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93 Cards in this Set
- Front
- Back
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Altretamine (Hexalen) Alkylating Agent |
- Treats myelodysplastic syndrome - Special considerations: premedicate with antiemetic; monitor blood counts and central nervous system status regularly |
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Bendamustine (Treanda) Alkylating Agent |
- Treats chronic lymphocytic leukemia - Special considerations: dosing may need to be adjusted based on blood counts; monitor for infection, skin reactions |
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Busulfan (Busulfex, Myleran) Alkylating Agent |
- Treats chronic myelogenous leukemia; not effective in blastic phase or without the Philadelphia chromosome - Special considerations: Dosing monitored by effects on bone marrow; always push fluids to decrease toxic renal effects; alopecia is common |
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Carboplatin (Paraplatin) Alkylating Agent |
- Palliative or initial treatment of returning ovarian cancer after prior chemotherapy; initial treatment of ovarian cancer with other chemotherapy; may be useful in several other cancers - Special considerations: Dose and timing determined by bone marrow response; alopecia is common |
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Carmustine (BiCNU, Gliadel) Alkylating Agent |
- Treatment of brain tumors, Hodgkin disease, multiple myelomas; available in implantable water form for treatment of glioblastoma - Special considerations: Dose determined by bone marrow toxicity; do not repeat for 6 wks because of delayed toxicity; often used in combination therapy |
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Chlorambucil (Leukeran) Alkylating Agent |
- Palliative treatment of lymphomas and leukemias including Hodgin disease; being considered for the treatment of rheumatoid arthritis and other conditions - Special considerations: Toxic to liver and bone marrow; dosing based on bone marrow response |
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Cisplatin (Platinol-AQ) Alkylating Agent |
- Combination therapy for metastatic testicular or ovarian tumors, advanced bladder cancers - Special considerations: Neurotoxic, nephrotoxic, can cause serious hypersensitivity reactions |
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Cyclophosphamide (Cytoxan, Neosar) Alkylating Agent |
- Treatment of lymphoma, myelomas, leukemias, other cancers in combo with other drugs - Special considerations: Hemorrhagic cystitis is a potentially fatal side effect; alopecia is common |
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Dacarbazine (DTIC-Dome) Alkylating Agent |
- Treatment of metastatic malignant melanoma and as second line therapy with other drugs from the treatment of Hodgkin disease - Special considerations: Bone marrow depression, gastrointestinal (GI) toxicity, severe photosensitivity are common; extravasation can cause tissue necrosis or cellulitis-use extreme care, and monitor injection sites regularly |
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Ifosfamide (Ilfex) Alkylating Agent |
- Combination therapy as third-line agent in treating germ cell testicular cancers; being tested for treatment of other cancers - Special considerations: Alopecia is common |
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Lomustine (CeeNU) Alkylating Agent |
- Palliative combination therapy for Hodgkin disease and primary and metastatic brain tumors - Special considerations: Immune suppression and GI effects are common |
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Mechlorethamine (Mustargen) Alkylating Agent |
- Nitrogen mustard; palliative treatment in Hodgkin disease, leukemia, bronchial carcinoma, other cancers; injected for treatment of effusions secondary to cancer metastases - Special considerations: GI toxicity, bone marrow suppression, impaired fertility are common |
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Melphalan (Alkeran) Alkylating Agent |
- Nitrogen mustard; treatment for multiple myeloma, ovarian cancers - Special considerations: Oral route is preferred; pulmonary fibrosis, bone marrow suppression, alopecia are common |
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Oxaliplatin (Eloxatin) Alkylating Agent |
- Treatment of metastatic carcinoma of the colon or rectum when disease progresses after standard therapy; used in combination therapy - Special considerations: Premedicate with antiemetics and dexamethasone: monitor for potentially dangerous anaphylactic reactions |
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Procarbazine (Matulane) Alkylating Agent |
- Used in combination therapy for treatment of stages III and IV of Hodgkin disease - Special considerations: Bone marrow toxicity; GI toxicity and skin lesions also limit use in some patients; severity of adverse effects regulate dose of the drug |
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Streptozocin (Zanosar) Alkylating Agent |
- Treatment of metastatic islet cell carcinoma of the pancreas - Special considerations: GI and renal toxicity are common; causes infertility; wear rubber gloves to avoid drug contact with the skin-if contact occurs, wash with soap and water |
