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oncology-hematology > Breast cancer > Flashcards

Breast cancer Flashcards

1
Q

What are the two main cncers that have the expression of HER-2?

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A

breast cancer and Gastric cancer

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2
Q

Receptors we can see in breast cancer?

A

HER-2
ER
PR

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3
Q

What is the MOA of Trastuzumab?

A

Binds EC portion of HER-2 receptor, blocking typically and almost exclusively the homodimerization

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4
Q

Trastuzumab works better in association with another drug, which one?

A

Pertuzumab

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5
Q

MOA of Pertuzumab?

A

blocks heterodimerization of HER2-HER3

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6
Q

What drugs represent the first line of treatment for metastatic HER-2 positive tumors?

A

Trastuzumab and Pertuzumb

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7
Q

What treatment can we give for post-menopausal patient, metastatic HER-2 positive?

A

Trastuzumab + Aromatase inhibitors

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8
Q

An important side effect of Trastuzumab ?

A

Cardiotoxicity, in the form of heart failure.

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9
Q

what is the mechanism that can cause heart failure with trastuzumab?

A

Down regulates Neuregolin-1

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10
Q

what type of drug is Ado-Trastuzumab ?

A

Chemically bound Trastuzumab to DM1 (Emtansine)

Cytoskeleton drug

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11
Q

Does pertuzumab binds to the same receoptor site as trastuzumab ?

A

No

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12
Q

cyclins 2/4/6 regulate which phase of the cell cycle?

A

Transition phase from G1 to S

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13
Q

MOA of cyclin 4/6 inhibitors ?

A

Inhibiting the cyclin D, it blocks the activity of E2F (transcription factor)

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14
Q

Indication of Lapatinib?

A
  1. HER-2 positive breast K, that became resistent to Trastuzumab (associated to Capecitabin)
  2. Pr+ breast K, associated to Aromatase inhibitors
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15
Q

What kind of agent is DM1 ?

A

Chemotherapeutic

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16
Q

can we use DM-1 alone?

A

No, it is too toxic

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17
Q

In what process does BRCA 1/2 proteins are involved?

A

DNA repair

18
Q

What is one of the principal risk factors for Mammarian carcinoma?

A

Estrogenic stiumuli

19
Q

which drug is able to reduce by 38% the incidence of mammary carcinoma?

A

Tamoxifen 20 mg/d

20
Q

secondary prevention in breast K?

A

Mammography screening
In asymptomatic women between the ages of 50-69, every two years

21
Q

How screening for breast K is performed in younger women ?

A

Ultrasound, in familial cases and px with risk factors

younger patients have a denser tissue (glandular)

22
Q

What is the principal prognostic factor in breast K?

A

Metastasis to axilary lymph nodes

23
Q

When do we have an elevated risk of relapse in axilary lymph node metastasis from breast K?

A

4 or more lymph nodes

24
Q

Which protein are we looking for in immunohistochemistry of breast K, that the higher it’s concentration, the higher the chance for relapse?

A

Ki67

25
Q

Does high percentage of hormonal receptors in breast (ER, PR) improve or worsens prognosis?

A

Improves, it lowers the risk of relapse.

26
Q

Which breast tumors are more chemo-sensitive but less endo-sensitive ?

A

Tumors with high proliferation index (Ki67)

27
Q

What is luminal A breast K?

A

Positive for ER and/or PgR
Negative for HER2

28
Q

What is luminal B breast K?

A

Positive for ER and/or PgR
Positive for HER2

29
Q

What is Basal like breast K?

A

Triple negative

30
Q

What is HER2-like breast K?

A

HER2 positive and negative ER and PgR

31
Q

Which drug for breast cancer is the most frequently used in pre-menopause?

A

Tamoxifene

32
Q

What is the indication for Tamoxifene ?
is it pre/post menopausal?

A

both prevention and treatment of breast K
ER+, pre menopause

33
Q

what is the MOA of Tamoxifene ?

A

Inhibiting the AF2 domain

34
Q

what is the most important side effect of Tamoxifen?

A

Increased risk of endometrial cancer, by stimulating the proliferation of the uterine mucosa

35
Q

How efficient are the aromatase inhibitors?

A

Like tamoxifen, but without the estrogenic activity on the endometrial mucosa.

36
Q

what generation is Anastrazole (aromatase inhibitor) ?

A

III

37
Q

Main indication for aromatase inhibitors?

A

ER positive breast cancer

38
Q

Important side effects of Aromatase inhibitors ?

A

Osteoporosis

Arthralgia (especially in the small articulations)

39
Q

what is the purpose of systemic neoadjuvant therapy?

A

Reduce the dimensions of the tumor before the surgical operation

40
Q

Targeted therapies in metastatic breast cancer?

“TAAL”

A

Trastuzumab
Ado-trastuzumab
Anti-VEGF
Lapatinib

41
Q

When do we use aromatase inhibitors? post/pre menopause?

A

post menopausal

oncology-hematology (11 decks)

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