Chapter 18: Anticancer agents (Part A)

01) What term is used to indicate the birth of a cancer?

a. Carcinogenesis
b. Apoptosis
c. Metastasis
d. Mutagenesis

02) What term is used to indicate the process by which a cell commits suicide?
a. Carcinogenesis
b. Apoptosis
c. Metastasis
d. Mutagenesis

03) What is the term given to a gene which has become mutated and which codes for an abnormal protein that is
implicated in the development of cancer?
a. Pre-oncogene
b. Proto-oncogene
c. Oncogene
d. Mutogene

04) Which of the following is a protein that is involved in the processes of cellular checking, repair and suicide?
a. Platelet-derived growth factor
b. Transforming growth factor
c. Cyclin dependent kinase
d. p53

05) Which of the following could contribute to the development of a tumour?

a. Abnormal signalling pathways
b. Abnormality in the cell cycle regulation
c. Evasion of programmed cell death
d. All of the answers are correct

06) Which of the following is involved in cell signal transduction pathways and can lead to cancer when it is in an
abnormal form?
a. Transforming growth factor α
b. Cyclins
c. The ras protein
d. Cyclin dependent kinases

07) Which of the following is involved in regulation of the cell cycle?

a. Cyclins and cyclin dependent kinases
b. Granzyme
c. Cytochrome c
d. Platelet-derived growth factor

08) Which of the following enzymes are responsible for protein degradation during apoptosis?
a. Telomerases
b. Caspases
c. Matrix metalloproteinases
d. Cyclin dependent kinases

09) What is the name of the structure at the end of chromosomes which is crucial to the immortalisation of cancer
cells?
a. Centromere
b. Telomere
c. Protein matrix
d. Histones

10) Which of the following induces metastasis?

a. VEGF
b. FGF-2
c. Angiostatin
d. Interleukin-6
11) Which group of enzymes is responsible for breaking down the basement membranes round blood vessels
prior to angiogenesis?
a. Cyclin dependent kinases
b. Matrix metalloproteinases
c. Telomerases
d. Caspases

12) Which of the following is the most effective treatment of cancers?

a. Surgery
b. Radiotherapy
c. Chemotherapy
d. A combination of all the answers

13) Which of the following is responsible for the resistance shown by some cancer cells to anticancer drugs?
a. Integrins
b. P53 protein
c. P-glycoprotein
d. Cyclins

14) What is the term used for the nitrogen mustard anticancer agents?
a. Alkylating agents
b. Chain cutting agents
c. Antimetabolites
d. Intercalating agents

15) What is the term used for the anticancer agent cyclophosphamide?
a. Alkylating agent
b. Chain cutting agent
c. Antimetabolite
d. Intercalating agent

16) What is the term used for the anticancer agent methotrexate?
a. Alkylating agent
b. Chain cutting agent
c. Antimetabolite
d. Intercalating agent

17) What is the term used for the cisplatin group of anticancer agents?
a. Alkylating agents
b. Chain cutting agents
c. Antimetabolites
d. Intercalating agents

18) Dactinomycin is an intercalating anticancer agent.

Which region of the molecule is crucial to intercalation?

a. The cyclic peptides
b. The amide groups
c. The tricyclic system
d. All of the regions

19) Dactinomycin is an intercalating anticancer agent.

Interactions with particular base pairs are favoured in the intercalation of this compound. Which base pairs are
favoured?
a. cytosine-guanine
b. adenine-thymine
c. adenine-uracil
d. thymine-guanine

20) Dactinomycin is an intercalating anticancer agent.

Which region of the molecule interacts with the sugar phosphate backbone of DNA?
a. The cyclic peptides
b. The amide groups
c. The tricyclic system
d. All of the answers are correct

21) The following group of structures are intercalating anticancer agents.

To which family of compounds do these structures belong?
a. Podophyllotoxins
b. Camptothecins
c. Anthracyclines
d. Bleomycins

22) The following group of structures are intercalating anticancer agents.

