Examples of SARMs?
FlutamideBicalutamide
Rare AE related to flutamide?
Liver toxicity. Reversible, but Liver fx should be monitored.
Examples of BRM?
Cytokines:Interleukin-2Alpha interferonTopical agent:Imiquimod (Aldara)
Interleukin AE?
Fluid retentionSkin changesKidney fx
Examples of antibodies
HerceptinTrastuzumabRituximabBevacizumabCetuximab
Herceptin dose
LD= 8mg/kg followed by 2mg/kg weekly orLD= 8mg/kg followed by 6mg/kg q3 weeks
Antibody that can cause tumor lysis syndrome and fatal infusion rxns
Rituximab
Examples of enzyme inhibitors and receptors down regulators?
AnastrozoleExemestaneFulvestrantLetrozole
Synthetic analog of progesterone used as additional hormonal treatment?
Megestrol
In case of extravasation use warm compression
Vinka alkLoids
Lomustine PO or IV?
PO
After infusion the urine may have a temporary blue-green tinting and sclera may turn blue
Mitoxantrone
Lifetime dose for epirubicin?
900mg/m2
Lifetime dose for doxarubicin and daunorubicin?
550mg/m2
Needs premed with phenytoin to prevent seizures?
Busulfan
Give dexamethasone ophthalmic to prevent conjunctivitis
Cytarabine
Tablet that converts to 5-FU
Capecitabine
Can cause hand and feet syndrome (palmar-plantar erythrodysethesias)?
5-FU
Folic acid increase or decrease the effect of MTX?
Decrease
Give dexamethasone ophthalmic to prevent conjunctivitis
Cytarabine
Avoid cold drinks or food during infusion due to spasm
Oxaliplatin
Fatal if given intrathecal
Vincristine
Do not PVC bag
Paclitaxel and docetaxel
Can cause pulmonary fibrosis and lifetime dose is 400units
Bleomycin
Rapid infusion causes HTN. Also increases coumadin INR
Etoposide
Drugs that can cause hemorrhagic cystitis
Cyclophosphamide and ifosfamide
Dose of Mesna to prevent hemorrhagic cystitis with Ifex
20% of ifex dose
Can cause kidney damage . So pre hydrate with K and Mg
Cisplatin
Given with leucovorin to increase it's activity
5-FU
How to diagnose colon polyps
CT colonographyFOBTColonoscopy
Risk factors for lung cancer
SmokingChronic lung diseaseAsbestosRadonFhx of lung cancer
Risk factors for colon cancer
FhxAgeDietObesitySmoking
Major colorectal cancer susceptibility syndromes are
Familial adenomatous polyposis(FAP)Hereditary non- polyposis colorectal cancer (HNPCC)
Carcinogens highly associated with lung cancer
BenzopyreneN-nitrosamine NNK
Most common type of noninvasive breast cancer
Ductal carcinoma in situ
Most common type of breast cancer
Infiltrating ductal carcinoma
Hypercalcemia in malignancy treatment
Pamidronate disodiumZolendric acid
Given as CIV 1mg/ml infused > 1h
Cisplatin
Administered along with MTX to reduce anemia
Leucovorin
Fludarabine main side effect
Strong bone marrow suppressor
Given IV over 30 min
Gemcitabine
Given intravesical to treat small bladder papilloma
Mitomycin C
Can cause diarrhea and abdominal cramps (life threatening)
Irinotecan. Give loperamide 4mg first onset, 2mg q2hs until diarrhea free for 12h. Atropine 0.25-1mg IV for prophylaxis
Pre-med for paclitaxel
Decadron 20mgIVBenadryl 50mg IVZantac 50mg IV
Risk factors for breast cancer in men
FhxAlcoholRadiotherapyTesticular abnormality or damageLiver damage or dysfunctionObesityKlinefelter's syndrome
Prostate cancer risk factors
FhxAgeRaceDiet
Metabolic abnormalities of TLS
HyperkalemiaHyperuricemiaHyperphosphatemia with secondary hypocalemia
TLS is seen more often in which kind of tumors?
Tumors with high growth factor and high sensitivity to chemo (burkitt lymphoma and T cell acute lymphoblastic leukemia)
Main types of lymphedema?
Primary and secondary
Class of drugs hepatically adjusted according to bilirrubin level
Vinca alkaloids
Antetabolites that can be given as IV push
MTX5-FUCytarabine
Drugs with high emetic risk
AC combinationCarmustine > 250mg/ m2Cisplatin >= 50cyclophosphamide > 1500AltretamineDacarbazineMechloretamineProcarbazineStreptozocin
Treatment for low risk emetic chemo
Metoclopramine +/- diphenhydramine orDexamethasone 12mg orProchlorperazine +/- lorazepam
Types of lung cancer
Small cell and non-small vell
Kinds of non-small lung cancer
Squamous cell carcinomaAdenocarcinomaLarge cell carcinoma
Which of the non-small cell lung cancer is associated with rapid tumor growth and poor prognosis
Large cell carcinoma
Lung cancer that develop in the central region of the lungs
Squamous cell carcinoma
Advanced lung cancer symptoms
Persistent coughSputum streaked with bloodChest painVoice changeRecurrent pneumonia or bronchitis
Common types of polyps
AdenomatousHyperplasticInflammatory
Lynch syndrome is also known as
Hereditary non-polyposis colorectal cancer
Dietary factors associated with decreased risk of colorectal cancer
Diet rixh in fruits and vegetables and calcium
Symptoms associated with advanced stages of colorectal cancer
Rectal bleedingBlood in the stoolChange in bowel habitsCramping pain in lower abdomen
What's the difference between in situ breast cancer and infiltrating
Insitu is confined to ducts and lobules of breast, while invasive spreads to the surrounding connective tissue
Breast cancer risk factors
Hx of breast cancerFhxAgeDietRaceRadiation exposureReproductive and menstrual hx
Ptns thy impact cancer risk
Alpha-fetoproteinhCG
Sumptoms of breast cancer in men
Painless lump in the breastNipple retraction, discharge or ulcerationPainful lump in the breastPaget's disease (skin rash around nipple)
Majority of breast cancer in men is
Invasive ductal carcinoma and ER positive
Dietary factors associated with prostate cancer
Diet rich in dairy and meat are associated with higher riskDiet rich in fish and tomato based products are associated with lower risk
Prostete cancer symptoms associated with late stage
Inability to peeDiscontinuous or weak urine flowFrequent urinationBlood in urinePain or burning with urinationContinuous back, pelvis or upper thigh painDifficulty in starting or stopping urine flow
Monoclonal antibody used to treat of squamous cell carcinoma of Rhadamanthus and neck that can cause dermatological toxicity such as acne like rash, pruritus and nail changes
Cetuximab
MAB that binds to VEGF
Bevacizumab
Anthracycline that can cause stomititis
Doxarubicin - tx with saline rising anf magic mouth wash + lidocaine
Chemo agents that can be given intrathecal
MTXCytarabine
Chemo drug that can be given intravesical
Mytomycin C for small bladde papilloma
Chemo drug that can be given Icav
Bleomycin
Chemo drug that can be given PO
6-MPChlorambucilCapeciyabineHydroxyureaLomustineTemozolomideBusulfanCyclophosphamideMelphalan
Taxan can cause hypersensitive most likely us to
CHEMAPHOR
BRM currently under investigation as a possible angiogenesis inhibitor
Alpha interferon
Don not give carboplatin if CrCL
<15
Examples of tumor suppressor genes
p53BRCAAPCRb