Kim Breast Cancer 166
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83 terms
Terms | Definitions |
|---|---|
 Tamoxifen | Nolvadex, hormonal therapy |
| Tamoxifen | 10-20 mg QD or BID. 10 mg QD for prevention. |
| Tamoxifen | Nonsteroidal anti estrogen SERM. DDI with paxil, Prozac. |
| Tamoxifen | thromboembolism, endometrial cancer risk, risk of bleeding with warfarin, osteoporosis, retinopathy, WG, HA |
| Tamoxifen | need routine eye exams |
| Tamoxifen | menopausal symptoms, tumor flare |
| Raloxifene | Evista, hormonal therapy (prevention only) |
| Raloxifene | 60 mg PO QD |
| Raloxifene | SERM, only for prevention |
| Raloxifene | menopausal symptoms, tumor flare, but benefit in osteoporosis |
| Anastrozole | arimidex, hormonal therapy |
| Anastrozole | nonsteroidal aromatase inhibitor |
| Anastrozole | musculoskeletal disorder (arthralgia, myalgia), osteoporosis |
| Letrozole | Femara, hormonal therapy |
| Letrozole | musculoskeletal disorder (arthralgia, myalgia), osteoporosis |
| Exemestane | Aromasin, hormonal therapy |
| Exemestane | musculoskeletal disorder (arthralgia, myalgia), osteoporosis |
| Toremifene | Farestron, SERM |
| Fulvestrant | Faslodex, estrogen receptor downregulator, IM |
| Goserelin | Zoladex, LHRH analog. |
| Doxorubicin | Adria |
| Doxorubicin | potential binder of iron, starts creating cardiomyopathy |
| Doxorubicin | myelosuppression (Dose limiting), red urine, mucositis, extravasions |
| Doxorubicin | overdose treat with dexrazoxane, DMSO |
| Doxorubicin | inhibit topoisomerase II. Lots of free radicals - starts necrotizing muscle |
| Epirubicin | similar to doxorubicin, less toxic on the heart |
| Cyclophosphamide | Cytoxan, alkylating agent |
| Cyclophosphamide | myelosuppression (DLT), leukopenia, hemorrhagic cystitis (clumps of blood in urine) |
| Methotrexate | given with leucovorin, PO, IV, or IT |
| Methotrexate | caution in renal dysfunction, prone to 3rd spacing. Keep patient hydrated though |
| Carboxypeptidase | glucarpidase - breaks mtx down |
| Methotrexate | BMS (Dose limiting), mucositig, renal impairment |
| 5-FU Continuous infusion | TS inhibition |
| 5-FU Bolus | RNA incorporation |
| 5-FU Continuous infusion | Less BMS, mucositis (DLT). Ice chips. Hand-foot syndrome worse |
| 5-FU Bolus | More BMS (DLT), mucositis, Less Hand-foot syndrome |
| 5-FU | significant DDI with warfarin |
| Capecitabine | Xeloda |
| Capecitabine | oral prodrug of 5FU, bypasses DPD. |
| Capecitabine | take on full stomach within 30 minutes of finishing a meal. Don't take with fruit juices. Both renally and hepatically eliminated. |
| Capecitabine | Hand-foot syndrome dose limiting toxicity |
| Paclitaxel | Taxol or Abraxae |
| Docetaxel | Taxotere |
| Paclitaxel | dose adjustment in liver impairment, elevated bili. If giving with cisplatin, give this first |
| Docetaxel | dose adjustment in liver impairment, elevated bili |
| Paclitaxel | increased neutropenia with infusion, hypersensitivity, cardiac abnormalities, myalgia. Need to use cremophor |
| Docetaxel | edema, skin rash, nail change |
| Docetaxel | premedicate with dexamethasone only. This is done to minimize fluid retention |
| Paclitaxel | premedicate with Benadryl, dexa, h2. Need to filter |
| Abraxane | paclitaxel bound to albumin -> lower hypersensitivity. Can use PVC bag with this. expensive |
| Cisplatin | Platinol |
| Cisplatin | Pt surrounded by Cl, must be mixed in NS, need pre and post hydration |
| Cisplatin | DDI with nephrotoxins and ototoxins (loop diuretics) |
| Cisplatin | Neurotoxicity, nephrotoxicity are dose limiting |
| Carboplatin | Paraplatin |
| Carboplatin | Pt, no Cl. Replaced by carboxycyclobutanes. Can be put in NS or D5W |
| Carboplatin | slower, less extensive plasma protein binding. Renal adjustments. |
| Carboplatin | uses the calvert EQ. AUC X (GFR+25) |
| Carboplatin | BMS is dose limiting |
| Trastuzumab | Herceptin |
| Trastuzumab | myocardial toxicity, LVEF needs to be monitored q3mo. Some injection site reaction, need to pretreat with Benadryl, dexamethasone, and/or epinephrine |
| Lapatinib | Tykerb |
| Lapatinib | advanced or metastatic breast cancer, failed anthracycline, taxane, Herceptin |
| Lapatinib | can be used with 5FU (capecitabine too) for additive effect, synergistic effect with trastuzumab |
| Lapatinib | needs to be taken 1 hour before or 1 hour after a meal |
| Lapatinib | cardiac effects, severe diarrhea, pulmonary tox |
| Eribulin | Halaven, for metastatic breast cancer |
| Eribulin | nontaxane microtubule inhibitor, halichondrin B analog |
| Eribulin | not compatible with dextrose |
| Eribulin | BMS (DLT), Peripheral neuropathy, QT prolongation, GI tox |
| Pamidronate | Aredia |
| Pamidronate | 90 mg IV over 2 hr q 3-4 weeks |
| Zoledronate | Zometa |
| Zoledronate | Renally adjusted (crCl 30-39 3 mg, 40-49 3.3, 50-59 3.5, 60+ 4mg) |
| Zoledronate | 4 mg IV over 15 minutes q 3-4 weeks |
| Zoledronate | 5 mg IV over 15 minutes (Reclast). Or 4 mg IV over 15 minutes q 6 months |
| Pamidronate | osteonecrosis of jaw, tumor flare, myalgias |
| Zoledronate | osteonecrosis of jaw, tumor flare, myalgias |
| Denosumab | Xgeva (solid tumor), Prolia (osteoporosis) - antibody targeting RANKL |
| Denosumab | prevention of aromatase inhibitor-induced osteoporosis |
| Denosumab | nephrotoxicity, hypoPhos, hypoCa, osteonecrosis of jaw |
| Denosumab | 120 mg SQ q 4 weeks (Xgeva) |
| Denosumab | 60 mg SQ q 6 months (Prolia) |
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