NEET PG

Educators Notes

Dr Arpit Agarwal
Pharma CAPSULE 1
Anti-Cancer Drugs
 NEET PG
Educators Notes

1. All of the following steps reduce the risk of cisplatin induced nephrotoxicity
A. Saline diuresis
B. Mannitol
C. Amifostine
D. Alkaline diuresis
.
 NEET PG
Educators Notes

2. A patient is suffering from Methotrexate toxicity. All of the following are

useful in the treatment of toxicity except?
a) Glucarpidase
b) Leucovorin
c) Amifostine
d) Alkalinization of urine

.
 NEET PG
Educators Notes

3. A patient on cisplatin therapy develops intractable vomiting on

the third day of treatment. DOC for controlling this vomiting is:
A. Aprepitant
B. Ondansetron
C. Metoclopramide
D. Prochlorperazine
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Educators Notes

4. Drug that is radioprotective is:

(a) Paclitaxel
(b) Vincristine
(c) Etoposide
(d) Amifostine
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Educators Notes

5. Which of the following agents is used for the treatment of

Thrombocytopenia secondary to myelosuppressive chemotherapy-
[A]. Filgrastim
[B]. Sargramostim
[C]. Oprelvekin
[D]. Aldesleukin
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Educators Notes

6. Which of the following is a wrong match with respect to the

anticancer drug and agents used against its toxicity as a
preventive measure?
A. Amifostine : Cisplatin
B. Calcium leucovorin : Cyclophosphamide
C. Dexrazoxane: Adriamycin
D. Oprelvekin: Nitrosurea
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Side effect Treatment Educators Notes
Neutropenia Filgrastim = G-CSF [DOC]
Sargramostim = GM-CSF
Thrombocytopenia IL-11 (oprelvekin) [DOC].
Romiplostim & Eltrombopag -Used in ITP
CINV DOC for CINV - 5-HT3 blocker [Palonosetron
DOC for Acute Phase -Palonosetron
DOC for Delayed phase - NK1 Antagonist
[Aprepitant]
Cyclophosphamide induced Mesna
cystitis
Ifosfamide induced Neurotoxicity Methylene Blue

Cisplatin induced Nephrotoxicity Amifostine &

Saline diuresis, and Mannitol
Doxorubicin cardiotoxicity Dexrazoxane [iron chelator]
Side effect NEET PG Treatment
Educators Notes
Paclitaxel induced Hypersensitivity Replace with Protein-Bound Paclitaxel

Methotrexate toxicity prevention Folinic acid [Leucovorin or tetrahydrofolate]

Methotrexate Crystalluria Urinary alkalization

Methotrexate toxicity in Renal Glucarpidase

failure patient

Pemetrexed toxicity Folic acid & Vitamin B 12

Irinotecan induced Diarrhoea Loperamide of Octreotide
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Educators Notes

7. All are CD 20 antagonist except

A. Ocrelizumab
B. Ofatumumab
C. Ibritumomab
D. Tocilizumab
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Educators Notes

8. Rituximab is used in all EXCEPT:

(a) Non-Hodgkin lymphoma
(b) Paroxysmal nocturnal hemoglobinuria
(c) Rheumatoid arthritis
(d) Systemic lupus erythematosus
 NEET PG
Educators Notes

9. All statements are true about Daratumumab except?

A.) Used for Multiple Myeloma
B.) CD-34 directed antibody
C.) Given by I/V route
D.) None of the above
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Educators Notes

10. HER-2/nue receptor play a role in-

[A]. Predicting therapeutic response
[B]. Determining treatment for recurrence of tumor
[C]. Diagnosis of breast Ca
[D]. Screening of breast Ca
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Educators Notes

11. All are drugs targeting HER2/neu except

A. Lapatinib
B. Neratinib
C. Pertuzumab
D. Ranibizumab
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Educators Notes

12. Regarding trastuzumab, all of the following are False except:

(a) Shows better response in combination with paclitaxel
(b) Causes upregulation of HER2/neu
(d) Causes bone marrow toxicity
(e) It is a monoclonal antibody containing only human component
 NEET PG
Educators Notes

