Flashcards in SG Cancer Deck (17)
Clear cell renal carcinoma, grade 2 (no mets). At this time, the next step of care is to:
Repeat physical exam + scan in 4-6 months - option makes sense if discovery of tumor was incidental finding
What genetic disease is correlated with clear cell renal carcinoma?
What are your 3 options for a solitary renal lesion?
Cryoablation: freeze thaw cycles
CT shows metastatic renal cancer consistent with pt's original primary tumor. Next step is:
PO sunitinib (tyrosine kinase inhibitor)
What are the 5 treatment options for advanced renal cell cancer
1. Immunotherapy: IL2, IFN
2. Monoclonal Abs: bevacizumab
3. TK inhibitors: sunitinib, etc
4. mTOR inhibitors: temsirolimus
IL 2 toxicities
LOOKS LIKE SEPSIS (admit to MICU for dosing)
Hypotension, tachycardia, vol depletion
Renal + hepatic failure
What type of monoclonal Ab is bevacizumab?
VEGF inhibitor - endothelial growth factor
BLEEDING RISK b/c impaired wound healing - no surgery
- C/I w/ active hemoptysis, brain mets, on anticoag
How do TK inhibitors work for renal cell carcinoma?
Inhibit proliferation and angiogenesis
TK inhibitors toxicities
Mechanism mTOR inhibitors
+ regulator of hypoxia-inducible factor dependent gene transcription
What worries you about treating bladder cancer?
What is the strongest risk factor for developing bladder cancer?
What is BCG? What does it treat?
Bacillus Calmette Guerin - live attenuated mycobacterium bovis
Treat bladder cancer
Inject into the bladder directly to trigger the immune system to fight the cancer
Cystitis, freq, huematuria
Fever, infection (systemic immune activation)
C/I in pts on statins
When can't you use BCG?
Muscle invasive disease - no longer localized disease even if it is still only in the bladder