6303 intro to cancer & therapeutics

max cumulative dose of this drug is 450 mg/m2


this class of drug causes harmless red urine

anthracycline (-rubicin)

chemoprotectant for cyclophosphamide or ifosfamide (mesnex)


chemoprotectant for cisplatin (ethyol)


Examples of oncogenes (k, c)


which side effect is peculiar to ifosfamide vs cyclophosphamide?


1. Uncontrolled growth
2. Lack of differentiation
3. Angiogenesis
4. Loss of contact inhibition
5. metastasis
6. ability to. avoid apoptosis
these are characteristics of which cells?

cancer cells

max dose of cisplatin

100 mg/m2/cycle

Which side effect is lessened by leucovorin when given after MTX? (my, mu, d)

myelosuppression, mucositis, diarrhea

Which side effect of EGFR-1 Moab has a positive correlation with tumor response?

Dermatologic toxicities

What is the generic of xtandi?


main side effect of Ara-C (cytosar/ cytarabine)

Cerebellar toxicity

what agents can cause hypomagnesemia? (ci, ce, pa)

Cisplatin, cetuximab, panitumumab

What is not a side effect of SERM (selective estrogen receptor modifier/ ex) tamoxifen) in post menopausal women?


Progression free survival always correlates with overall survival. True or false.


What type of cancer is the leading cause of death amongst male and female?

lung cancer

Active metabolite of cyclophosphamide & ifosfamide that causes irritation to the lining of the bladder.


what is the brand name of erlotinib?


Which agent is most likely to cause HTN and VTE? (avastin)


Which medication requires you to infuse over > 1 hr to lower risk of hypotension?

monoclonal antibody

Which drug is used with zytiga to reduce corticosteroids inducing side effects & its dosing?

Prednisone 5 mg PO BID

What is the oral prodrug for 5-FU? (xeloda)


Antidote for Fluorouracil DPD related toxicity (uridine triacetate)


Interstitial pulmonary fibrosis is a side effect of what medication?


What is the chemoprotectant used for doxorubicin?


This class of medication is associated with the assembly of microtubules.

vinca alkaloid

Premedication with dexamethasone, H1 antagonist, and H2 antagonist is used for the prevention of hypertensive reactions of what class of medication?


You must check the status of what virus prior to starting rituximab as it can cause a reactivation?


Which class of medication displaces methotrexate from the binding site?


Which medication causes neuropathy exacerbated by cold exposure?


What medication has the side effects such as hepatitis, colitis and pneumonitis? (keytruda)


Which class of drug causes diarrhea, hypothyroidism, QTc prolongation, CYP 3A4 interactions, rash, and LFT abnormalities?

TKI (tyrosine kinase inhibitors)

What DDI would you be concerned with when using 5-FU or capecitabine?


It is part of the REMS program and needs 2 forms of contraception. (thalomid)


What prodrug uses UGT1A1 to metabolize its active drug SN-38? (camptosar)


When using anthracyclines, you should avoid concurrent chemotherapy with what? (t, p)

Transtuzumab, paclitaxel

Which of the following agents is not associated with tumor flare?
1. Lupron
2. Zoladex
3. Firmagon
4. None of the above


Which of the following medications does not cause hand-foot syndrome?
1. Sunitinib
2. Capecitabine
3. Bevacizumab
4. sorafenib


Brand & generic names. Which match is correct?
1. Keytruda-imatinib
2. Firmagon-zoladex
3. Gleevec- pembrolizumab
4. Xtandi- enzalutamide


LM has stage 3 lung cancer and stays in bed > 50% of the time, what is the PS?
1. ECOG PS 5
2. Karnofsky PS 80%
3. Karnofsky PS 20%
4. ECOG PS 3


Which cytotoxic agent does NOT cause myelosuppression?
1. Bleomycin, vincristine, prednisone
2. Bleomycin, vinblastine, prednisone
3. Cisplatin, irinotecan, vincristine
4. Irinotecan, bleomycin, vincristine, prednisone


What vaccines are available to prevent cancer?
1. Gardasil-9, Hep B vaccine
2. Hep A, gardasil-9, Hep B vaccine
3. Hep A, gardasil-9
4. Gardasil-9, hep A


When using tamoxifen, which drug can cause a DDI?
1. Duloxetine, bupropion
2. venlafaxine, bupropion
3. Venlafaxine, citalopram, bupropion


60 y/o female who smokes 2 packs of cigarettes per day x 15 yrs. What cancer screenings are recommended for her? (M,C,L,H)

