Buy Antineoplastic Drugs Discussion Solutions

Buy Antineoplastic Drugs Discussion Solutions
Buy Antineoplastic Drugs Discussion Solutions
Questions 1−4
1. B
2. E
3. D
4. F
Learning objective: Outline the anticancer use of trastuzumab.
5. C Trastuzum ab is a m onoclonal antibody against a surface
protein called hum an epiderm al grow th factor receptor 2
(HER-2), w hich m ay be overexpressed in prim ary breast carcinom a. The drug binds w ith high a nity to this receptor,
thus preventing the binding of HER to the sam e receptor. In
this way, tum or grow th is inhibited. Trastuzum ab is used in
HER-2 positive, m etastasized breast cancer, alone or in com –
bination w ith paclitaxel.
A, B, D−F These drugs are not used in breast cancer
chem otherapy.
Learning objective: Explain the concept of rescue therapy in anticancer drug treatment.
Buy Antineoplastic Drugs Discussion Solutions
6. E Rescue therapy is a strategy aim ed at alleviating som e adverse e ects of anticancer chem otherapy by the use of drugs
that can “rescue” the norm al cells exposed to the anticancer
drug. Leucovorin (formyl tetrahydrofolate, also called folinic
acid) is accum ulated m ore readily by norm al cells than by
neoplastic cells. The adm inistration of this drug results in rescue of the norm al cells, as the drug bypasses the two steps in
the purine synthesis that are blocked by m ethotrexate (i.e.,
folate to dihydrofolate and dihydrofolate to tetrahydrofolate).
A Log kill is a rule that states that a given dose of an anticancer drug kills a constant proportion of the tum or cell
population.
B Recruitm ent refers to a strategy that involves initial use
of cell cycle nonspeci c (CCNS) anticancer drugs to achieve a
signi cant cell kill. This kill “enrolls” previously resting cells
in the G0 phase of the cell cycle. At this stage, cell cycle speci c
(CCS) anticancer drugs are given. Because these drugs are active against dividing cells, m axim al cell kill m ay be achieved.
C Pulsing is a strategy that involves cycles of treatm ent w ith
very high doses of an anticancer drug. Between cycles, norm al
cells can recover from the cytotoxic e ects of the drug.
D Com bination therapy is the rule in anticancer treatm ent
and is usually done w ith drugs having di erent m echanism s
of action and (w hen possible) di erent toxic e ects.
Learning objective: Explain why carmustine and other nitrosoureas
are used to treat brain tumors.
7. B Carm ustine belongs to the nitrosoureas group of drugs.
These alkylating agents have a high lipophilicit y that facilitates their entry into the brain. In fact, their concentration in
the cerebrospinal uid is 15 to 70% of the concurrent plasm a
values. Because of this, nitrosoureas are the m ain chem otherapeutic agents used in the treatm ent of brain tum ors.
A Nitrosoureas are alkylating agents that actually can kill
both neoplastic and nonneoplastic cells.
C Carm ustine actually can cause encephalopathy w hen
given in high doses.
D The am ine pum p is speci c for m onoam ines. Nitrosoureas are not m onoam ines.
E The half-life of carm ustine is actually short, about 15 to
30 m inutes.
Learning objective: Explain the mechanism of anticancer action
of doxorubicin.
8. A Doxorubicin is an anthracycline antibiotic, thus the A in
the ABVD acronym ; alternatively, the A m ay be considered to
stand for Adriamycin, a brand nam e for doxorubicin. These
anticancer drugs likely act w ith m ultiple m echanism s, including intercalation between adjacent base pairs of DNA, thus
causing blockade of DNA replication; blockade of topoisom erase II, the enzym e that catalyzes DNA repair (it breaks and
then reseals DNA strands); and generation of free radicals that
can oxidize DNA bases. The end result of these m ultiple m echanism s is cell apoptosis.
B This is the m echanism of action of taxanes.
C This is the m echanism of action of vinca alkaloids.
D This is the m echanism of action of alkylating drugs.
E This is the m echanism of action of m ethotrexate.
Learning objective: Describe the adverse e ects of doxorubicin.
Buy Antineoplastic Drugs Discussion Solutions
9. B In the CHOP acronym, C stands for cyclophosphamide ide; H for
hydroxydaunorubicin, which is another name for doxorubicin; O is for Oncovin, which is a brand name for vincristine;
and P is for prednisone or prednisolone. The CHOP regimen
has been considered the best treatment for the initial therapy
of patients with di use non-Hodgkin lym phom a. Recently, it
has been shown that the combination of CHOP with rituximab can improve response rates, disease-free survival, and
overall survivals compared with CHOP chemotherapy alone.
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