Cancer Basics
Uncontrolled cell growth
Drugs that kill cells in any phase of the cell cycle are called:
Cell cycle non-specific
Cyclophosphamide and ifosfamide belongs to this class
Alkylating agents
Severe diarrhea is a boxed warning for this drug
Irinotecan
What lab value is essential for calculating carboplatin dosing?
Serum creatine
Cancer that originates from epithelial tissue
Carcinoma
S-phase specific drug classes include (2):
Antimetabolites (methotrexate, 5-FU, capecitabine), topoisomerase I inhibitors (irinotecan)
This drug class intercalates into DNA, inhibits topoisomerase II and creates oxygen-free radicals that damage cells
Anthracyclines
Hemorrhagic cystitis is associated with these alkylating agents (2)
Cyclophosphamide and ifosfamide
High dose methotrexate requires this rescue therapy
Leucovorin rescue
What is the difference between leukemia and lymphoma?
Neoadjuvent therapy
Which drug intercalates DNA and generates free radicals?
Anthracyclines
Capecitabine is an oral prodrug of which chemotherapy agent?
5-FU
This anthracycline toxicity is cumulative and dose-dependent
Cardiotoxicity
Leucovorin is given with this drug to as a "rescue" medication
Methotrexate
What is sarcoma?
Cancer arising from connective tissue like bone, fat or muscle
Topoisomerase II inhibitors (etoposide, bleomycin) work in which cell phase?
G2 phase
Methotrexate and pemetrexed interfere with which biochemical cycle
Folic acid cycle
Vinca alkaloids are fatal if given by this route
Intrathecal administration
Which electrolytes must be monitored closely with cisplatin therapy? (2)
K and mg
MC has stage 3 melanoma and is getting 2 cycles of ipilimumab and nivolumab every three weeks followed by surgery. What is this regimen an example of?
Neoadjuvent chemotherapy
A tumor has a very low growth fraction with most cells in G0. Predict which class of chemotherapy (cell cyle-specific vs non-specific) would be most effective and why
Cell cycle non-specific because they can kill cells regardless of the phase
JR is on fluorouracil (5-FU), oxaliplatin and high dose leucovorin for his colon cancer. Why is leucovorin added to this regimen?
To increase the efficacy of 5-FU
Which traditional chemotherapy agent should patients avoid cold exposure on?
Oxaliplatin
A patient is ordered for carboplatin AUC 5. His vitals/labs are as follows: SCr 0.9 mg/dL, age 60, weight 70 kg. Calculate the carboplatin dose
560 mg