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CONTINUING PROFESSIONAL DEVELOPMENT
upsets. While the bioavailability
and absorption of some TKIs are not
affected by co-administration with food
(e.g. imatinib, dasatinib), others can
be significantly changed. For instance,
the oral bioavailability of nilotinib is
significantly increased when taken
with food, so it is recommended that
it is taken on an empty stomach to
prevent an increase in side effects.
Patients must be given tailored advice
on whether the TKI they are prescribed
should and should not be taken
Are there special handling instructions
Conventional cytotoxic chemotherapeutic
agents are associated with stringent
recommendations around the storage,
handling, administration and disposal
processes to reduce the risk of exposure
to health practitioners and surrounding
Strategies include the use of
personal protective equipment, biological
safety cabinets when compounding
or modifying the dosage forms, using
separate dedicated equipment (and
decontamination), and special training for
people that need to come in contact with
the medicines. As TKIs are not cytotoxic
drugs, in theory, these recommendations
are not applicable for the newer
non-cytotoxic agents. However, as there
is a distinct lack of information and clarity
around the safe handling of these newer
non-cytotoxic medicines, it is reported
that many institutions have adopted the
practices used with the cytotoxic agents.
Whether this is necessary remains to be
determined, and until more research and
information comes to light, it is safer to
comply with the same guidelines used for
1. NPS MedicineWise. Targeted cancer treatments. In:
Medicinewise Living. 2013. At: www.nps.org.au/
2. Brunton LL, Chabner BA, Knollmann BC, ed. Goodman and
Gilman’s the pharmacological basis of therapeutics. 12th
edn. New York: McGraw-Hill; 2011.
3. Patrick GL. An introduction to medicinal chemistry. 5th
edn. Oxford: Oxford University Press; 2013.
4. Rossi S, ed. Australian medicines handbook. Adelaide:
Australian Medicines Handbook; 2015.
5. Hartmann JT, Haap M, Kopp HG, et al. Tyrosine kinase
inhibitors – a review on pharmacology, metabolism and
side effects. Curr Drug Metab 2009;10(5):470–81.
6. Dipiro JT, Talbert RL, Yee GC et al. Pharmacotherapy: a
pathophysiologic approach. 8th edn. New York: The
7. Reeves DJ, Kam TC, Storey SH. Oral antineoplastic handling
at health care institutions in the United States: survey of
nurses and pharmacists. Hosp Pharm 2013;48(4):308–13.
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1. Which of the following statements
regarding tyrosine kinase inhibitors
(TKIs) is CORRECT?
a) All TKIs target the same tyrosine kinase.
b) TKIs are cytotoxic, and work by targeting
the rapidly dividing cells.
c) TKIs are also known as monoclonal
d) TKIs inhibit specific tyrosine kinases
that play a role in cancer growth and
2. Select the CORRECT statement
regarding the use of TKIs in the
management and treatment of cancer.
a) All TKIs have the same effect and can
therefore be used interchangeably.
b) TKIs only inhibit one type of tyrosine
kinase, so TKIs are only used in the
management and treatment of one
type of cancer.
c) Cancer cells can develop resistance to
TKIs, rendering TKIs ineffective against
d) Protein kinase inhibitors work by
phosphorylating amino acids in protein
substrates by catalysing the transfer of a
phosphate group from ATP.
3. Select the INCORRECT match
between the tyrosine kinase that is
inhibited, accepted indication, and
a) BCR-ABL1, C-Kit, PDGFR – chronic
myeloid leukaemia – imatinib.
b) EGFR, HER2 – HER2-positive breast
cancer – erlotinib.
c) JAK1, JAK2 – myelofibrosis – ruxolitinib.
d) VEGFR2, VEGFR3, EGFR, RET – medullary
thyroid cancer – vandetanib.
4. Select the CORRECT statement in
relation to mechanism of action
a) ErbB1 inhibitors block epithelial cell
growth and differentiation.
b) BCR-ABL kinase inhibitors block
epithelial cell growth and differentiation.
c) EGFR inhibitors block angiogenesis by
d) VEGFR targets the pathway associated
with deregulated ABL kinase activity.
5. Select the CORRECT statement in
relation to counselling that may be
provided to patients prescribed TKIs.
a) TKIs are targeted therapies, so they do
not cause side effects.
b) TKIs should always be taken with food
to prevent gastrointestinal side effects.
c) TKIs are prone to side effects and close
monitoring of patients is required.
d) TKIs are safe to use during pregnancy
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