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PHM703 Heme/Onc/Crit Care > Exam 2 - Prostate Cancer > Flashcards

Exam 2 - Prostate Cancer Flashcards

(50 cards)

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1
Q

List risk factors for prostate cancer?

A

African American (less common in Asians), older age, family history

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2
Q

What is the median age at diagnosis for prostate cancer?

A

67

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3
Q

What are harms from screening for prostate cancer?

A

urinary complications, erectile dysfunction, infections

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4
Q

List signs/symptoms of prostate cancer?

A

asymptomatic if localized, ureteral dysfunction, urinary frequency/hesitancy/incomplete emptying, flank pain, lower-extremity edema, anemia, pathologic fractures

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5
Q

What is considered a low Gleason score? High?

A

low = 6 or less; high = 8+

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6
Q

What is treatment for all types of localized recurrence risks for prostate cancer?

A

observation, active surveillance, external beam radiation therapy (EBRT), or radical prostatectomy (RP)

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7
Q

What is treatment for regional recurrence risks for prostate cancer?

A

observation, active surveillance, external beam radiation therapy (EBRT), androgen deprivation therapy (ADT), abiraterone, radical prostatectomy (RP), or pelvic lymph node dissection (PLND)

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8
Q

What is treatment for castrate naïve (sensitive) advanced prostate cancer?

A

non-metastatic = monitoring or androgen deprivation therapy (ADT), metastatic = androgen deprivation therapy (ADT) plus abiraterone or enzalutamide or apalutamide or darolutamide or docetaxel x6 cycles

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9
Q

What is treatment for castrate resistant advanced prostate cancer?

A

recurrent = androgen deprivation therapy (ADT) plus PSADT, metastatic = ADT plus abiraterone, doxetaxel x6 cycles, enzalutamide, sipuleucel-T, radium 223, other hormonal therapy (adenocarcinoma) or chemotherapy options with best supportive care (small cell or neuroendocrine)

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10
Q

What is considered the gold standard for prostate cancer therapy?

A

androgen deprivation therapy (ADT)

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11
Q

What is the goal testosterone level and when while on an LHRH agonist?

A

<50 ng/dL by one month

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12
Q

List the LHRH agonists? (4)

A

goserelin (Zoladex), leuprolide (Lupron IM, Eligard SQ), triptorelin (Trelstar), histrelin (Vantas)

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13
Q

What are acute AEs of LHRH agonists?

A

tumor flare (increased testosterone), hot flashes, ED, edema, gynecomastia, injection site reactions

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14
Q

What are long-term AEs of LHRH agonists?

A

osteoporosis (calcium and Vitamin D supplementation), obesity, insulin resistance (diabetes), CV events, hyperlipidemia

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15
Q

List the LHRH antagonists? (2)

A

degarelix (Firmagon), relugolix (Orgovyx)

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16
Q

List disadvantages to LNRH antagonists? (2)

A

less flexibility in dosing, high cost

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17
Q

List the first-generation antiandrogens?

A

bicalutamide (Casodex), flutamide (Eulexin), nilutamide (Nilandron)

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18
Q

List the second-generation antiandrogens?

A

apalutamide, enzalutamide, darolutamide

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19
Q

What are AEs of antiadrogens?

A

diarrhea, gynecomastia, elevated LFTs, hot flashes

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20
Q

Explain the consensus regarding combined androgen blockades for prostate cancer treatment?

A

associated with more ADEs and provide modest to no benefit over castration alone

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21
Q

What is recommendation for PSA doubling time >10 months?

Study These Flashcards
A

monitor OR other secondary hormone therapy

22
Q

What is recommendation for PSA doubling time </=10 months?

Study These Flashcards
A

apalutamide, enzalutamide, darolutamide, other secondary hormone therapy

23
Q

List examples of other secondary hormone therapies for prostate cancer? (4)

Study These Flashcards
A

first generation antiandrogens (nilutamide, flutamide, bicalutamide), corticosteroids, antiandrogen withdrawal, ketoconazole plus hydrocortisone

24
Q

What is the MOA of apalutamide (Erleada)?

Study These Flashcards
A

nonsteroidal androgen receptor (AR) inhibitor; binds directly to the AR ligand-binding domain to prevent androgen-receptor translocation, DNA binding, and receptor-mediated transcription

25
What are AEs of apalutamide (Erleada)?
fatigue, HTN, rash, GI, arthralgias, fractures, edema
26
What is a side effect unique to apalutamide (Erleada) and enzalutamide (Xtandi)?
seizures
27
What is the MOA of darolutamide (Nubeqa)?
competitive androgen receptor (AR) inhibitor
28
What are AEs of darolutamide (Nubeqa)?
fatigue, HTN, rash
29
What is the MOA of enzalutamide (Xtandi)?
pure androgen receptor (AR) signaling inhibitor
30
What are AEs of enzalutamide (Xtandi)?
diarrhea, fatigue, HA, myalgias, edema
31
What are preferred regimens for metastatic CRPC with no prior therapies? (3)
abiraterone, docetaxel, enzalutamide
32
What are preferred regimens for metastatic CRPC with prior novel hormone therapy/no prior docetaxel? (2)
docetaxel, olaparib or rucaparib
33
What are preferred regimens for metastatic CRPC with prior docetaxel/no prior novel hormone therapy? (3)
abiraterone, cabazitaxel, enzalutamide
34
What are preferred regimens for metastatic CRPC with prior docetaxel and novel hormone therapy? (2)
cabazitaxel, docetaxel rechallenge
35
What is recommended treatment for symptomatic bone metastases from CRPC?
radium 223
36
What is the MOA of docetaxel (Taxotere)?
promotes assembly of microtubules and inhibits depolymerization of tubulin
37
What are AEs of docetaxel (Taxotere)?
myelosuppression, alopecia, edema, peripheral neuropathy, hypersensitivity, CAUTION IN LIVER IMPAIRMENT
38
What is the MOA of abiraterone (Zytiga, Yonsa)?
selectively and irreversibly inhibits CYP17, an enzyme required for androgen biosynthesis
39
What are AEs of abiraterone (Zytiga, Yonsa)?
diarrhea, edema, hypokalemia, HTN, hepatotoxicity, hypertriglyceridemia
40
What is the MOA of olaparib (Lynparza)?
selectively inhibits poly (ADP-ribose) polymerase (PARP) enzymes, which aid in DNA repair
41
What are AEs of olaparib (Lynparza)?
GI, neutropenia, leukopenia, URTIs, double cancer risk
42
What is the MOA of radium-223 (Xofigo)?
alpha-emitter that causes ds breaks
43
What are AEs of radium-223 (Xofigo)?
nausea, myelosuppression, edema
44
What is the MOA of sipuleucel-T (Provenge)?
dendritic cell vaccine designed to enhance immune T-cell response (CAR-T therapy)
45
What are AEs of sipuleucel-T (Provenge)?
infusion related reactions, fever-like symptoms, HA
46
What is the MOA of cabazitaxel (Jevtana)?
promotes assembly of microtubules and inhibits depolymerization of tubulin
47
What are AEs of cabazitaxel (Jevtana)?
febrile neutropenia, hypersensitivity reactions, mucositis, edema
48
What is the MOA of lutetium-177 (Pluvicto)?
beta-emitter that selectively binds to PSMA receptors on prostate cancer cells
49
What are AEs of lutetium-177 (Pluvicto)?
fatigue, dry mouth, nausea, myelosuppression
50
What is treatment for ADT-induced bone loss in prostate cancer? Osteoporosis?
denosumab (Prolia), zoledronic acid (Reclast)

PHM703 Heme/Onc/Crit Care (18 decks)

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