How many rings of the tetracyclic system are involved in intercalation?

a. 1
b. 2
c. 3
d. 4

23) The following group of structures are intercalating anticancer agents.

What role does the ammonium ion play in the molecule's mode of action?
a. It makes the molecule water soluble.
b. It prevents the molecule crossing cell membranes.
c. It forms a hydrogen bond to a deoxyribose sugar moiety on the DNA backbone.
d. It forms an ionic bond to a phosphate group on the DNA backbone.

24) What enzyme is involved in relieving the tension created in DNA when the DNA double helix is unravelled?
a. Telomerase
b. DNA polymerase
c. Helicase
d. Topoisomerase II

25) Which of the following drugs inhibits topoisomerase II?

a. Uracil mustard
b. Daunorubicin
c. Cyclophosphamide
d. Cisplatin

26) Which amino acid in the enzyme topoisomerase II is responsible for cleaving a phosphate-sugar link in a DNA
strand?
a. Tyrosine
b. Threonine
c. Serine
d. Cysteine

27) The following is representative of a group of natural products which are intercalating anticancer agents.
What are these group of compounds called?
a. Podophyllotoxins
b. Camptothecins
c. Anthracyclines
d. Bleomycins

28) Bleomycins are natural products which are intercalating anticancer agents.

Which region of the molecule is involved in intercalation?

a. The carbohydrate ring system
b. The pyrimidine ring
c. The imidazole ring
d. The bithiazole ring system

29) Bleomycins are natural products which are intercalating anticancer agents.
They chelate a ferrous ion as part of their mechanism of action. Which region of the molecule is important in
chelating ions?
a. The pyrimidine ring
b. The imidazole ring
c. The primary amine groups
d. All of the answers are correct

30) The following structure is used as an anticancer agent

What is the name of the structure?

a. Epipodophyllotoxin
b. Teniposide
c. Etoposide
d. Podophyllotoxin

31) The following structure (etoposide) is used as an anticancer agent

Etoposide is a semi-synthetic derivative of which compound?
a. Epipodophyllotoxin
b. Teniposide
c. Etoposide
d. Podophyllotoxin

32) The following structure (etoposide) is used as an anticancer agent

Which enzyme is targeted by etoposide?

a. Topoisomerase II
b. DNA polymerase
c. DNA ligase
d. Topoisomerase I

33) Etoposide is used as an anticancer agent

Which of the following groups is crucial to the mechanism of etoposide in producing radical species?
a. The bicyclic substituent at position 4
b. The lactone
c. The methoxy substituents at positions 3' and 5'
d. The phenolic substituent at position 4'

34) The following group of compounds are cytotoxic alkaloids used as anticancer agents.

What are the group of compounds illustrated above?

a. Bleomycins
b. Camptothecins
c. Podophyllotoxins
d. Anthracyclines

35) Camptothecins are cytotoxic alkaloids used as anticancer agents.

What is the target for these compounds?

a. Topoisomerase II
b. DNA polymerases
c. DNA ligase
d. Topoisomerase I

36) Camptothecins are cytotoxic alkaloids used as anticancer agents.

Which of the following moieties is particularly important for activity?

a. Rings A and B
b. Rings A, B and C
c. Ring D
d. Ring E

37) The following agent is used for the treatment of Hodgkin's lymphoma as part of a multi-drug regime.
What is the name of the compound?
a. Cisplatin
b. Busulfan
c. Carmustine
d. Chlormethine

38) The following agent is used for the treatment of Hodgkin's lymphoma as part of a multi-drug regime.

What sort of agent is it?

a. A topoisomerase inhibitor
b. An alkylating agent
c. An antimetabolite
d. A receptor antagonist

39) The following agent is used for the treatment of Hodgkin's lymphoma as part of a multi-drug regime.

