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GI cancer pharmacology
Gastrointestinal cancer pharmacology: M2
34
Medical
Professional
08/28/2013

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Cards

Term
Cisplatin/Carboplatin/Paraplatin MOA
Definition
    similar to alkylating agents, so often classified with them; forms platinum complexes at N7 of guanine and forms inter- and intrastrand cross-links.  The resulting cytotoxic lesion inhibits both DNA replication and RNA synthesis.  Cells are most vulnerable in G1 and S phases
Term
Cisplatin/Carboplatin/Paraplatin Resistance Mechanisms
Definition
elevated glutathione or increased DNA repair or decreased cellular uptake; increased levels of metallothionein bind to and inactivate both drugs
Term
Vinblastine and Vincristine MOA
Definition
block polymerization of microtubules, preventing cell division
Term
Taxane/Paclitaxel/Docetaxel MOA
Definition

stabilize microtubules and prevent depolymerization

Term
Paclitaxel/Docetaxel Side Effects
Definition
Neuropathy is the dose limiting factor.
Term
Paclitaxel/Docetaxel Drug Interactions
Definition

carboplatin/cisplatin for increased risk of neuropathy

Term
Levamisole Buzz Words for question stem
Definition

crack cocaine

Ascaris/de-worming

skin lesions/necrosis

Term
Levamisole MOA
Definition
Not positive of the MOA, but thought to be immunomodulatory by stimulating NK cells and T-cells
Term
5-FU MOA
Definition
FDUMP inhibits thymdylate synthetase, causing DNA damage and cell death
Term
5-FU Interactions
Definition
Metronidazole due to decreased clearance of 5-FU
Term
Trastuzumab MOA
Definition
Monoclonal antibody that binds the external domain of HER2/neu, a receptor that is greatly amplified in cancer cells
Term
Trastuzumab Side Effects
Definition
Cardiotoxicity is the dose limiting factor.
Term
Monoclonal Antibody Resistance Mechanisms
Definition

1. therapeutic agent can't recognize target

2. compensatory signaling causing upregulation of other HER receptors or another family of receptors

3. altered downstream signaling

4. competition for binding therapeutic agent

Term
Gastric Adenocarcinoma Treatment
Definition

Cisplatin with epirubicin or docetaxel

or

5-FU with irinotecan

Term
Topotecan/Irinotecan MOA
Definition
Stabilizes the cleavable complex of Topoisomerase binding to DNA, causing a double-stranded DNA break
Term
Treatment of H. pylori
Definition

treat with a PPI and antibiotic series

 

Term
Eradication of H. pylori often cures
Definition
MALToma/low grade B cell lymphoma
Term
Treatment of B cell lymphoma if there is chromosomal abnormality preventing cure by eradication of H. pylori
Definition

Cyclophosphamide

Hydroxydaunorubicin (doxorubicin)

Oncovin (Vincristine)

Prednisone

+ rituximab

 

CHOP + rituximab

Term
Cyclophosphamide MOA
Definition
alkylating agent
Term
Rituximab MOA
Definition
CD20 monoclonal antibody that makes cell susceptible NK cells
Term
Doxorubicin Dose-Limiting Effect
Definition
cardiotoxicity, cumulative effect
Term
Treatment of Pancreatic Cancer
Definition
Single agent therapy of Gemcitabine
Term
Gemcitabine MOA
Definition
inhibits DNA synthesis
Term
GIST Treatment
Definition
Single agent therapy of Imatinib
Term
Imatinib MOA
Definition

tyrosine kinase inhibitor

 inhibits the c-Kit pathway

Term
Why does concomitant use of leucovorin with 5-FU improve its efficacy?
Definition
Increases efficacy of 5-FU by stabilizing the binding of FDUMP to thymidylate synthetase
Term
Treatment of Metastatic Colorectal Cancer
Definition

FOL = Leucovorin (folinic acid)

F = 5-FU

OX = oxaliplatin

 

or

 

FOL

F

IRI = irinotecan

Term

In treating colorectal cancer,                and

                appear to have therapeutic synergy with irinotecan even in patients previously resistant to the drug.

Definition
cetuximab and panitumumab
Term
Cetuximab and panitumumab are not effective in colon tumors with                       mutations.                and other tyrosine kinase inhibitors do not appear to be effective
Definition

K-ras

Erlotinib

Term
                                                               therapy with concomitant chemotherapy has resulted in biopys proven disappearance of all anal cancer tumors in >80% of patients whose initial leasion was <3 cm in size.
Definition
external beam radiation.
Term
Most often used chemotherapeutics in treatment of anal cancer
Definition
combo of 5-FU and mitomycin
Term
Rate limitation of external bean radiation therapy for anal cancer
Definition
pelvic fractures in women
Term
Mitomycin C MOA
Definition
Works best in hypoxic tumors due to chemical necessity for reduction. It is a potent radiosensitizer
Term
Mitomycin Clinical Use
Definition
best available therapy for use in combination with radiation therapy to attack hypoxic tumor cells, making ideal if you need to use less radiation because of limitation factors, such as in anal cancer
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