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Temozolomide (Temodar) Alkylating Agent |
- Treatment of refractory astrocytoma or glioblastoma in patients refractory to other treatments - Special considerations: Monitor bone marrow closely; especially toxic in women and the elderly |
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Thiotepa (Thioplex) Alkylating Agent |
- Treatment of adenocarcinoma of the breast and uterus and papillary carcinoma of the bladder; available intrathecally to treat effusion - Special considerations: Infertility, rash, GI toxicity, dizziness, headache, bone marrow suppression are common |
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Capecitabine (Xeloda) Antimetabolite |
- Treats metastatic breast cancer with resistance to paclitaxel or anthracyclines; treats metastatic colorectal cancer as first line therapy treatment of breast cancer with docetaxel in patients with metastatic disease; postsurgery Dukes C colon cancer - Special considerations: Severe diarrhea can occur-monitor hydration and nutrition; monitor for bone marrow suppression |
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Cladribine (Leustatin) Antimetabolite |
- Treatment of active hairy cell leukemia - Special considerations: Severe bone marrow depression can occur-monitor patient closely and reduce dose as needed; fever is common, especially early in treatment |
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Clofarabine (Clolar) Antimetabolite |
- Treatment of patients 1-21 yrs of age with acute lymphocytic leukemia (ALL) after at least two relapses on other regimens - Special considerations: GI toxicity, bone marrow suppression, infection are common |
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Cytarabine (DepoCyt, Tarabine PFS) Antimetabolite |
- Treatment of meningeal and myelocytic leukemias; used in combination with other agents; lymphomatous meningitis; non-hodgkin lymphoma in children - Special considerations: GI toxicity and cytarabine syndrome (fever, myalgia, bone pain, chest pain, rash, conjunctivitis, malaise) are common-this syndrome sometimes responds to corticosteroids; alopecia may occur |
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Floxuridine (FUDR) Antimetabolite |
- Palliative management of GI adenocarcinoma metastatic to the liver in patients who are not candidates for surgery - Special considerations: Administer by intraarterial line only; bone marrow suppression, GI toxicity, neurotoxicity, alopecia are common |
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Fludarabine (Fludara) Antimetabolite |
- Treatment of chronic lymphocytic leukemia (CLL); unresponsive B cell CLL with no progress with at least one other treatment - Special considerations: CNS toxicity can be severe; GI toxicity, respiratory complications, renal failure, tumor lysis syndrome are common |
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Fluorouracil (Adrucil, Carac, Efudex, Fluoroplex) Antimetabolite |
- Palliative treatment of various GI cancers: topical treatment of basal cell carcinoma and actinic and solar keratoses - Special considerations: GI toxicity, bone marrow suppression, alopecia, skin rash are common; avoid occlusive dressings with topical forms; wash hands thoroughly after coming in contact with drug |
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Gemcitabine (Gemzar) Antimetabolite |
- Treatment of locally advanced or metastatic adenocarcinoma of the pancreas: given with cisplatin for the treatment of inoperable non-small cell lung cancer; metastatic breast cancer, ovarian cancer after failure of a platinum-base therapy - Special considerations: Can cause severe bone marrow depression, GI toxicity, pain, alopecia, interstitial pneumonitis |
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Mercaptopurine (Purinethol) Antimetabolite |
- Remission induction and maintenance therapy in acute leukemias - Special considerations: bone marrow toxicity and GI toxicity are common; hyperuricemia is a true concern-ensure that the patient is well hydrated during therapy |
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Methotrexate (Rheumatrex, Trexall) Antimetabolite |
- Treatment of leukemias, psoriasis, rheumatoid arthritis, choriocarcinomas - Special considerations: Hypersensitivity reactions can be severe; liver toxicity and GI complications are common; monitor for bone marrow suppression and increased susceptibility to infections; dose pack available for oral treatment of psoriasis and rheumatoid arthritis |
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Pemetrexed (Alimta) Antimetabolite |
- Treatment of malignant mesothelioma in patients whose disease is unresectable or who are not candidates for surgery; locally advanced or metastatic non-small cell lung cancer as a single agent after other chemotherapy - Special considerations: Pretreat with corticosteroids, folic acid, vitamin B12; monitor for bone marrow suppression and GI effects |
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Pentostatin (Nipent) Antimetabolite |
- Hairy cell leukemia in adults if refractory to interferon-alpha therapy - Special considerations: Associated with severel renal, hepatic, CNS, pulmonary toxicities-monitor patient closely and reduce dose; 3-6 months interferon-alpha therapy should be tried before using pentostatin |
