PGX EXAM 3 QUESTIONS WITH CORRECT ANSWERS
Irinotecan is a prodrug converted to the active SN-38 form by - CORRECT
ANSWER✅✅carboxylesterases
SN38 is deactivated by _______ in the liver and eliminated by biliary excretion - CORRECT
ANSWER✅✅glucuronidated by UDP-glucuronosyltransferases
______ is a contraindication for irinotecan - CORRECT ANSWER✅✅major liver impairment
dose reduction if moderate liver impairment
______ and ______ also metabolize irinotecan - CORRECT ANSWER✅✅CYP3A4 and 3A5
Irinotecan and its metabolites are actively effused outside the cells by _____ transporters such as -
CORRECT ANSWER✅✅ABC
Multidrug resistant protein-1 (MDR1) and Multidrug resistance-associated protein-1 and protein-2
(MRP1 and MRP2)
_______ is a strong UGT1A1 and UGT1A9 inhibitor - CORRECT ANSWER✅✅Regorafenib
would inhibit glucoronidation of SN28 and inactivation
_______ polymorphism is the biomarker for ironotecan - CORRECT ANSWER✅✅UGT1A1*28
TATA7 polymorphism
______ and ______ are polymorphisms in the coding region (exon 1) for UGT1A1 - CORRECT
ANSWER✅✅*6 and 27
, which alleles are implicated in Gilbert's syndrome with reduced UGT1A1 function - CORRECT
ANSWER✅✅*6, 27, 28
what is gilbert's syndrome - CORRECT ANSWER✅✅harmless liver condition in which the liver doesn't
properly process bilirubin.
what is the limitation of genetic testing for UGT1A1 in pts about to start irinotecan - CORRECT
ANSWER✅✅only tests for TATA box polymorphism and does not detect other genes
5-FU and Capecitabine are inactivated by - CORRECT ANSWER✅✅Dihydropyrimidine Dehydrogenase
(DPD)
normal DPD function - CORRECT ANSWER✅✅Carrying two copies of normal alleles (e.g:*1/1, 1/9A).
low DPD function - CORRECT ANSWER✅✅Carrying one functional allele and one non-functional
(e.g:*1/2) .
no DPD function - CORRECT ANSWER✅✅Carrying two copies of non-functional alleles (e.g: 2/2, 2/13).
DPD deficiency results in - CORRECT ANSWER✅✅Exaggerated 5-FU-related toxicities: Neutropenia;
Mucositis, Stomatitis, Diarrhea; Skin rash; Neurologic toxicities; Death.
DPD intermediate metabolizer - CORRECT ANSWER✅✅reduce starting dose
DPD poor metabolizer - CORRECT ANSWER✅✅avoid 5-FU and capecitabine
_____ and _____ are effective in pts with EGFR expression and *wild type* KRAS and can be used in
colorectal cancer and NSCLC - CORRECT ANSWER✅✅Cetuximab and Panitumumab
what is KRAS - CORRECT ANSWER✅✅Oncogene and downstream effector of EGFR; controls: Cell
growth, Differentiation, Apoptosis (survival).
Irinotecan is a prodrug converted to the active SN-38 form by - CORRECT
ANSWER✅✅carboxylesterases
SN38 is deactivated by _______ in the liver and eliminated by biliary excretion - CORRECT
ANSWER✅✅glucuronidated by UDP-glucuronosyltransferases
______ is a contraindication for irinotecan - CORRECT ANSWER✅✅major liver impairment
dose reduction if moderate liver impairment
______ and ______ also metabolize irinotecan - CORRECT ANSWER✅✅CYP3A4 and 3A5
Irinotecan and its metabolites are actively effused outside the cells by _____ transporters such as -
CORRECT ANSWER✅✅ABC
Multidrug resistant protein-1 (MDR1) and Multidrug resistance-associated protein-1 and protein-2
(MRP1 and MRP2)
_______ is a strong UGT1A1 and UGT1A9 inhibitor - CORRECT ANSWER✅✅Regorafenib
would inhibit glucoronidation of SN28 and inactivation
_______ polymorphism is the biomarker for ironotecan - CORRECT ANSWER✅✅UGT1A1*28
TATA7 polymorphism
______ and ______ are polymorphisms in the coding region (exon 1) for UGT1A1 - CORRECT
ANSWER✅✅*6 and 27
, which alleles are implicated in Gilbert's syndrome with reduced UGT1A1 function - CORRECT
ANSWER✅✅*6, 27, 28
what is gilbert's syndrome - CORRECT ANSWER✅✅harmless liver condition in which the liver doesn't
properly process bilirubin.
what is the limitation of genetic testing for UGT1A1 in pts about to start irinotecan - CORRECT
ANSWER✅✅only tests for TATA box polymorphism and does not detect other genes
5-FU and Capecitabine are inactivated by - CORRECT ANSWER✅✅Dihydropyrimidine Dehydrogenase
(DPD)
normal DPD function - CORRECT ANSWER✅✅Carrying two copies of normal alleles (e.g:*1/1, 1/9A).
low DPD function - CORRECT ANSWER✅✅Carrying one functional allele and one non-functional
(e.g:*1/2) .
no DPD function - CORRECT ANSWER✅✅Carrying two copies of non-functional alleles (e.g: 2/2, 2/13).
DPD deficiency results in - CORRECT ANSWER✅✅Exaggerated 5-FU-related toxicities: Neutropenia;
Mucositis, Stomatitis, Diarrhea; Skin rash; Neurologic toxicities; Death.
DPD intermediate metabolizer - CORRECT ANSWER✅✅reduce starting dose
DPD poor metabolizer - CORRECT ANSWER✅✅avoid 5-FU and capecitabine
_____ and _____ are effective in pts with EGFR expression and *wild type* KRAS and can be used in
colorectal cancer and NSCLC - CORRECT ANSWER✅✅Cetuximab and Panitumumab
what is KRAS - CORRECT ANSWER✅✅Oncogene and downstream effector of EGFR; controls: Cell
growth, Differentiation, Apoptosis (survival).
