Oncology Pharmacology Flashcards

Immune-related adverse events (irAEs) from checkpoint inhibitors most commonly affect which organ systems?

Answer: Skin, GI tract, liver, and endocrine glands

Checkpoint inhibitors cause autoimmune-like reactions most frequently in skin (rash), gut (colitis), liver (hepatitis), and endocrine organs (thyroiditis).

PARP inhibitors such as olaparib are most effective in cancers with defects in which pathway?

Answer: Homologous recombination repair (BRCA1/2 mutations)

PARP inhibitors exploit synthetic lethality in BRCA-mutated cells that cannot repair DNA through homologous recombination, leading to cancer cell death.

CAR-T cell therapy requires which critical patient preparation step?

Answer: Lymphodepleting chemotherapy before infusion

Lymphodepleting chemotherapy (conditioning) before CAR-T infusion removes endogenous lymphocytes to create space for the engineered T-cells to expand.

Cytokine release syndrome (CRS) is a potentially life-threatening complication most associated with which therapies?

Answer: CAR-T cell therapy and bispecific antibodies

CRS is a systemic inflammatory response caused by massive cytokine release when immune cells are activated by CAR-T cell therapy or bispecific antibodies.

Which agent is used as antidote or reversal for severe methotrexate toxicity when leucovorin is insufficient?

Answer: Glucarpidase (carboxypeptidase G2)

Glucarpidase rapidly converts methotrexate to inactive metabolites in the plasma, used when methotrexate levels remain dangerously high despite leucovorin rescue.

Which drug requires REMS (Risk Evaluation and Mitigation Strategy) program enrollment due to teratogenicity in oncology?

Answer: Thalidomide and lenalidomide

Thalidomide and lenalidomide are teratogenic drugs managed under REMS (THALOMID REMS and REVLIMID REMS) requiring pregnancy testing, contraception, and restricted dispensing.