Mammogram, colonoscopy, low dose helical CT scan, HPV

anastrazole- breast cancer, arthralgias (manage -> APAP/NSAID), menopause sx, OP, bone mineral density, pregnancy x


Bicalutamide- prostate cancer, hot flashes, constipation, diarrhea, mhepatotoxicity, OP, chemoprotectanct = amifostine


Cyclophosphamide- hemorrhagic cystitis, PO QAM, chemoprotectant = mesna


Doxorubicin- max dose 450 mg/m2, harmless urine discoloration, chemoprotectant = dexrazoxane


Erlotinib- QTc, rash (continue tx)


Paclitaxel - hypersensitivity reactions, bone marrow suppression, H1/H2 antagonists, CS to prevent anaphylaxis


Pembrolizumab - PD-1 inhibitor, immune-related toxicities


Rituximab- CD20, infusion site rxn, Hep B serology before tx,


Trastuzumab- cardiomyopathy, infusion-related rxn, pulmonary toxicity, birth defect


tumor suppressor genes

P53, BRCA 1,2

Sites of metastasis (lu, li, ly, br, bo, bom)

lung, liver, lymph nodes, brain, bone, bone marrow

chemo agents that can cause leukemia

alkylating agents, topoisomerase 2 inhibitors

5 types of non-cancer cells that can commonly be affected by cytotoxic chemo (f, c, b, g, h) b/c they a re rapidly dividing cells

fetus, cancer cell, bone marrow, gi mucosa, hair follicle

2 vaccines prevent cancer (h (9-45 y/o),he (newborns))

HPV, Hep B

vitamin _ increase risk of lung cancer, vitamin _ (folic acid) increase risk of colorectal cancer

A, B9

Anogenital warts- common in immunosuppressed & pregnant pts, usually asx, recurrence common, 90% caused by HPV _ & __, which is considered as low risk subtypes, this warts is called __

6, 11, condylomata acuminata

HBV subtypes that are associated to cervical cancer are HIV _ and _


ugly duckling sign- ABCDE

asymmetry, border, color, diameter > 6 mm, evolving

TNM system

T- tumor spread
N- node involvement
M- presence of distant metastasis

Cancer Stages

0-4, 0 is in situ, 1 localized, 2 limited spread, 3 regional spread, 4 metastasis

ECOG scale

0 normal, 1 sx, 2 in bed < 50%, 3 in bed > 50%, 4 in bed 100% 5 dead

Karnofsky Performance Scale

100% normal, 80% sx, 60% in bed < 50%, 40% in bed > 50%, 20% in bed 100%, 0% dead

3 most common causes of cancer-related death in men (l, c, p)- men 1:2 probability of developing cancer

lung; colorectal, prostate

3 most common causes of cancer-related death in women (l, c, b)- women 1:3 probability of developing cancer

lung, colorectal, breast

Log-kill hypothesis

A particular log fraction of cancer cells are killed with every chemotherapy treatment. The goal is to eventually reach a threshold from which the cancer cannot recover.

secondary leukemia agents (d,-latency 1-3 yrs, e- latency 1-3 yrs, i- latency 5-7 yrs)

doxorubicin, etoposide, ifosfamide

Hemorrhagic cystitis

Cyclophosphamide, ifosfamide

alkylating agent that has side effects of MAOI activity, disulfiram reaction, CNS change (depression, nigghtmare, hallucination, dizziness), PO only


alkylating agent need to take on empty stomach & and at bedtime


Oxaliplatin toxicity

can cause cold induced neuropathy, and N/V

Cisplatin toxicity

nephrotoxicity, ototoxicity. neuropathy

Carboplatin toxicity


Etoposide (topoisomerase 2 inhibitor) brand name


Topoisomerase 1 inhibitor, produce ss-DNA nick, brand name camptosar, dose-limiting diarrhea (give atropine SQ, loperamide), active metabolite SN-38, glucuronidated by UGT1A1


topoisomerase 2 inhibitor, brand name VP-16, , dose not interchangeable, hypotension, ppt (use filter, final diluted conc. 0.4 mg/ml), no fridge, secondary leukemia risk in 1-3 yrs


anthracycline cardiomyopathy- risk increased with concurrent chemotx with __, __ (t,p)

trastuzumab, paclitaxel

vinblastin toxicity


Vincristine side effects

peripheral neuropathy, constipation
no myelosuppression

vincristine constipation management with s__ + d__

senna, DSS

red colored urines in classes of a__, v__

anthracycline, vinca alkaloid

potent vesicants are classes of a__, v__

anthracycline, vinca alkaloids

Docetaxel brand


Paclitaxel brand name


paclitaxel side effects

hypersensitivity (rash)
bone marrow suppression

paclitaxel solvent responsible for fatal type 1 immediate hypersensitivity reaction

