Study Questions

1. A patient of yours has been receiving 5-fluorouracil as palliative therapy for adenocarcinoma of the pancreas. You suspect that the patient has become resistant to the treatment. You want to understand the most likely cause of the resistance before you select another agent. Which of the following is the most likely cause?

(A) Drug transport into cells is decreased.

(B) P-glycoprotein is increased.

(C) The tumor can no longer activate the drug.

(D) The tumor is detoxifying the drug more rapidly.

(E) The tumor has developed an increase in metal-lothionein content.

2. Neurotoxicity is rarely dose limiting in cancer chemotherapy. The only antineoplastic agent that has a dose-limiting neurotoxicity is

(A) Bleomycin

(B) Cisplatin

(C) Vincristine

(D) Doxorubicin

(E) Methotrexate

3. You are asked to devise therapy for a patient with rapidly dividing cancer. You have no additional information on the nature of the tumor, but you decide that you want to begin by choosing a drug that will kill the tumor cells but spare normal cells. You have the following agents to choose among. Which is your first choice?

(A) Hydroxyurea

(B) Cytarabine

(C) Bleomycin

(D) Mechlorethamine

(E) Dactinomycin

4. To optimize drug therapy, it is necessary to know in what phase of the cell cycle antineoplastic agents are effective. Which one of the following agents is cytotoxic only to cells in the S-phase of the cycle?

(A) Hydroxyurea

(B) Mechlormethamine

(C) Bleomycin

(D) Carmustine

(E) Fluorouracil

5. Combination chemotherapy is frequently used and is often superior to single-agent treatment. All of the following principles have been used in designing combinations EXCEPT which of the following?

(A) Each drug in the combination regimen should have some therapeutic activity individually.

(B) Drugs with different dose-limiting toxicities should be used to avoid damage to a single organ.

(C) Several cycles of treatment should be given.

(D) Intensive intermittent schedules of drug treatment.

(E) Drugs with similar dose-limiting toxicities should be used as initial combination therapy.

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