13. Mechanism of action of bevacizumab is

(a) Acts on VEGF
(b) EGFR antagonist
(c) PDGF monoclonal antibody
(d) Tyrosine kinase inhibitor
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Educators Notes

14. Which of the following drug is used in the treatment of diabetic

retinopathy?
A. Eculizumab
B. Adalimumab
C. Etanercept
D. Bevacizumab
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Educators Notes

15. Panitumumab is used for which cancer?

a) Colon cancer
b) Lung cancer
c) Breast cancer
d) Osteoclastoma
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Educators Notes

16. Wrong match about Drug and its Molecular Target?

A. Imatinib: c-Kit
B. Sunitinib: EGFR
C. Rituximab: CD20
C. Alemtuzumab: CD52
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Educators Notes

17. Tyrosine kinase inhibitors are first line treatment in:

(a) Gastrointestinal stromal tumors
(b) Receptor mediated neuroendocrine tumors
(c) Breast cancer
(d) Renal cell carcinoma
 NEET PG
Educators Notes

18. Adverse effect of the imatinib are all except -

a) Periorbital edema
b) Myalgia
c) Pleural effusion
d) Arthralgia
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Educators Notes
Imatinib
 Bcr-Abl oncoprotein (t9:22)TK # - DOC for CML
 Also inhibits TK of c-Kit - used in GIST
 TK of PDGFR - CMML
S/E – edema [pleural effusion, periorbital] diarrhea, Myalgia [not arthralgia]

• CML refractory to imatinib - Nilotinib/ Dasatinib, Bosutinib

• CML with T315I mutant resistant to I/D/N /B - Ponatinib

• S/E- thromboembolism

Omacetaxine = protein translation inhibitor

• GIST refractory to imatinib - sunitinib or regorafenib [c-kit TK #]
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Educators Notes

19. Which of the following is not true about erlotinib?

A. Inhibitor of tyrosine kinase associated with EGFR receptors.
B. Approved for Rx of refractory non-small cell lung cancer
C. Food reduces its bioavailability.
D. Acniform eruptions and diarrhea are its common side effects.
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Educators Notes

20. Which of the following drug acts by inhibiting tyrosine kinase activated by
EGF receptor as well as HER2?
(a) Imatinib
(b) Geftinib
(c) Erlotinib
(d) Lapatinib
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Educators Notes
Drug Molecular Useful in:
Target
Trastuzumab HER2/neu Breast cancer
(Herceptin) (ERBB2)

Cetuximab EGFR Colon cancer, squamous cell carcinoma

of the head and neck

Panitumomab EGFR Colon cancer

Rituximab CD20 B cell lymphomas and leukemias that
express CD20
Alemtuzumab CD52 Chronic lymphocytic leukemia and
CD52-expressing lymphoid tumors

Bevacizumab VEGF Colon, lung, breast cancers; data

pending in other tumors
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Educators Notes
Drug Molecular Target Useful in:
Imatinib Bcr-Abl, c-Abl, c- Chronic myelogenous leukemia; GIST
Kit, PDGFR

Sunitinib c-Kit, VEGFR-2, RCC

PDGFR-, Flt-3 GIST; Pancreatic cancer

Sorafinib RAF, VEGFR-2, RCC

PDGFR-/, Flt-3, c- Hepatocellular cancer
Kit melanoma when
Erlotinib EGFR Non-small cell lung cancer
Pancreatic cancer
Gefitinb EGFR Non-small cell lung cancer
Bortezomib Proteasome Multiple myeloma
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Educators Notes

21. Thalidomide, trues is

[A]. Possess good anti leprotic activity
[B]. Characterized by enantiomeric interconversion
[C]. Metabolized extensively by hepatic CYP system
[D]. Safe for use in pregnant female
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Educators Notes

22. Thalidomide is used in all except-

[A]. HIV induced peripheral neuropathy
[B]. HIV induced mouth ulcer
[C]. Bechet’s syndrome
[D]. Erythema nodosum leprosum