Devita, Hellman, and Rosenberg's Cancer

LWBK1006-11 LWW-Govindan-Review November 24, 2011 11:21

Chapter 11•Systemic Therapy for Cancer 127

Question 11.18. The safety profile of everolimus is similar to that seen with temsirolimus.

Which of the following is MOST correct regarding common side effects

of therapy with everolimus?

A. Pulmonary toxicity, such as increased cough, dyspnea, and pul-

monary infiltrates are a relatively common event.

B. Dry skin with acneiform skin rash can occur but it is a relatively rare

event observed in about 1% of patients.

C. Hyperlipidemia and hyperglycemia occur in up to 90% of patients.

D. Venous thromboembolism is a common occurrence, and it is recom-

mended that patients begin prophylactic anticoagulation.

Question 11.19. Asparaginase is commonly used in combination with methotrexate as

part of acute lymphoblastic leukemia treatment protocols. Which of the

following statements regarding administration of these drugs is TRUE?

A. Asparaginase should be given concurrently with methotrexate in

order to inhibit methotrexate’s clearance and increase its cytotoxi-

city.

B. Asparaginase should be given immediately before methotrexate in

order to decrease the risk of methotrexate neurotoxicity.

C. Asparaginase should be given 12 hours before methotrexate in order

to prime cancer cells for methotrexate’s antimetabolite activity.

D. Asparaginase and methotrexate should be given sequentially at least

24 hours apart secondary to methotrexate antagonism.

Question 11.20. A 59-year-old female is admitted to the inpatient service for week one of

induction interferon therapy for malignant melanoma. Her daughter is a

nurse practitioner and would like to know more information about the

treatment. Which of the following statements can you correctly tell her?

A. Interferons enhance the activity of the innate immune response but

have little to no effect on the adaptive immune response.

B. Appetite stimulation and weight gain are typically seen with high-

dose interferon for malignant melanoma.

C. Interferons exhibit antiangiogenic properties by directly inhibiting

endothelial cells.

D. There are a large number of clinically significant drug–drug interac-

tions that have been reported with interferons.

Question 11.21. Which of the following statements regarding side effects of high-dose

interferon therapy is FALSE?

A. Acute hepatic toxicity has been reported, but dose reductions are not

suggested for patients who develop transaminitis during therapy.

B. Neutropenia requiring dose reduction is reported to occur in up to

60% of patients.

C. The risks and benefits of therapy should be considered carefully in

patients with a history of depression or other psychiatric disorders.

D. The most common toxicities seen with all interferon therapy are con-

stitutional, including fever, chills, headache, and fatigue.