GMS 6540 Exam Questions with
Complete Answers
Mechanism of resistance - ANSWER-- drug metabolism
- alteration in drug target
- decreased intracellular drug concentration
- increased DNA repair
- inhibition of drug induced apoptosis
- sanctuary sites (brain)
Cytotoxic agents - ANSWER-- chemo
- block cell proliferation
- non-specific (kills cancer & healthy cells)
Cyclophosphamide - ANSWER-- DNA alkylating agent
- cross links guanines in DNA blocking replication & triggering cell death
* myelosuppression
* secondary malignancies
* hemorrhagic cystitis
Cisplatin - ANSWER-- crosslinks DNA externally at guanine
* renal dose limiting toxicity
* peripheral neuropathy
* minimal myelosuppression
Bleomycin - ANSWER-- binds and breaks DNA creating free radicals
* minimal myelosuppression
* pulmonary fibrosis
* erythema
Topotecan - ANSWER-- topoisomerase I inhibitor
- traps topo-I-DNA complex causing DNA strand breaks
- acts in S-phase
* major myelosuppression
Doxorubicin - ANSWER-- topoisomersase II inhibitor
- traps topo-II-DNA complex causing DNA strand breaks
- effective in all stages of cell cycle
* myelosuppression
* cardiotoxicity
Microtubule drugs - ANSWER-- only effective in M-phase of cell cycle
- vincristine
- paclitaxel
- binds tubulin - blocking mitosis
* neurotoxicity
, * myelosuppression - paclitaxel
Antimetabolites - ANSWER-- methotrexate
- cytosinse arabinoside
- 5-Fluorouracil
Methotrexate - ANSWER-- inhibits dihydrofolate reductase (DHFR)
- blocks synthesis of thymidine & purines - blocking DNA synthesis
- S-phase specific
* myelosuppression
* mucositis
5-Fluorouracil - ANSWER-- thymidine analogue - prodrug activated by FdUMP
- inhibits synthesis of thymidine by thymidylate synthase
* myelosuppression
* mucositis
Cytosine arabinoside - ANSWER-- nucleoside analog - prodrug
- inhibits DNA polymerase & DNA synthesis
- S-phase specific
* myelosuppression
Targeted therapies - ANSWER-- monoclonal antibodies
- tyrosine kinase inhibitors
- target Philidelphia Chromosome
- imatinib
- vemurafenib
Imatinib - ANSWER-- inhibits Bcr-Abl tyrosine kinase in Philidelphia Chromosome
CML
Vemurafenib - ANSWER-- targets BRAFv600E mutations in melanoma
Immunotherapy - ANSWER-- PD1:PD-L1 inhibitors
- CAR-T cell
* cytokine release syndrome
* neurotoxicity
PD1:PD-L1 inhibitors - ANSWER-- pembrolizumab
- melanoma
CAR-T cells - ANSWER-- tisagenlecleucel (CTL019)
- Axicabtagene
Pembrolizumab - ANSWER-- PD-1:PD-L1 inhibitor
- t-cells express PD-1 - programmed cell death protein 1
- PD-1:PD-L1 interaction with cancer cells blocked to allow for destruction
Tisagenlecleucel - ANSWER-- CAR-T
- built to destroy CD19-expressing cells using patients own cells
Complete Answers
Mechanism of resistance - ANSWER-- drug metabolism
- alteration in drug target
- decreased intracellular drug concentration
- increased DNA repair
- inhibition of drug induced apoptosis
- sanctuary sites (brain)
Cytotoxic agents - ANSWER-- chemo
- block cell proliferation
- non-specific (kills cancer & healthy cells)
Cyclophosphamide - ANSWER-- DNA alkylating agent
- cross links guanines in DNA blocking replication & triggering cell death
* myelosuppression
* secondary malignancies
* hemorrhagic cystitis
Cisplatin - ANSWER-- crosslinks DNA externally at guanine
* renal dose limiting toxicity
* peripheral neuropathy
* minimal myelosuppression
Bleomycin - ANSWER-- binds and breaks DNA creating free radicals
* minimal myelosuppression
* pulmonary fibrosis
* erythema
Topotecan - ANSWER-- topoisomerase I inhibitor
- traps topo-I-DNA complex causing DNA strand breaks
- acts in S-phase
* major myelosuppression
Doxorubicin - ANSWER-- topoisomersase II inhibitor
- traps topo-II-DNA complex causing DNA strand breaks
- effective in all stages of cell cycle
* myelosuppression
* cardiotoxicity
Microtubule drugs - ANSWER-- only effective in M-phase of cell cycle
- vincristine
- paclitaxel
- binds tubulin - blocking mitosis
* neurotoxicity
, * myelosuppression - paclitaxel
Antimetabolites - ANSWER-- methotrexate
- cytosinse arabinoside
- 5-Fluorouracil
Methotrexate - ANSWER-- inhibits dihydrofolate reductase (DHFR)
- blocks synthesis of thymidine & purines - blocking DNA synthesis
- S-phase specific
* myelosuppression
* mucositis
5-Fluorouracil - ANSWER-- thymidine analogue - prodrug activated by FdUMP
- inhibits synthesis of thymidine by thymidylate synthase
* myelosuppression
* mucositis
Cytosine arabinoside - ANSWER-- nucleoside analog - prodrug
- inhibits DNA polymerase & DNA synthesis
- S-phase specific
* myelosuppression
Targeted therapies - ANSWER-- monoclonal antibodies
- tyrosine kinase inhibitors
- target Philidelphia Chromosome
- imatinib
- vemurafenib
Imatinib - ANSWER-- inhibits Bcr-Abl tyrosine kinase in Philidelphia Chromosome
CML
Vemurafenib - ANSWER-- targets BRAFv600E mutations in melanoma
Immunotherapy - ANSWER-- PD1:PD-L1 inhibitors
- CAR-T cell
* cytokine release syndrome
* neurotoxicity
PD1:PD-L1 inhibitors - ANSWER-- pembrolizumab
- melanoma
CAR-T cells - ANSWER-- tisagenlecleucel (CTL019)
- Axicabtagene
Pembrolizumab - ANSWER-- PD-1:PD-L1 inhibitor
- t-cells express PD-1 - programmed cell death protein 1
- PD-1:PD-L1 interaction with cancer cells blocked to allow for destruction
Tisagenlecleucel - ANSWER-- CAR-T
- built to destroy CD19-expressing cells using patients own cells
