Question

JK is a 48 yo premenopausal women recently diagnosed with breast cancer. She weighs 150lbs and is 65 inches tall. Basic metabolic labs are normal. The cancer tumor measures between 2 and 5cm and found in 1 to 3 axillary lymph nodes. Her cancer is HER2 positive, ER positive, and PR positive.

1. JK’s cancer is most likely to be classified as (give the stage)? ________

2. Since her cancer is HER2 +, which medication would she most likely be started on first to target the HER2 receptor?

A. Gleevac

B. Herceptin

C. Megace

D. Aromasin

3. What would be the most common dose range of her first line therapy?

A.136mg-272mg given IV

B.300mg-600mg given IV

C.25mg daily give orally

D. 400-600mg daily given orally

E. 13,600 units given IV

4. She will also be started on estrogen therapy. Which medication should she be started on first line? Please select all that apply.

A. Arimidex

B. Aromasin

C. Nolvadex

D. Emcyt

E. Efudex

5. JK starts to have stomach upset, difficulty breathing, and fever. Which medication are these symptoms most associated with? ____________

Answer 1

1.The stage is classified based on TNM staging (Tumor,Node,Metastasis )

Her tumor is 2 to 5cm which is classified in T2

It has spread to 1- 3 axillary lymph noded which is classified as N1

It hs metastases to axillary lymphomas which is in Stage IIA

So it is depicted as T1N1M0

2.The treatment is usually targeted therapy. The HER2 receptors are blocked so thst the cancer cells cannot grow.The drugs used are Lapatinib,Neratinub,Pertuzumab, Transtuzumab.The brand name of transtuzumab is Herceptin

Aromacin for blocking estrogen receptor (ER positive)

Megase is an appetite stimulant

Gleevac is used to treat ALL,chronic myeloid leukaemia,gastrointestinal Timor and not for breast cancer

Ans:B.Herceptin

3.The common dose range for this patient is 4mg/kg IV (Herceptin)

Here patient weight is 150 pounds=60kg

60×4=240mg

So a range of 132 mg -272mg can be the initial dose for this patient

Ans.A.132-272 mg given IV

4.Aromacin is a drug which blocks the estrogen receptor (ER positive )Armidex for PR positive

Ans.B.Aromacin

5.The drug Herceptin cause adverse events like nausea,vomiting, infusion reaction,infection,fever,diarrhoea, dyspnea,headaches,fatigue ,rash,anaemia in the patients receiving it.