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Pralatrexate (Folotyn) Antimetabolite |
- Treatment of relapsed or refractory peripheral T-cell lymphoma - Special considerations: Bone marrow suppression common; severe mucositis can occur, patient should receive vitamin B12 1 mg IM every 8-10 wks and folic acid 1-1.25 mg/d PO |
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Thioguanine (Tabloid) Antimetabolite |
- Remission induction and maintenance of acute leukemias alone or as part of combination therapy - Special considerations: Bone marrow suppression, GI toxicity, miscarriage, birth defects have been reported; monitor bone marrow status to determine dose and redosing; ensure that the patient is well hydrated during therapy to minimize hyperuricemia-patient may respond to allopurinol and urine alkalinization |
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Bleomycin (Blenoxane) Antineoplastic Antibiotic |
- Palliative treatment of squamous cell carcinomas, testicular cancers, lymphomas; used to treat malignant pleural effusion - Special considerations: GI toxicity, severe skin reactions, hypersensitivity reactions may occur; pulmonary fibrosis can be a serious problem-baseline and periodic chest radiographs and pulmonary function tests necessary |
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Dactinomycin (Cosmegen) Antineoplastic Antibiotic |
- Combination drug therapy in treating cariety of sarcomas and carcinomas; potentiates effects of radiation therapy - Special considerations: Bone marrow suppression and GI toxicity, which may be severe, limit the dose; effects may not appear for 1-2 wks; local extravasation can cause necrosis and should be treated with injectable corticosteroids, ice to the area, and restarting of the IV line in a different vein |
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Daunorubicin (DaunoXome) Antineoplastic Antibiotic |
- First line treatment of advanced HIV infection and associated Kaposi sarcoma - Special considerations: Complete alopecia is common, and GI toxicity and bone marrow suppression may also occur; severe necrosis may occur at sites of local extravasation-immediate treatment with corticosteroids, normal saline, and ice may help; if ulcerations occur, a plastic surgeon should be called |
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Doxorubicin (Adriamycin, Doxil) Antineoplastic Antibiotic |
- Treatment of number of leukemias and cancers; used to induce regression; available in a liposomal form for treatment of AIDS-associated Kaposi sarcoma - Special considerations: Complete alopecia is common; GI toxicity and bone marrow suppression may occur; severe necrosis may occur at sites of local extravasation-immediate treatment with corticosteroids, normal saline, ice may help; if ulcerations occur, a plastic surgeon should be called; toxicity is dose related-an accurate record of each dose received is important in determining dose; severe pulmonary toxicity, alopecia, injection site and GI toxicity occur |
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Epirubicin (Ellence) Antineoplastic Antibiotic |
- Adjuncting therapy in patients with evidence of axillary node tumor involvement after resection of primary breast cancer - Special considerations: May cause cardiotoxicity and delayed cardiomyopathy; monitor for myelosuppression and hyperuricemia; severe local cellulitis and tissue necrosis can occur with extravasation |
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Idarubicin (Idamycin) Antineoplastic Antibiotic |
- Combination therapy for treatment of acute myeloid leukemia in adults - Special considerations: May cause severe bone marrow suppression, which regulates dose; associated with cardiac toxicity, which can be severe; GI toxicity and local necrosis with extravasation are also common; severe necrosis may occur at sites of local extravasation-immediate treatment with corticosteroids, normal saline, and ice may help; if ulcerations occur, a plastic surgeon should be called; it is essential to monitor heart and bone marrow function to protect the patient from potentially fatal adverse effects |
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Mitomycin (Mutamycin) Antineoplastic Antibiotic |
- Treatment of disseminated adenocarcinoma of the stomach and pancreas - Special considerations: Severe pulmonary toxicity, alopecia, and injection-site and GI toxicity occur |
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Mitoxantrone (Novantrone) Antineoplastic Antibiotic |
- Part of combination therapy in treatment of adult leukemias; treatment of bone pain in advanced prostatic cancer; reduction of neurological disability and frequency of relapses in chronic progressive, relapsing multiple sclerosis - Special considerations: Severe bone marrow suppression may occur and limits dose; alopecia, GI toxicity, and congestive heart failure often occur; avoid direct skin contract with the drug-use gloves and goggles; monitor bone marrow activity and cardiac activity to adjust dose or discontinue drug as needed |
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Valrubicin (Valstar) Antineoplastic Antibiotic |
