Step I anti-neoplastics

[Aclamity]

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Anyone know how high-yield it is to know the specific cancers each one is used for? They seem largely random to say the least. After 600 UW questions I have yet to see one where we needed to know this info. Even the intro paragraph for the heme/onc chap in FA says it's "low-yield," but for those who've taken the test, is it really?

 

[missmedschool]

It's very low yield. Just know the mechanisms. I've never come across a question where they ask what cancer the drug is used for & I've finished UW, Kaplan, the the NBME shelf in pharm.

 

[ijn]

After seeing all 10 NBMEs, pharm shelf, and 2 CBSEs I'd say for most drugs you don't need to know what cancer they treat. Side effects, mechanism , and any associated biochemistry and cell biology principles are way more important. There are a few exceptions that you definitely need to know, like herceptin/anastrozole/tamoxifen for breast cancer, imantinib for CML or vitamin A for M3 AML. For something etoposide it's a waste of time to learn what it's used to treat.

Also knowing which antineoplastics can cause cancer is kind of high yield. Especially the relationship between alkylating agents and AML.

 

[djquickfingers]

Anyone know how high-yield it is to know the specific cancers each one is used for? They seem largely random to say the least. After 600 UW questions I have yet to see one where we needed to know this info. Even the intro paragraph for the heme/onc chap in FA says it's "low-yield," but for those who've taken the test, is it really?

its not HY to know what cancers each one treats. Know the big ones, but specifically, know what side effects and WHAT STAGE OF THE CELL CYCLE they work upon. That is the most HY. Know the cell cycle cold, and what stages each drugs works on and what exactly its mechanism is within that stage. That is where you will see most of your questions. Know the diagram and be able to draw it out. Thank me later

 

[Aclamity]

Sweet, thank y'all. I was afraid this was going to turn into one of those rote memorization thingies. glad to see it won't

 

[futuredoctor10]

Glad to hear this too! I always wondered when I saw all the specific uses listed in FA but have not come across a question asking specifically about this area. Thanks for the feedback!

 

[mdeast]

Glad to hear this too! I always wondered when I saw all the specific uses listed in FA but have not come across a question asking specifically about this area. Thanks for the feedback!

Yeah. Don't know the specific cancers. The only ones I can think of...is maybe know that nitrosureas (lomustine, semustine, streptozocin, etc.) treat brain tumors. They are unique in that they can cross the blood-brain barrier...so this could be a way they could test that.

Example: You are considering neoplastic drugs for a patient who was recently diagnosed with gliobastoma multiforme and want to select an alkylating agent that will be effectively delivered to the cancer tissue upon IV administration. Which drug would you choose?

Though, still probably low yield.

 

[iPodtosis]

How do anti-metabolites target S phase instead of G1 phase?
I would assume those nucleotides are made in the G1 phase and then incorporated into DNA replication in the S phase.
The only anti-metabolite that I can think of targeting the S phase is Cytarabine.
Can someone explain?
Thanks

 

[futuredoctor10]

Yeah. Don't know the specific cancers. The only ones I can think of...is maybe know that nitrosureas (lomustine, semustine, streptozocin, etc.) treat brain tumors. They are unique in that they can cross the blood-brain barrier...so this could be a way they could test that.

Example: You are considering neoplastic drugs for a patient who was recently diagnosed with gliobastoma multiforme and want to select an alkylating agent that will be effectively delivered to the cancer tissue upon IV administration. Which drug would you choose?

Though, still probably low yield.

Yeah I think the only 2 ones I am going to learn (because they are unique):
1. nitrosureas (carmustine) can cross the BBB (use: brain tumors)
2. actinomycin for rhabdomyosarcoma, Wilms tumor (childhood tumors)

And actinomycin is easy to remember with FA's mnemonic "children ACT out"

 

[futuredoctor10]

How do anti-metabolites target S phase instead of G1 phase?
I would assume those nucleotides are made in the G1 phase and then incorporated into DNA replication in the S phase.
The only anti-metabolite that I can think of targeting the S phase is Cytarabine.
Can someone explain?
Thanks

Nucleotides are actually synthesized in S phase.

Antimetabolite drugs like methotrexate inhibit DHFR, preventing the synthesis of purines and DNA, during the S phase of the cell cycle.

Other antimetabolites are nucleotide analogs (e.g. mercaptopurine, a purine analog) which are incorporated into the DNA during the S phase, and subsequently inhibit cell division.

That is my understanding!

 

[Valadi]

I'm reading this thread as an M4 and just astounded at how much information I've forgetten...