What is the name of the activated species which is formed from the above structure and which is the actual
alkylating agent?
a. A quaternary ammonium ion
b. An iminium ion
c. A cyclopropylamine ion
d. An aziridinium ion

40) The following structure is a modification of chlormethine:

What is the name of the structure?

a. Chlorambucil
b. Uracil mustard
c. Melphalan
d. Estramustine
41) The following structure is a modification of chlormethine

What advantages does this structure have over chlormethine?

a. The aromatic ring increases the nucleophilicity of the amine nitrogen.
b. It contains a mimic for the amino acid tyrosine.
c. It is more likely to be taken into cells by carrier proteins.
d. All of the above.

42) The following anticancer agent has been used in the treatment of chronic lymphatic leukaemia. It contains a
nucleic acid base as part of its structure.

What nucleic acid base has been incorporated into the structure?
a. Thymine
b. Uracil
c. Cytosine
d. Adenine

43) The following anticancer agent has been used in the treatment of chronic lymphatic leukaemia. It contains a
nucleic acid base as part of its structure.

What is the rationale for the presence of this moiety?

a. The drug is more likely to be incorporated into DNA.
b. The drug is more likely to be incorporated into RNA.
c. The drug is more likely to be taken up by fast growing cancer cells.
d. The drug is less likely to produce an immune response.

44) The following structure has been used as an anticancer agent.

What is the name of the structure?
a. Chlormethine
b. Uracil mustard
c. Melphalan
d. Estramustine

45) The following structure has been used as an anticancer agent.

A steroid structure has been incorporated into the structure. Which steroid has been incorporated?
a. Cholesterol
b. Testosterone
c. Oestrone
d. Oestradiol

46) The following drug is commonly used in anticancer therapy.

What is it called?
a. Cyclophosphamide
b. Cisplatin
c. Carmustine
d. Chlormethine

Title: Chapter 18a Question 47

47) The following drug is commonly used in anticancer therapy.
Which of the following statements is not true of the above structure?
a. It is relatively non toxic.
b. It acts as a prodrug.
c. It cannot be taken orally.
d. The structure is metabolised to release acrolein.

48) The following drug is commonly used in anticancer therapy.

Which of the following enzymes is important in activating the above structure?

a. Esterases
b. Phosphorylases
c. Kinases
d. Cytochrome P450 enzymes

49) The following structure is used in the treatment of brain tumours.

To which group of compounds does it belong?

a. Nitrosoureas
b. Nitrogen mustards
c. Camptothecins
d. Podophyllotoxins

50) The following structure is called lomustine and is used in the treatment of brain tumours.

Which of the following statements is true regarding the above structure?

a. It cannot cross the blood brain barrier.
b. It is activated by an enzymatic metabolic reaction.
c. It cannot be given orally.
d. It is both an alkylating and a carbamoylating agent.

51) The following agent is used in the treatment of chronic granulocytic leukaemia:
What is the structure called?
a. Carmustine
b. Busulfan
c. Streptozotocin
d. Cyclophosphamide

52) The following agent is used in the treatment of chronic granulocytic leukaemia:

Which of the following statements is not true regarding the above agent?
a. The sulfonate groups are good leaving groups.
b. It readily alkylates guanine residues.
c. It produces interstrand cross linking of DNA.
d. The mechanism involves an SN1 nucleophilic substitution.

53) The following agent is used for the treatment of testicular and ovarian cancers.

What is the agent called?

a. Carboplatin
b. Oxaliplatin
c. Cisplatin
d. Transplatin

54) The following agent is used for the treatment of testicular and ovarian cancers.

Which of the following statements is untrue regarding the above structure?

a. The chlorine groups are displaced before the drug becomes active.
b. Intrastrand cross linking of DNA results from the action of the agent.
c. Base pairing between adenine and thymine is disrupted by the agent.
d. Ondansetron is often administered with the agent to reduce nausea.

55) The following agent is used in the treatment of a variety of cancers including melanoma:

What is the agent called?

a. Procarbazine
b. Busulfan
c. Dacarbazine
d. Mitomycin C

56) The following agent (dacarbazine) is used in the treatment of a variety of cancers including melanoma.

Which of the following statements is true regarding dacarbazine?

a. It is a prodrug which is activated by peptidases.
b. The active agent is a methyldiazonium ion.
c. Acetaldehyde is lost during degradation of the compound.
d. The active agent acts as an enzyme inhibitor.