- Intravesical therapy for carcinoma in situ of the bladder if refractory to bacille Calmette-Guerin therapy (orphan drug) - Special considerations: Use goggles and gloves when handling, avoid contact with eyes; severe bladder spasms have occurred; use caution with history of irritable bowel syndrome; do not clamp bladder catheter in place |
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Cabazitaxel (Jevtana) Mitotic Inhibitor |
- In combination with oral prednisone for the treatment of patients with hormone refractory metastatic prostate cancer previously treated with a docetaxel-containing regimen - Special considerations: Serious to life-threatening hypersensitivity reactions have occurred; serious neutropenia can occur; monitor neutrophil count and withold drug as needed; patient may experience GI disturbances, renal or hepatic failure, elderly patients more susceptible to adverse effects |
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Docetaxel (Taxotere) Mitotic Inhibitor |
- Treatment of breast cancer and non-small cell lung cancer; androgen-dependent prostate cancer; gastric adenocarcinoma - Special considerations: Monitor patient closely-deaths have occurred during use; severe fluid retention can occur-premedicate with corticosteroids and monitor for weight gain; skin rash and nail disorders are usually reversible; monitor patients closely during use |
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Etoposide (Toposar, VePesid) Mitotic Inhibitor |
- Treatment of testicular cancers refractory to other agents; non-small cell lung carcinomas - Special considerations: Fatigue, GI toxicity, bone marrow suppression, alopecia are common side effects; avoid direct skin contact with the drug; use protective clothing and goggles; monitor bone marrow function to adjust dose; rapid fall in blood pressure can occur during IV infusion-monitor patient carefully |
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Ixabepilone (Ixempra) Mitotic Inhibitor |
- In combination with capecitabine for treatment of patients with metastatic or locally advanced breast cancer - Special considerations: Peripheral neuropathies are common; monitor for bone marrow suppression and hepatic impairment; dose will need to be adjusted based on these tests |
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Paclitaxel (Abraxane, Onxol Taxol) Mitotic Inhibitor |
- Treatment of advanced ovarian cancer, breast cancer, non-small cell lung cancer, AIDS-related Kaposi sarcoma - Special considerations: Anaphylaxis and severe hypersensitivity reactions have occurred-monitor very closely during administration; monitor for bone marrow suppression; cardiovascular toxicity and neuropathies have occurred |
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Teniposide (Vumon) Mitotic Inhibitor |
- In combination with other drugs for induction therapy in childhood acute lymphoblastic leukemia - Special considerations: GI toxicity, CNS effects, bone marrow suppression, alopecia are common; avoid direct skin contract with drug-use protective clothing and goggles; monitor bone marrow function to adjust dose; rapid fall in blood pressure can occur during IV infusion-monitor patient carefully |
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Vinblastine (Velban) Mitotic Inhibitor |
- Palliative treatment of various lymphomas and sarcomas; advanced Hodgkin disease; alone or as part of combination therapy for the treatment of advanced testicular germ cell cancers - Special considerations: GI toxicity, CNS effects, total loss of hair are common; antiemetics may help; avoid contact with drug and use protective clothing, goggles; monitor injection sites for reactions |
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Vincristine (Oncovin, Vincasar)
Mitotic Inhibitor |
- Treatment of acute leukemia, various lymphomas, and sarcomas - Special considerations: Extensive CNS effects are common, GI toxicity, local irritation at injection IV site, hair loss commonly occur; syndrome of inappropriate secretion of antidiuretic hormone has been reported-monitor urine output and arrange for fluid restriction and diuretics as needed |
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Vinorelbine (Navelbine) Mitotic Inhibitor |
- First line treatment of unresectable advanced non-small cell lung cancer; stage IV non-small cell lung cancer and stage III non-small cell lung cancer with cisplatin - Special considerations: GI and CNS toxicity are common; total loss of hair, local reaction at injection site, bone marrow suppression occur; prepare calendar for return dates for series of injections; avoid extravasation but arrange for hyaluronidase infusion if it occurs; antiemetics may be helpful if reaction is severe |
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Anastrazole (Arimidex) Hormone Modulator |
- Treats advanced breast cancer in postmenopausal women after tamoxifen therapy; first line and adjunctive treatment of post-menopausal women with locally advanced breast cancer - Action: Antiestrogen drug; blocks estradiol production without effects on adrenal hormones - Special considerations: GI effects, signs and symptoms of menopause-hot flashes, mood swings, edema, vaginal dryness and itching-as well as bone pain and back pain, treatable with analgesics, may occur; monitor lipid concentrations in patients at risk for high cholesterol level |
