GALVE QUESTIONS RECALL

TUMOR SUPPRESSOR GENES the normal wild form

Cancer chemotherapy CAN BE CURATIVE : Germ cell cancer, Non-
Hodgkins lymphoma, Hodgkins Disease, Choriocarcinoma, Burkitts
lymphoma, acute lymphoblastic leukemia
Neoadjuvant treatment for localized disease for whom local forms of
treatment like surgery or radiation are inadequate
Primary Induction Chemotherapy --- > to palliate tumor-related
symptoms, improve quality of life, and prolong time to tumor
progression
-Interferon in high risk malignant melanoma
Log cell-kill kinetics a given agent would be predicted to kill a constant
fraction of cells as opposed to a constant number ; Cell kill is proportional
regardless of tumor burden ; inverse relation between cell number and
curability
Gompertzian kinetics --- > Growth fraction of the tumor is not constant but
decreases exponentially with time ; SOLID TUMORS
Primary resistance absence of response on first exposure; associated with
genomic instability
Acquired resistance change in genetic apparatus of tumor cell
Multi drug resistance- resistance to a variety of natural product anticancer
drugs of differing structures developing after exposure to a single agent ;
MDR1
Phosphoramide Mustard and Acrolein (hemorrhagic cystitis) --- >
cytotoxic forms of cyclophosphamide
Streptozocin -- > in treating insulin secreting islet cell carcinoma of the
pancreas
PROCARBAZINE - > weak MAO metabolite
CISPLATIN --- nephrotoxicity first generation
Carboplatin myelosuppression second generation
Oxaliplatin neurotoxicity
PEMETREXED -- pyrrolopyrimidine antifolate
 .6-Mercaptopurine - hypoxanthine-guanine phosphoribosyl transferase
(HGPRT); not given with allopurinol
METHOTREXATE -- Folic acid antagonist that binds to the catalytic
site of dihydrofolate reductase (DHFR) ; LACK OF THIS COFACTOR
interrupts de novo synthesis of thymidylate ; Leucovorin rescue
GEMCITABINE -- Fluorine-substituted deoxycytidine analog ;
Neutropenia- principal dose limiting toxicity
VINCRISTINE -- SIADH can occur
VINORELBINE -- Myelosuppression with neutropenia is dose limiting
toxicity
Etoposide (VP-16) and Teniposide -- action is inhibition of
topoisomerase II
TOPOTECAN and IRINOTECAN ( CAMPTOTHECINS )-- > inhibitor
of topoisomerase 1
PACLITAXEL AND DOCITAXEL ( TAXANES) INHIBIT TUBULIN
POLYMERIZATION
Abraxane- albumin-bound paclitaxel
Dexrazoxane iron-chelating agent to prevent or reduce anthracycline-
induced cardiotoxicity
Mitoxantrone -- Blue discoloration of the fingernails, sclera, and urine
MITOMYCIN -- Streptomyces caespitosus; Hemolytic-uremic syndrome
TAMOXIFEN -- Chemopreventive agent in women at high risk for
breast cancer
Leuprolide and Goserelin -- analogs of naturally occuring
GnRH and LHRH
IMATINIB -- domain of the Bcr-Abl oncoprotein
CETUXIMAB -- monoclonal antibody directed against the extracellular
domain of EGFR
BEVACIZUMAB -- VEGF-A - vascular endothelial growth
TRETINOIN -- Active in patients with Acute Promyelocytic Leukemia
Arsenic Trioxide - inducing differentiation through degradation of the
chimeric PML/RAR- protein

CASE STUDY
Non-Hodgkins Lymphoma ( CD20 +)
TREATMENT CHOP
Nodular or follicular type- better prognosis compared with diffuse type
with median survival of 2 months
Heterogenous disease - related to the underlying histopathologic
features and extent of disease involvement