57) The following agent is used as an anticancer drug against a variety of cancers:

What is the structure called?

a. Procarbazine
b. Adozelesin
c. Dacarbazine
d. Mitomycin C

58) The following agent is called mitomycin C and is used as an anticancer drug against a variety of cancers.

The structure is a prodrug which is converted in the body to the active compound. What is the initial step in this
activation process?
a. Ring opening of the aziridine ring
b. Hydrolysis of the urethane group
c. Alkylation of the primary amino group
d. Reduction of the quinone ring system

59) The following agent is called mitomycin C and is used as an anticancer drug against a variety of cancers:
Which of the following statements is true regarding the above drug?
a. It is one of the safest anticancer agents used in clinical practice.
b. It promotes intrastrand cross linking in DNA.
c. Adenine units are alkylated by the agent.
d. It is possible that the drug may be more effective against tumours in oxygen starved environments.

60) The following structure is an anti tumour agent derived from a bacterium:

What is the name of the agent?

a. Calicheamicin γ1
b. Adozelesin
c. Dacarbazine
d. Oblimersen

61) The following structure is calicheamicin γ1 and is an anti tumour agent derived from a bacterium.

Which of the following functional groups is not involved in the mechanism of action?
a. Thioamide
b. Trisulfide
c. α,β-unsaturated ketone
d. Enediyne system

62) The following structure is calicheamicin γ1 and it is an anti tumour agent derived from a bacterium:
What effect does the agent have?
a. It alkylates DNA
b. It is an antimetabolite
c. It inhibits topoisomerases
d. It cleaves the DNA chain by the production of radicals

63) Which of the following is an antisense drug?

a. Calicheamicin γ1
b. Adozelesin
c. Dacarbazine
d. Oblimersen

64) The following structure is a biosynthetic precursor for an important enzyme cofactor required by the enzyme
thymidylate synthase.

Which cofactor is involved?

a. Folic acid
b. Dihydrofolic acid
c. Tetrahydrofolic acid
d. N5, N10-methylene tetrahydrofolic acid

65) What reaction does the enzyme thymidylate synthase catalyse?

a. dUMP to dTMP
b. dTMP to dUMP
c. UMP to TMP
d. TMP to UMP

66) The following structure is a widely used antimetabolite in anticancer therapy:

What is the name of the above structure?

a. Folic acid
b. Methotrexate
c. Raltitrexed
d. Tetrahydrofolate
67) The following structure is a widely used antimetabolite in anticancer therapy:

Which enzyme is directly inhibited by the above structure?

a. Thymidylate synthase
b. Dihydrofolate reductase
c. Adenosine deaminase
d. Ribonucleotide reductase

68) The following structure is used in the treatment of breast, liver and skin cancers.

What is the name of the above structure?

a. 5-fluorothymidine
b. 5-fluorouracil
c. 5-fluorocytosine
d. 5-fluoropyrimidine

69) The following structure is used in the treatment of breast, liver and skin cancers.

What is the target for the above structure?

a. Thymidylate synthase
b. Dihydrofolate reductase
c. Adenosine deaminase
d. Ribonucleotide reductase

70) The following structure is used in the treatment of breast, liver and skin cancers.
The above structure is a prodrug which is converted to an active agent. What is the active agent?
a. FdTMP
b. FdCMP
c. FdUMP
d. FdGMP

71) The following structure is used in the treatment of breast, liver and skin cancers.

What role is played by the active agent formed from the above structure?
a. Allosteric enzyme inhibitor
b. Reversible enzyme inhibitor
c. Suicide substrate
d. Transition state analogue

72) The following structure is used as a treatment of colorectal cancer. What is it called?

a. Folic acid
b. Methotrexate
c. Raltitrexed
d. Tetrahydrofolate

73) The following structure has been used in combination therapy for the treatment of a variety of cancers.