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Bicalutamide (Casodex) Hormone Modulator |
- In combination with a luteinizing hormone for the treatment of advanced prostate cancer - Action: Antiandrogen drug that competitively binds androgen receptor sites - Special considerations: Gynecomastia and breast tenderness occur in 33% of patients; GI complaints are common; pregnancy category X |
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Degarelix (Degarelix for Injection) Hormone Modulator |
- Treats patients with advanced prostate cancer - Action: Gonadotropin-releasing-hormone-receptor-site antagonist, leads to decreased follicle-stimulating hormone and luteinizing hormone and decreased testosterone levels - Special considerations: Pregnancy category X; risk of prolonged QT interval; injection-site reactions, hot flashes, increased weight are common |
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Estramustine (Emcyt) Hormone Modulator |
- Palliative for treatment of metastatic and progressive prostate cancer - Action: Binds to estrogen steroid receptors, causing cell death - Special considerations: GI toxicity, rash, bone marrow depression, breast tenderness, cardiovascular toxicity are common adverse effects; 30-90d of therapy may be required before effects are seen; monitor cardiovascular, liver, bone marrow function throughout therapy |
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Exemestane (Aromasin) Hormone Modulator |
- Treatment of advanced, metastatic breast cancer in postmenopausal women whose disease has progressed after tamoxifen therapy - Action: Inactivates steroid aromatase, lowering circulating estrogen levels and preventing conversion of androgens to estrogen - Special considerations: Avoid use in premenopausal women or in patients with liver or renal dysfunction; hot flashes, headache, GI upset, anxiety, depression are common |
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Flutamide Hormone Modulator |
- With luteinizing hormone for treatment of locally confined and metastatic prostate cancer - Action: Antiestrogenic drug, inhibits androgen uptake and binding on target cells - Special considerations: May cause liver toxicity, so liver function should be monitored regularly; associated with impaired fertility and cancer development; urine may become greenish; protect patient from exposure to the sun-photosensitivity is common |
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Fulvestrant (Faslodex) Hormone Modulator |
- Treatment of hormone receptor-positive metastatic breast cancer in postmenopausal women with disease progression after entiestrogen therapy - Action: Binds to estrogen receptors, downregulating estrogen receptor protein in breast cancer cells - Special considerations: Pregnancy category X; hot flashes, depression, headache, GI upset common; mark calendar with monthly injection dates; injection site reactions can occur |
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Goserelin (Zoladex) Hormone Modulator |
- Treats advanced prostatic and breast cancers; management of edometriosis - Action: Synthetic luteinizing hormone that inhibits pituitary release on gonadotropic hormones - Special considerations: Associated with hypercalcemia and bone density loss-monitor serum calcium; impairs fertility and is carcinogenic; monitor male patients for uretal obstruction especially during 1st month |
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Histrelin (Vantas) Hormone Modulator |
- Palliative treatment of advanced prostate cancer - Action: Inhibits gonadotropic secretion; decreases follicle-stimulating hormone and luteinizing hormone levels and testosterone levels - Special considerations: Must be surgically implanted and not removed; hot flashes common, monitor implantation site |
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Letrozole (Femara) Hormone Modulator |
- Treatment of advanced breast cancer in postmenopausal women with disease after antiestrogen therapy; postsurgery adjunct for postmenopausal women with early hormone receptor-positive breast cancer - Action: Prevents conversion of precursors to estrogens in all tissues - Special considerations: GI toxicity; bone marrow depression, alopecia, hot flashes, CNS depression common; discontinue if cancer progresses |
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Leuprolide (Lupron, Eligard) Hormone Modulator |
- Treats advanced prostate cancer; also used to treat precocious puberty and endometriosis; depot form for uterine leiomyomata - Action: Natural luteinizing hormone that blocks release of gonadotropic hormones - Special considerations: Monitor cancer patient's prostate-specific antigen levels periodically; monitor bone density and serum calcium levels; warn patient that he may have difficulty voiding the first few weeks and may experience bone pain, hot flashes, pain at injection site |
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Megestrol (Megace) Hormone Modulator |
- Palliative treatment of advanced breast or endometrial cancer; appetite stimulant for HIV patients
- Action: Blocks luteinizing hormone release; efficacy not understood - Special considerations: Monitor for thromboembolic events and weight gain; not for use during pregnancy |
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Mitotane (Megace) Hormone Modulator |
