Cancer Treatment: Endocrine Therapy Flashcards
(13 cards)
1
Q
endocrine therapy in breast cancer
A
- 2/3 tumours ER+, meaning they respond to oestrogens
- can treat with oestrogen deprivation (removing ovaries, radiotherapy)
- treat with oestrogen antagonists
2
Q
3 main oestrogen therapies
A
- AIs (aromatase inhibitors)
- SERMs (selective oestrogen receptor modulators)
- SERDs (selective oestrogen receptor degraders)
3
Q
AIs
A
- inhibit conversion of androgens to oestrogens bu inhibiting aromatase
- can be steroidal or non-steroidal, and can switch between the two subtypes based on progression with one
- steroidal: exemestane
- non-steroidal: anastrozole, letrozole
4
Q
SERMs
A
- modulates receptors so that oestrogens cannot bind
- tamoxifen
5
Q
SERDs
A
- oestrogen receptor antagonist
- down regulate oestrogen receptors
- downward signalling pathways blocked despite oestrogen binding
- fulvestrant
6
Q
non-routine options
A
- growth factor inhibitors
7
Q
menopausal vs premenopausal women
A
- premenopausal women have working ovaries so need multiple mechs of action to block hormone circulation
8
Q
clinical uses of endocrine therapy
A
- prevention
- neoadjuvant
- primary
- adjuvant
- advanced
9
Q
neoadjuvant endocrine therapy
A
- treatment before surgery
- aims to: downsize and downstage tumour and postpone surgery
- can also use neoadjuvant chemo
10
Q
endocrine therapy as primary treatment option
A
- women who are agains or unable to have surgery
11
Q
adjuvant endocrine therapy
A
- after surgery
- treatment for systemic disease (mets and micromets)
- selection based on risk and ER status
- use NPI to stage risk for breast cancer
12
Q
advanced endocrine therapy
A
- preferred option to chemo in advanced cancers
- depends on wether cancer is endocrine sensitive or endocrine resistant
13
Q
tolerability
A
- fulvestrant preferred over anastrozole in case of joint disorders