What is the name of the above structure?

a. Pentostatin
b. Hydroxycarbamide
c. Fludarabine
d. Cytarabine

74) The following structure has been used in combination therapy for the treatment of a variety of cancers.
What is the target for the above structure?
a. DNA polymerase
b. Adenosine deaminase
c. Thymidylate synthase
d. Ribonucleotide reductase

75) Hydroxycarbamide has been used in combination therapy for the treatment of a variety of cancers.

The compound destabilises a metal ion centre in the target enzyme, ribonucleotide reductase. Which ion is
involved?
a. Magnesium
b. Calcium
c. Iron
d. Zinc

76) The following structure is a natural product used for the treatment of leukaemia:

What is the name of the above structure?

a. Pentostatin
b. Hydroxycarbamide
c. Fludarabine
d. Cytarabine

77) Pentostatin is a natural product used for the treatment of leukaemia.

What is the target for pentostatin?

a. DNA polymerases
b. Adenosine deaminase
c. Thymidylate synthase
d. Ribonucleotide reductase

78) Pentostatin is a natural product used for the treatment of leukaemia.

What is the name of the enzyme target that is indirectly inhibited by the above structure?
a. DNA polymerases
b. Adenosine deaminase
c. Thymidylate synthase
d. Ribonucleotide reductase

79) Which of the following structures inhibits DNA polymerases?

a. Cytarabine
b. Gemcitabine
c. Fludarabine
d. All of the structures

80) The following structure is used in the treatment of leukaemias:

What is it called?
a. Cytarabine
b. Gemcitabine
c. Fludarabine
d. 6-Mercaptopurine

81) The following structure is used in the treatment of leukaemias:

What nucleoside does the above structure mimic?
a. 2'-deoxycytidine
b. 2'-deoxythymidine
c. 2'-deoxyguanosine
d. 2'-deoxyadenosine

82) Cytarabine is used in the treatment of leukaemias:

The above structure acts as a prodrug. What is the active compound?

a. Monophosphate
b. Diphosphate
c. Triphosphate
d. Polyphosphate

83) Which of the following definitions describes metastasis?

a. The birth of a cancer
b. The process by which cells 'commit suicide'
c. The ability of a cancer to invade other parts of the body and to produce secondary tumours
d. The promotion of mutations in a cell's DNA

84) Which of the following definitions describes carcinogenesis?

a. The birth of a cancer
b. The process by which cells 'commit suicide'
c. The ability of a cancer to invade other parts of the body and to produce secondary tumours
d. The promotion of mutations in a cell's DNA

85) Which of the following definitions describes apoptosis?

a. The birth of a cancer
b. The process by which cells 'commit suicide'
c. The ability of a cancer to invade other parts of the body and to produce secondary tumours
d. The promotion of mutations in a cell's DNA

86) Which of the following definitions describes mutagenesis?

a. The birth of a cancer
b. The process by which cells 'commit suicide'
c. The ability of a cancer to invade other parts of the body and to produce secondary tumours
d. The promotion of mutations in a cell's DNA

87) What is meant by the term oncogene?

a. It is a protein that is involved in cell signal transduction pathways and can lead to cancer when it is in an abnormal
form.
b. It is the process by which new blood vessels are formed.
c. It is a gene which has become mutated and which codes for an abnormal protein that is implicated in the
development of cancer.
d. It is a protein that is involved in the processes of cellular checking, repair and suicide.

88) What is meant by the term p53?

a. It is a protein that is involved in cell signal transduction pathways and can lead to cancer when it is in an abnormal
form.
b. It is the process by which new blood vessels are formed.
c. It is a gene which has become mutated and which codes for an abnormal protein that is implicated in the
development of cancer.
d. It is a protein that is involved in the processes of cellular checking, repair and suicide.

89) What is meant by the term angiogenesis?

a. It is a protein that is involved in cell signal transduction pathways and can lead to cancer when it is in an abnormal
form.
b. It is the process by which new blood vessels are formed.
c. It is a gene which has become mutated and which codes for an abnormal protein that is implicated in the
development of cancer.
d. It is a protein that is involved in the processes of cellular checking, repair and suicide.