- Palliative treatment of inoperable adrenocortical carcinoma - Action: Cytotoxic to corticosteroid-forming cells of adrenal gland - Special considerations: Can cause GI toxicity, CNS toxicity with vision and behavioral changes, adrenal insufficiency, monitor adrenal function, arrange for replacement therapy as indicated |
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Nilutamide (Nilandron) Hormone Modulator |
- With surgical castration for treatment of metastatic prostate cancer - Action: Antiestrogenic drug, inhibits androgen uptake and binding on target cells - Special considerations: May cause liver toxicity, liver function tests should be monitored; associated with interstitial pneumonitis-baseline and periodic chest radiographs should be obtained and drug discontinued at first sign of dyspnea |
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Tamoxifen (Soltamox) Hormone Modulator |
- In combination therapy with surgery to treat breast cancer; treatment of advanced breast cancer in men and women; first drug approved for prevention of breast cancer in women at high risk for breast cancer - Action: Antiestrogen, competes with estrogen for receptor sites in target tissues - Special considerations: Signs and symptoms of menopause are common effects; CNS depression, bone marrow depression, GI toxicity are common; can change visual acuity and cause corneal opacities and retinopathy-pretherapy and periodic ophthalmic examinations are indicated |
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Toremifene (Fareston) Hormone Modulator |
- Treats advanced breast cancer in women with estrogen receptor-positive disease - Action: Binds to estrogen receptors and prevents growth of breast cancer cells - Special considerations: Signs and symptoms of menopause are common effects; CNS depression and GI toxicity common |
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Triptorelin Pamoate (Trelstar Depot) Hormone Modulator |
- Treats advanced prostatic cancer
- Action: Analogue of luteinizing hormone-releasing hormone; causes a decrease in follicle-stimulating hormone and luteinizing hormone levels, leading to a suppression of testosterone production - Special considerations: Monitor prostate-specific antigen and testosterone levels regularly; sexual dysfunction, urinary tract symptoms, bone pain, hot flashes are common; schedule depot injections and mark calendars for patient |
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Everolimus (Afinitor) Protein Tyrosine Kinase Inhibitor |
- Treats advanced renal cell carcinoma after failure of treatment with sunitinib or sorefenib - Special considerations: Pneumonitis, fatal infections, oral ulcerations, elevations in blood glucose, lipid, creatinine levels may occur, monitor patient very closely; do not use in pregnancy |
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Gefitinib (Iressa) Protein Tyrosine Kinase Inhibitor |
- Monotherapy for treatment of patients with locally advanced or metastatic non-small cell lung cancer after failure with platinum-based or docetaxel chemotherapies; use limited to patients doing well on therapy-not for new use - Special considerations: Interstitial lung disease may occur; monitor pulmonary function closely; eye changes may require stopping drug for a while; do not use during pregnancy; numerous drug-drug interactions possible - Slowly absorbed from GI tract, peaking 3-7 hrs - Metabolized in liver |
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Imatinib (Gleevec) Protein Tyrosine Kinase Inhibitor |
- Treatment of CML patients in blast crisis or in chronic phase after interferon-alpha therapy; treatment of patients with kit-positive malignant gastrointestinal stromal tumor; first line treatment of CML - Special considerations: Administer with a meal and full glass of water; arrange for small frequent meals if GI upset occurs; provide analgesics for headache and muscle pain; monitor CBC and for edema to arrange for dose reduction; patient should receive consultation to deal with high cost of drug - Selectively inhibits Bcr-Abl tyrosine kinase created by Philadelphia chromosome abnormality in CML, inhibiting proliferation and induces cell division in Bcr-Abl-positive cell lines, as well as in new leukemic cells, thereby inhibiting tumor growth in CML patients in blast crisis - Slowly absorbed from GI tract, peaks 2-4 hrs - Metabolized in liver - Associated with GI upset, muscle cramps, heart failure, fluid retention, skin rash - Bone marrow suppression, alopecia, severe GI effects associated with more traditional antineoplastic therapy do NOT occur - Caution when giving with other drugs affected by cytochrome P450 enzyme system |
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Lapatinib (Tykerb) Protein Tyrosine Kinase Inhibitor |
- In combination with capecitabine for treatment of patients with advanced or metastatic breast cancer whose tumors overexpress HER2 and who have received prior treatment including anthracycline, taxane, trastuzumab - Special considerations: Monitor heart function closely and decrease dose as needed; monitor for rash, GI toxicity; avoid grapefruit juice; many drug-drug interactions - PO - Absorbed from GI tract peaks 1-1.5 hrs - Metabolized in liver - Causes diarrhea and can cause liver impairment and altered heart function |
