LWBK1006-11 LWW-Govindan-Review November 24, 2011 11:21
Chapter 11•Systemic Therapy for Cancer 131efficacy from these drugs. Azacitidine is a DNA demethylating agent
that is able to be administered by either intravenous or subcutaneous
routes. It is very unstable and needs to be administered quickly after
reconstitution.Answer 11.12. The answer is C.
Mesna bladder protection is required for all patients receiving ifosfamide
and for those patients receiving high doses of cyclophosphamide. It works
by providing a free sulfhydryl group that conjugates with the toxic
metabolite (acrolein) of ifosfamide and cyclophosphamide. The dosing
of mesna should be equal to 60% of the total dose of ifosfamide or
cyclophosphamide.Answer 11.13. The answer is B.
Oxaliplatin is associated with significant acute neuropathy that is exac-
erbated by cold and delayed peripheral neuropathy. It has been demon-
strated in colon cancer that infusions of calcium and magnesium prior to
and after oxaliplatin infusions can lessen the incidence and severity of the
delayed peripheral neuropathy. Cisplatin is associated with a much higher
rate of ototoxicity than carboplatin. Cisplatin should also be avoided
in patients with renal insufficiency, while oxaliplatin is well tolerated in
patients with mild-to-moderate renal insufficiency.Answer 11.14. The answer is C.
The binding of oblimersen (an antisense oligodeoxyribonucleotide) to its
target mRNA forms an mRNA–DNA complex. This elicits the activity
of RNase H that cleaves the mRNA strand coding for the Bcl-2 protein
from the mRNA–DNA complex. This leads to decreased transcription of
Bcl-2.Answer 11.15. The answer is A.
Bortezomib is FDA approved for use in combination with melphalan and
prednisone for front-line therapy of multiple myeloma. The drug is given
on days 1, 4, 8, 11, of a 3-week cycle. The drug is also approved for use
as a single agent for patients with relapsed multiple myeloma.Answer 11.16. The answer is D.
At low concentrations (0.2 to 1 mcM), the azacytosine nucleosides show
dose-dependent reversal of DNA methylation and induction of terminal
differentiation. As concentrations are increased; however, induction of
cell apoptosis and DNA damage become the prominent cytotoxic effects.Answer 11.17. The answer is B.
Preclinical studies have shown that combining PARP inhibitors with anti-
cancer treatment modalities that result in DNA instability (e.g., radiation
therapy and platinum chemotherapy agents) potentiates their cytotoxic-
ity. In the presence of BRCA mutations, PARP inhibitors cause impaired