90) What is meant by the term ras?

a. It is a protein that is involved in cell signal transduction pathways and can lead to cancer when it is in an abnormal
form.
b. It is the process by which new blood vessels are formed.
c. It is a gene which has become mutated and which codes for an abnormal protein that is implicated in the
development of cancer.
d. It is a protein that is involved in the processes of cellular checking, repair and suicide.

91) Which of the following statements is true regarding the cell cycle?
a. It is the life time of the cell
b. It is the various stages that the cell goes through leading up to and including cell division
c. The cell cycle involves four stages labelled G 1 S, G2 and D
d. The cell cycle includes 3 growth stages

92) What is the function of cyclins and cyclin dependent kinases?

a. They regulate the cell cycle.
b. They are responsible for protein degradation during apoptosis.
c. They are the structures at the end of chromosomes which are crucial to the immortalisation of cancer cells.
d. They inhibit angiogenesis.

93) What is the function of caspases?

a. They regulate the cell cycle
b. They are responsible for protein degradation during apoptosis
c. They are the structures at the end of chromosomes which are crucial to the immortalisation of cancer cells
d. They inhibit angiogenesis

94) What is the function of a telomere?

a. It regulates the cell cycle.
b. It is responsible for protein degradation during apoptosis.
c. It is the structure at the end of a chromosome which is crucial to the immortalisation of cancer cells.
d. It inhibits angiogenesis

95) What is the function of angiostatin?

a. It regulates the cell cycle
b. It is responsible for protein degradation during apoptosis
c. It is the structure at the end of a chromosome which is crucial to the immortalisation of cancer cells
d. It inhibits angiogenesis

96) What is the function of interleukin-6?

a. It is involved in the anchoring of cells to an extracellular matrix.
b. It breaks down the basement membranes round blood vessels prior to angiogenesis.
c. It is responsible for the resistance shown by some cancer cells to anticancer drugs.
d. It induces metastasis.

97) What is the function of matrix metalloproteinases?

a. They are involved in the anchoring of cells to an extracellular matrix.
b. They break down the basement membranes round blood vessels prior to angiogenesis.
c. They are responsible for the resistance shown by some cancer cells to anticancer drugs.
d. They induce metastasis.

98) What is the function of integrins?

a. They are involved in the anchoring of cells to an extracellular matrix
b. They break down the basement membranes round blood vessels prior to angiogenesis
c. They are responsible for the resistance shown by some cancer cells to anticancer drugs
d. They induce metastasis

99) What is the function of a P-glycoprotein?

a. They are involved in the anchoring of cells to an extracellular matrix.
b. They break down the basement membranes round blood vessels prior to angiogenesis.
c. They are responsible for the resistance shown by some cancer cells to anticancer drugs.
d. They induce metastasis.

100) Which of the following acts as an intercalating agent?

a. Nitrogen mustards
b. Calicheamicin γ1
c. Methotrexate
d. Anthracyclines

101) Which of the following acts as an alkylating agent?

a. Nitrogen mustards
b. Calicheamicin γ1
c. Methotrexate
d. Anthracyclines

102) Which of the following acts as an antimetabolite?

a. Nitrogen mustards
b. Calicheamicin γ1
c. Methotrexate
d. Anthracyclines

103) Which of the following acts as a chain cutting agent?

a. Nitrogen mustards
b. Calicheamicin γ1
c. Methotrexate
d. Anthracyclines

104) Identify the following structures:

a. Etoposide = Structure
b. Doxorubicin = Structure
c. Mitoxantrone = Structure
d. Dactinomycin = Structure

105) Which of the following structures is not an intercalating agent?

a. Structure A
b. Structure B
c. Structure C
d. Structure D

106) Which of the following structures is an example of an androgen?

a. Megestrol acetate
b. Fluoxymesterone
c. Prednisolone
d. Ethinylestradiol

107) Which enzyme is inhibited by all the following agents?

a. Topoisomerase I
b. Topoisomerase II
c. Helicase
d. DNA ligase

108) Which of the following structures is a simplified analogue of another?

a. Structure A
b. Structure B
c. Structure C
d. Structure D

109) Dactinomycin contains a tricylic ring system. What purpose does it serve in its mechanism of action?
a. The primary amine group is ionised and interacts with the phosphate groups of the DNA sugar-phosphate
backbone.
b. It acts as an alkylating agent.
c. It intercalates between the base pairs of DNA.
d. It binds to the active site of the enzyme topoisomerase II.