cremophor EL

docetaxel solvent responsible for fatal type 1 immediate hypersensitivity reaction

polysorbate 80

taxan hypersensitivity management with premedications (d__, H1 (D__), H2 (C__, R__, F__) 30 minutes prior taxans

dexamethasone 20 mg, diphenhydramine 50 mg IV, cimetidine 300 mg, ranitidine 50 mg, famotidine 20 mg IV

paclitaxel give in __ container & give __ filter, no __

non-pvc, in-line, refrigerator

hepatic adjustment classes- a__, an__, v__, ta__

alkylating agent, anthracycline, vinca alkaloid, taxans

tamoxifen brand name - used in both pre-& post menopausal breast cancer


Fulvestrant brand name - used for second line post-menauposal breast cancer


anti epileptic medications that are not interact with tamoxifen, so recommended -> v__, c__

venlafaxine, citalopram

aromatase inhibitor side effects -> o__, ar__, my__, V__

OP, arthralgia, myalgia, VTE

GnRH antagonist that is used for prostate cancer, brand name is firmagon, no hormone surge (no tumor flare), QM dosing, no need to use with antiandrogens


QTc prolonging medications -> de__ (GnRH antagonist)


antiandrogen - bicalutamide brand name


antiandrogen - enzalutamide brand name


Androgen biosynthesis inhibitor, brand name zytiga


empty stomach agents -> t__ (alkylating agent), ab__ (zytiga)

temozolomide, abiraterone

drug used for mineralocorticoid excess of abiraterone (zytiga) & dosing --> p__ 5 mg BID or e__

prednisone, eplerenone

cytarabine, gemicitabine, fluorouracil, capecitabine are which class of cancer agents?

pyrimidine analog

fludarabine, mercaptopurine, azathioprine, thioguanine are which class?

purine analog

Cytarabine Brand name and class

Cytosar, Ara-C, antimetabolite

gemicitabine brand name


Capecitabine Brand name and class

Xeloda, antimetabolite

cerebellar toxicity associated with high dose of which drug?it's brand name is ara-c , cytosar


Mercaptopurine (6-MP) brand name


Thioguanine (6-TG)

MECH: purine metabolite that inhibits many enzymes in purine metabolism
USE: leukemias and lymphomas




Purine antimetabolite (adenosine analog)

purine analog side effects ex) fludarabine

immunosuppression (prolonged t cell recovery, opportunistic infection risk)


Antifolate antimetabolite

Hep B reactivation is related to which agent? it is moniclonal ab work against CD-20


this side effect is found on all CD targeted moabs due to JC virus


autoimmune diseases such as colitis, hepatitis, pneumonitis are common side effect of this immune checkpoint inhibitor, its brand name is keytruda


Trastuzumab (Herceptin) MOA

By binding to the HER2 protein, trastuzumab inhibits the growth of tumor cells and mediates antibody-dependent cellular cytotoxicity (ADCC) in cancer cells that overexpress the HER2 protein

trastuzumab (herceptin), pertuzumab, etuximab (erbitux), panitumumab are which class?

EGFR targeted monoab

management for non-severe dermatologic toxicities of EGFR targeted monoab (cetuximab (erbitux), panitumumab)

continue tx, topical clindamycin or TCN, steroid

VEGF inhibitors

Bevacizumab (AVASTIN)

Bevacizumab (Avastin) side effects

BIG TIP HTN (bleeding, impaired wound healing, GI perforation, thromboembolism, infusion related rxn, proteinuria, HTN)

BRAF mutation



myelogenous leukemia

Erlotinib (Tarceva)

Tyrosine Kinase inhibitor
Inhibit epidermal growth factor receptor (EGFR) tyrosine kinase
Non-small lung cancer; pancreatic cancer
Rash, diarrhea, appetite loss, N & V, stomach pain, fatigue, shortness of breath, mouth sores, dry skin, itching, cough

cyclophosphamide, capecitabine, imatinib (gleevec) requires take with


REMS program

thalidomide (thalomid), immunomodulatory agent

can be used for tx of breast cancer or prostate cancer (l)


nystagumus and ataxia can occur with higgh dose of c__-


omeprazole and ibuprofen may decrease clerance of M__


DPD deficiency -> side effect includes diarrhea, myelosuppression

genomic biomarker for 5-FU, capecitabine