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Nilotinib (Tasigna) Protein Tyrosine Kinase Inhibitor |
- Treats chronic-phase and accelerated-phase Philadelphia chromosome-positive chronic myelogenous leukemia in adult patients resistant or intolerant to prior therapy that included imatinib
- Special considerations: Monitor for prolonged QT interval, bone marrow suppression, possible liver toxicity - Peaks 3 hrs after absorption - Most excreted unchanged in stool - Avoid using with other drugs that prolong QT interval |
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Pazopanib (Votrient) Protein Tyrosine Kinase Inhibitor |
- Treatment of advanced renal cell carcinoma - Special considerations: Monitor for prolonged QT interval; fatal hemorrhagic events have been reported; GI perforation and fistulas, hypertension, hypothyroidism have been reported; common effects include diarrhea, depigmentation of hair and GI upset - PO peaks 2-4 hrs - Metabolized in liver and excreted in feces - Associated with bone marrow depression, liver impairment as well |
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Sorafenib (Nexavar) Protein Tyrosine Kinase Inhibitor |
- Treatment of patients with advanced renal cell carcinoma and unresectable hepatocellular carcinoma - Special considerations: Monitor for skin reactions, hand-foot syndrome, hypertension - Well absorbed from GI tract after PO peaks in 1-2 hrs - Excreted unchanged in stool |
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Sunitinib (Sutent) Protein Tyrosine Kinase Inhibitor |
- Treatment of GI stromal tumor if patient is intolerant to or tumor progresses after imatinib therapy - Special considerations: Monitor for GI disturbances, bone marrow suppression; adjust dose as needed - PO slowly absorbed from GI tract and peaks 6-12 hrs - Metabolized in liver |
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Temsirolimus (Torisel) Protein Tyrosine Kinase Inhibitor |
- Treatment of advanced renal cell carcinoma - Special considerations: Monitor lung function, blood glucose, renal function; may experience slowed healing; avoid grapefruit juice, St. John's Wort - Only IV peaks at end of infusion - Metabolized in liver and excreted in feces |
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Erlotinib (Tarceva) Epidermal Growth Factor Inhibitor |
- Treatment of locally advanced or metastatic non-small cell lung cancer after failure of at least one other drug regimen; first-line treatment of pancreatic cancer when used in combination with gemcitabine - Special considerations: Serious to fatal interstitial lung disease-monitor with hepatic impairment;do not use during pregnancy - Well absorbed PO from GI tract peaks in 4 hrs - Metabolized in liver - Associated with cardiovascular events and pulmonary toxicity |
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Bortezomib (Velcade) Proteasome Inhibitor |
- Treatment of multiple myelome in patients with disease progression after two other therapies - Special considerations: May cause peripheral neuropathies, hypotension, bone marrow suppression; do not use during pregnancy - Given IV and peaks at end of infusion - Metabolized in liver - Associated with cardiovascular events and pulmonary toxicity - Also associated with peripheral neuropathy and liver and kidney impairment |
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Arsenic Trioxide (Trisenox) Miscellaneous Antineoplastic |
- Induction and consolidation in patients with acute promyelocytic leukemia (APL) who are refractory to or relapsed from standard therapy - Action: Causes damage to fusion proteins and DNA failure, leading to cell death - Special considerations: Monitor for cardiac toxicity; do not use during pregnancy |
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Asparaginase (Elspar) Miscellaneous Antineoplastic |
- As part of combination therapy to induce remission in children with APL - Actions: An enzyme that hydrolyzes amino acid asparagine, which is needed by malignant cells for protein synthesis; inhibits cell proliferation; most effective in G1 phase of cell cycle - Special consideration: Can cause severe bone marrow depression, renal toxicity, fatal hyperthermia; hypersensitivity reactions are common, patients should be tested and desensitized, if necessary, before using this drug |
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Azacitidine (Vidaza) Miscellaneous Antineoplastic |
- Treats myelodysplastic syndrome - Action: Causes demethylation of DNA - Special considerations: Premedicate for nausea; monitor for bone marrow suppression; patient should avoid pregnancy and fathering children while on drug |
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Bexarotene (Targretin) Miscellaneous Antineoplastic |
- Treats cutaneous manifestations of cutaneous t-cell lymphoma in patients refractory to at least one other systemic therapy - Action: Binds and activates retinoid receptors - Special considerations: Risk of serious pancreatitis, photosensitivity |
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Decitabine (Dacogen) Miscellaneous Antineoplastic |
- Treats myelodysplastic syndromes - Action: Affects DNA and inhibits DNA transfer - Special considerations: Premedicate with antiemetics; monitor for bone marrow suppression |