110) What role does the enzyme topoisomerase II have?

a. It catalyses the formation of protective units at the end of chromosomes
b. It catalyses the synthesis of DNA
c. It catalyses the unwinding of the DNA double helix
d. It catalyses crossing over of DNA strands to relieve the tension created in DNA when the DNA double helix is
unravelled

111) Which of the following drugs inhibits topoisomerase II?

a. Mitomycin C
b. Epirubicin
c. Dacarbazine
d. Carboplatin

112) What important role does the amino acid tyrosine play in the enzyme topoisomerase II?
a. It cleaves a phosphate-sugar link in a strand of DNA.
b. It acts as a hydrogen bond donor in binding a strand of DNA.
c. It acts as a hydrogen bond acceptor in binding a strand of DNA.
d. It is ionised and forms an ionic interaction with the sugar phosphate backbone of a strand of DNA.

113) Which of the following structures includes an amino acid?

a. Structure A
b. Structure B
c. Structure C
d. StructureD

114) Which of the following structures includes a nucleic acid base?

a. Structure A
b. Structure B
c. Structure C
d. Structure D

115) Identify the following structures:

a. Chlormethine = Structure
b. Uracil mustard = Structure
c. Melphalan = Structure
d. Estramustine = Structure

116) Which of the following statements is false regarding melphalan?

a. The aromatic ring increases the nucleophilicity of the amine nitrogen

b. It contains a mimic for the amino acid phenylalanine
c. It is more likely to be taken into cells by pinocytosis
d. It is an intercalating agent

117) Identify the following drugs:

a. Cyclophosphamide = Structure
b. Streptozotocin structure = Structure
c. Lomustine = Structure
d. Busulphan = Structure

118) Which of the following statements is not true of cyclophosphamide?

a. It is relatively non toxic
b. It acts as a prodrug
c. It can be taken orally
d. The structure is stable to metabolism

119) Which of the following statements is false regarding the anticancer drug cyclophosphamide?

a. Acrolein is formed as a metabolite of this drug.

b. Acrolein acts as the alkylating agent which is responsible for cyclophosphamide's anticancer activity.
c. Cyclophosphamide is the most commonly used alkylating agent used in cancer chemotherapy.
d. It is metabolised by cytochrome P450 enzymes.

120) Which of the following statements is true regarding the structure below?

a. It can cross the blood brain barrier

b. It is activated by an enzymatic metabolic reaction
c. It cannot be given orally
d. It is both an alkylating agent and an intercalator

121) Which of the following statements is not true regarding the following structure:

a. The sulfonate groups are good leaving groups.

b. It readily alkylates adenine residues.
c. It produces interstrand cross linking of DNA.
d. The mechanism involves an SN2 nucleophilic substitution.

122) Identify the following structures:

a. Carboplatin = Structure
b. Oxaliplatin = Structure
c. Cisplatin = Structure
d. JM216 = Structure

123) Cisplatin is used for the treatment of testicular and ovarian cancers.

Which of the following statements is untrue?

a. The amino groups are displaced before the drug becomes active
b. Intrastrand cross linking of DNA results from the action of the agent
c. Base pairing between cytosine and guanine is disrupted by the agent
d. Ondansetron is often administered with the agent to reduce nausea

124) Identify the following structures:

a. Procarbazine = Structure
b. Calicheamicin γ1 = Structure
c. Dacarbazine = Structure
d. Mitomycin C = Structure

125) Dacarbazine is used in the treatment of a variety of cancers including melanoma. Which of the following
statements is true regarding the structure below?

a. It is a prodrug which is activated by peptidases.

b. The active agent is a carbocation.
c. Formaldehyde is lost during degradation of the compound.
d. The active agent acts as an enzyme inhibitor.

