SS, reduce duodenal bicarb, amylase, gastric acidity, gallbladder contractility, bile secretion, inhibits meal induced increases in SMA and portal venous blood flow
Octreotide issues
monitor blood glucose, dose-related diarrhea
Sunitinib MOA
inhibitor of >80 RTKs
Sunitinib issues
Thrombocytopenia, bleeding, QT prolongation, GI complications including perforation
Trastuzumab MOA
HER2-neu antibody. Inhibition of Her2–> accumulation of cdk inhibitor p26–> cell cycle arrest. Inhibits constitutive Her2 shedding by MP (correlate with clinical activity)
Trastuzumab issues
LVEF dysfunction, cardiomyopathy, anaphylaxis, angioedema, pulmonary toxicity