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Hydroxyurea (Hydrea) Miscellaneous Antineoplastic |
- Inhibits enzymes essential for synthesis of DNA, causing cell death - Action: Treatment of melanoma, ovarian cancer, CML; in combination therapy for primary squamous cell cancers of the head and neck; also used in treatment of sickle cell anemia - Special considerations: Can cause bone marrow depression, headache, rash, GI toxicity, renal dysfunction; encourage patient to drink 10-12 glasses of water each day while taking this drug |
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Irinotecan (Camptosar) Miscellaneous Antineoplastic |
- Treatment of metastatic colon or rectal cancer after treatment with fluorouracil (5-FU) or given with 5-FU - Action: Disrupts DNA strands during DNA synthesis, causing cell death - Special considerations: Can cause severe bone marrow depression, which regulates doses of the drug; causes GI toxicity, dyspnea, alopecia |
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Nelarabine (Arranon) Miscellaneous Antineoplastic |
- Treatment of T-cell acute lymphobastic leukemia and T-cell lymphobastic lymphoma when disease has progressed after standard therapy - Action: Inhibit DNA synthesis and cause cell death - Special considerations: Watch for neurological toxicities, including neuropathies and demyelination disorders; bone marrow suppression is common |
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Pegaspargase (Oncaspar) Miscellaneous Antineoplastic |
- Treatment of APL in patients who are hypersensitive to asparaginase - Action: Enzyme that hydrolyzes amino acid asparaginase, which is needed by malignant cells for protein synthesis; inhibits cell proliferation; most effective in G1 phase of cell cycle - Special considerations: Can cause potentially fatal hyperthermia, bone marrow depression, renal toxicity, pancreatitis; monitor patient regularly, arrange decreased dose as appropriate if toxic effects occur |
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Porfimer (Photofrin) Miscellaneous Antineoplastic |
- Photosensitizing agent that is used with laser light to decrease tumor size in patients with obstructive esophageal cancers not responsive to laser treatment alone; transitional cell carcinoma in situ of urinary bladder; endothelial non-small cell lung cancer - Actions: Taken up by cells, causing radical reactions when cells are exposed to laser light, causing cell death - Special Considerations: Has been associated with pleural effusion and fistula; associated with GI and cardiac toxicity; must be given in conjunction with scheduled laser treatment, with at least 30 days between treatments; protect patient from exposure to light with protective clothing for 30 days after treatment (sunscreen not effective); avoid direct contract with drug-protective clothing and goggles suggested |
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Supileucel-T (Provenge) Miscellaneous Antineoplastic |
- Autologous cellular immunotherapy used to induce immune response to antigens found in most prostate cancers: treatment of asymptomatic or minimally symptomatic metastatic hormone refractory prostate cancer - Special considerations: Premedicate with oral acetaminophen and an antihistamine; universal precautions are required; severe infusion reactions possible, monitor closely during administration; patient may experience fever, headache, nausea, joint pain |
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Talc Powder (Sclerosol) Miscellaneous Antineoplastic |
- Prevention of recurrence of malignant pleural effusion - Action: Induces inflammatory response, promoting adhesion of the pleura and preventing accumulating of fluid - Special considerations: Monitor for cardiac and respiratory effects; no actual antineoplastic actions |
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Topotecan (Hycamtin) Miscellaneous Antineoplastic |
- Treatment of patients with metastatic ovarian cancer after failure of other agents - Action: Damages DNA strand, causing cell death during cell division - Special considerations: Can cause severe bone marrow depression, which regulates dose of the drug; total alopecia, GI toxicity, CNS effects may limit use of the drug; analgesics may be helpful |
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Tretinoin (Vesanoid) Miscellaneous Antineoplastic |
- Used to induce remission in APL; can cause severe respiratory and cardiac toxicity, including myocardial infarction and cardiac arrest - Action: Promotes cell differentiation and repopulation of bone marrow with normal cells in patients with APL - Special considerations: GI toxicity, pseudotumor cerebri (Papilledema, headache, nausea, vomiting, visual changes), skin rash, fragility may limit use in some patients; discontinue drug at first sign of toxic effects; use for induction of remission only-then other chemotherapeutic agents should be used |
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Vorinostat (Zolinza) Miscellaneous Antineoplastic |
- Treatment of cutaneous manifestations in patients with cutaneous t-cell lymphoma - Action: Histone deacetylase inhibitor - Special considerations: Monitor for increased bleeding; excessive nausea and vomiting may occur; encourage fluid intake to prevent dehydration |