126) Which of the following statements is true regarding mitomcin C?

a. It is one of the safest anticancer agents used in clinical practice.
b. It promotes interstrand cross linking in DNA.
c. Adenine units are alkylated by the agent.
d. It is possible that the drug may be more effective against tumours in oxygen rich environments.

127) What sort of drug is oblimersen?

a. An alkylating agent
b. An intercalating agent
c. An enzyme inhibitor
d. An antisense drug

128) Identify the following structures:

a. N5,N10-methylene tetrahydrofolate = Structure

b. Methotrexate = Structure
c. Folic acid = Structure
d. Raltitrexed = Structure

129) Which of the following structures is the cofactor for the enzyme thymidylate synthase?
a. Structure A
b. Structure B
c. Structure C
d. StructureD

130) Which of the following structures does not interact with the enzyme thymidylate synthase?
a. Structure
b. Structure
c. Structure
d. Structure

131) Identify the following structures:

a. cytarabine = Structure
b. pentostatin = Structure
c. 6-mercaptopurine = Structure
d. fludarabine = Structure

132) Which of the following structures acts as a transition state inhibitor?

a. Structure A
b. Structure B
c. Structure C
d. Structure D

133) Which of the following structures inhibits the enzyme adenosine deaminase?

a. Structure A
b. Structure B
c. Structure C
d. Structure D

134) Which of the following structures mimics 2-deoxycytidine?

a. Structure A
b. Structure B
c. Structure C
d. Structure D

135) Which of the following structures acts as a prodrug and is converted into two different active compounds?

a. Structure A
b. Structure B
c. Structure C
d. Structure D

136) Which compounds combine with intracellular receptors to form nuclear transcription factors?
a. Peptides
b. Steroids
c. Prostaglandins
d. Oligonucleotides

137) Which of the following structures is an example of a glucocorticoid?

a. Megestrol acetate
b. Fluoxymesterone
c. Prednisolone
d. Ethinylestradiol

138) Which of the following structures is an example of an oestrogen?

a. Megestrol acetate
b. Fluoxymesterone
c. Prednisolone
d. Ethinylestradiol

139) Which of the following structures is an example of a progestin?

a. Megestrol acetate
b. Fluoxymesterone
c. Prednisolone
d. Ethinylestradiol

140) Which of the following structures is an example of an androgen?

a. Megestrol acetate
b. Fluoxymesterone
c. Prednisolone
d. Ethinylestradiol

Answer Key
1) A 27) D 53) C 79) D 105) C 131)
2) B 28) D 54) C 80) A 106) B 132) A
3) C 29) D 55) C 81) A 107) B 133) A
4) D 30) C 56) B 82) C 108) D 134) B
5) D 31) A 57) D 83) C 109) C 135) D
6) C 32) A 58) D 84) A 110) D 136) B
7) A 33) D 59) D 85) B 111) B 137) C
8) B 34) B 60) A 86) D 112) A 138) D
9) B 35) D 61) A 87) C 113) A 139) A
10) D 36) D 62) D 88) D 114) B 140) B
11) B 37) D 63) D 89) B 115) 141)
12) D 38) B 64) D 90) A 116) B 142)
13) C 39) D 65) A 91) B 117) 143)
14) A 40) C 66) B 92) A 118) D 144)
15) A 41) C 67) B 93) B 119) B 145)
16) C 42) B 68) B 94) C 120) D 146)
17) A 43) C 69) A 95) D 121) B 147)
18) C 44) D 70) C 96) D 122) 148)
19) A 45) D 71) C 97) B 123) A 149)
20) A 46) A 72) C 98) A 124) 150)
21) C 47) C 73) B 99) C 125) B 151)
22) C 48) D 74) D 100) D 126) B 152)
23) D 49) A 75) C 101) A 127) D 153)
24) D 50) D 76) A 102) C 128) 154)
25) B 51) B 77) B 103) B 129) D
26) A 52) D 78) D 104) 130)