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Prostate Cancer Flashcards

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1
Q

Which major cell type is responsible for a vast majority of prostate cancer cases?

A

Adenocarcinoma

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2
Q

What are risk factors for prostate cancer?

A
  • African American
  • Age >65
  • Men with 1st generation relative who had prostate cancer
  • BRCA-2 mutation
  • Lynch syndrome
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3
Q

What are some advanced disease complications of prostate cancer?

A
  • Back pain
  • Cord compression
  • Lower-extremity edema
  • Pathologic fractures
  • Anemia
  • Weight loss
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4
Q

What are prognostic factors of prostate cancer?

A
  • PSA
  • Tumor size
  • Histologic grade (Gleason score)
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5
Q

T/F: A high PSA is diagnostic of prostate cancer

A

FALSE: other markers are required

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6
Q

What are the three parts of the staging system for prostate cancer testing?

A
  • Tumor
  • Node
  • Metastasis
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7
Q

After trying castration, what treatment options do we have for metastatic adenocarcinoma prostate cancer?

A
  • Abiraterone
  • Docetaxel x 6 cycles
  • Enzalutamide
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8
Q

What is the gold standard for advanced prostate cancer?

A

Androgen deprivation therapy
- Surgical castration (bilateral orchiectomy)
- Medical castration (luteinizing hormone receptor modulators)

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9
Q

What is the goal serum testosterone of LHRH therapy after 1 month?

A

<50 ng/dL

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10
Q

What are the LHRH agonists?

A
  • Goserelin
  • Leuprolide
  • Triptorelin
  • Histrolin
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11
Q

What are acute ADEs of LHRH agonists?

A
  • Tumor flare
  • Hot flashes
  • ED
  • Edema
  • Gyno
  • Injection site reactions
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12
Q

What are long-term ADEs of LHRH agonists?

A
  • Osteoporosis
  • Fracture
  • Obesity
  • Diabetes
  • CV events
  • HLD
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13
Q

What supplementation should be given with LHRH agonists?

A
  • Vitamin D
  • Calcium
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14
Q

What are the LHRH antagonist drugs?

A
  • Degarelix
  • Relugolix
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15
Q

What are the first generation antiandrogens?

A
  • Bicalutamide
  • Flutamide
  • Nilutamide
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16
Q

What should be monitored while a patient is on antiandrogens?

Study These Flashcards
A
  • LFTs*
  • Testosterone
  • PSA
  • Pulmonary function
17
Q

What are the second generation antiandrogens?

Study These Flashcards
A
  • Apalutamide
  • Enzalutamide
  • Darolutamide
18
Q

T/F: Patients on androgen blockade therapy typically relapse within 2-4 years

19
Q

Which treatment has significant benefit for patients with high-risk castration-sensitive prostate cancer?

Study These Flashcards
A

ADT + Abiraterone or Apalutamide or Enzalutamide

20
Q

Which treatment improves survival for patients with high-volume castration-sensitive metastatic prostate cancer fit for chemotherapy?

Study These Flashcards
A

ADT + Docetaxel + Abiraterone or Darolutamide

21
Q

What defines castration-resistant prostate cancer?

Study These Flashcards
A

Serum testosterone <50 ng/dL with continued disease progression

22
Q

When is hormonal therapy strongly recommended in castration-resistant non-metastatic prostate cancer?

Study These Flashcards
A

If PSA doubling time is <10 months

23
Q

What treatment can be used for M1 CRPC (PSADT <10mo) and involves an androgen metabolism inhibitor?

Study These Flashcards
A

Abiraterone with prednisone or methylprednisolone

24
Q

When does apalutamide need to be IMMEDIATELY discontinued?

Study These Flashcards
A

If a seizure occurs during treatment

25
Which 2nd generation antiandrogen needs to be given with food?
Darolutamide
26
What are the preferred regimens for M1 CRPC with no prior docetaxel and no prior hormone therapy?
- Abiraterone - Docetaxel - Enzalutamide
27
What are the preferred regimens for M1 CRPC with no prior docetaxel, but prior novel hormonal therapy?
- Docetaxel - Olaparib or rucaparib (BCRA mutation)
28
What are the preferred regimens for M1 CRPC with no prior novel hormonal therapy, but prior docetaxel?
- Abiraterone - Cabazitaxel - Enzalutamdie
29
What are the preferred regimens for M1 CRPC with prior novel hormonal therapy and prior docetaxel?
- Cabazitaxel - Docetaxel rechallenge
30
What treatment can be considered for patients with visceral metastases?
Docetaxel
31
What treatment can be considered for patients with minimal-to-no symptoms, no liver metastases, life expectancy >6 months, and ECOG performance status
Sipuleucel-T
32
What are ADEs of docetaxel?
- Alopecia - Edema - Peripheral neuropathy - Hypersensitivity reaction - Myelosuppression
33
Why are steroids used with abiraterone?
To minimize the mineralocorticoid excess
34
T/F: Zytiga and Yonsa have a 1:1 dose conversion
FALSE
35
Which CRPC treatment is a PARP inhibitor that can cause neutropenia and cancer?
Olaparib
36
When is radium-223 used?
Symptomatic bone metastases WITHOUT visceral metastases prior to and after docetaxel therapy
37
What is Lu-177 approved for?
PSMA-positive M1 CRPC
38
What drugs can be used to prevent skeletal-related events in PC due to metastases?
- Zoledronic acid - Denosumab

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