Chemotherapy: imatinib: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Chemotherapy: imatinib

Sample item

A 45-year-old man with massive splenomegaly and a leucocyte count of 2.4 lakh per microlitre has the Philadelphia chromosome t(9;22). Imatinib is started. Which statement about the drug is correct?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. It inhibits the BCR-ABL tyrosine kinase and is also effective in gastrointestinal stromal tumour through c-KIT inhibition

Imatinib inhibits the constitutively active BCR-ABL kinase produced by the Philadelphia chromosome, and also c-KIT and PDGFR, so it is used for gastrointestinal stromal tumours that carry c-KIT mutations. Adverse effects include fluid retention, nausea, myalgia and cytopenias. Resistance is commonly due to ABL kinase domain mutations.

Option by option

  • A. It inhibits the BCR-ABL tyrosine kinase and is also effective in gastrointestinal stromal tumour through c-KIT inhibition (correct)

    Correct. Targeting the kinase addresses the driver in both diseases.

  • B. It inhibits EGFR and is also effective in lung adenocarcinoma

    EGFR inhibition describes gefitinib, erlotinib and osimertinib.

  • C. It inhibits the proteasome and is also effective in myeloma

    Proteasome inhibition describes bortezomib.

  • D. It binds CD20 and is also effective in follicular lymphoma

    Binding CD20 is the action of rituximab, a monoclonal antibody.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is A, It inhibits the BCR-ABL tyrosine kinase and is also effective in gastrointestinal stromal tumour through c-KIT inhibition. Imatinib inhibits the constitutively active BCR-ABL kinase produced by the Philadelphia chromosome, and also c-KIT and PDGFR, so it is used for gastrointestinal stromal tumours that carry c-KIT mutations.

Why is "It inhibits EGFR and is also effective in lung adenocarcinoma" not the answer?

EGFR inhibition describes gefitinib, erlotinib and osimertinib.

Why is "It inhibits the proteasome and is also effective in myeloma" not the answer?

Proteasome inhibition describes bortezomib.

Why is "It binds CD20 and is also effective in follicular lymphoma" not the answer?

Binding CD20 is the action of rituximab, a monoclonal antibody.

What concept does this question test?

It tests Chemotherapy: imatinib in Pharmacology. Adverse effects include fluid retention, nausea, myalgia and cytopenias. Resistance is commonly due to ABL kinase domain mutations.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Chemotherapy: imatinib?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.