Bladder 2 Flashcards

1
Q

Midline cystic mass with calcifications near the bladder is consistent with what malignancy?

A

Urachal cancer

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2
Q

Plasmacytoid histology is associated with what mutation?

A

CDH1

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3
Q

Localized small cell bladder cancer treatment paradigm

A

Neoadjuvant small cell chemotherapy then surgery

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4
Q

What T stage becomes MIBC?

A

T2

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5
Q

What T stage is no longer considered resectable?

A

T4b = fixed to pelvic sidewall

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6
Q

What TNM stages are considered unresectable urothelial cancer? (3)

A

T4b
N+
M+

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7
Q

Treatment of cTa low grade

A

TURBT

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8
Q

Treatment of high grade cTa urothelial cacncer

A

TURBT, intravesical BCG maintenance

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9
Q

Treatment of cT1 low grade

A

TURBT, intravesical BCG maintenance

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10
Q

Treatment of cT1 high grade

A

TURBT, intravesical BCG maintenance

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11
Q

Treatment of Tis

A

TURBT, intravesical BCG maintenance

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12
Q

Treatment for NMIBC that is BCG unresponsive

A

Pembro

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13
Q

Who is a candidate for neoadjuvant chemotherapy?

A

cT2-T4a
N0

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14
Q

Treatment options (2) for neoadjuvant chemo

A

Gem + Cis (not carboplatin)
ddMVAC

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15
Q

2 instances to give adjuvant chemotherapy

A

No neoadjuvant given
pT3-4 or N+ disease

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16
Q

Minimal LN dissection to be removed during surgery

A

Minimum 13-15

17
Q

Patient undergoes neoadjuvant GC and then cystectomy for T3N0 urothelial cancer. He has residual ypT2 disease. Anything to be done in adjuvant setting?

A

Nivo improves PFS, no OS

18
Q

What are treatment options for localized bladder cancer for patients who don’t want a cystectomy?

A

ChemoRT with
5FU-Mitomycin
5FU-Cis
Cis-Taxol

19
Q

1L mUC treatment

A

EV-Pembro

20
Q

1L mUC in patients who can’t receive ICI?

A

Gem+Cis+ Avelumab maintenance if good response

21
Q

1L mUC treatment in patients who are Cis eligible but can’t get EV-Pembro (2)

A

ddMVAC
Gem Cis Nivo

22
Q

1L mUC treatment for patients who are cis ineligible and can’t get EV-Pembro (3)

A

Gem-Carbo
Atezo (PDL1 high)
Pembro

23
Q

What 5 things makes a patient cisplatin ineligible?

A

GFR <60
Neuopathy >G2
Poor hearing
ECOG 2+
NYHA Class 3 CHF

24
Q

Patient with mUC treated with Gem + Cis with a partial response on imaging at the end of chemo. What to do now?

A

Maintenance avelumab

25
Q

2L treatment for mUC post-platinum? (3)

A

Pembro (preferred)
Nivo
Taxane

26
Q

2L+ in mUC after ICI (3)

A

Erdafitinib (FGFR3 mut)
Sacituzumab
Enfortumab vedotin

27
Q

Indication for Erdafitinib

A

Post chemo, post ICI mUC with FGFR3 alteration

28
Q

Toxicity of EV (5)

A

Hyperglycemia
Neuropathy
Skin: bullous, peeling, SJS
Diarrhea
Hepatotoxic (use in caution with cirrhosis)

29
Q

Indication for adjuvant Nivo

A

Residual disease at surgery (no pCR)
ypT2-ypT4 or ypN+

30
Q

Treatment for T1N0 small cell bladder cancer

A

Neoadjuvant cis/etop then cystectomy

31
Q

Treatment of T2N0 bladder adenoca

A

up front surgery

32
Q

T3N0 UC is treated with neoadjuvant ddMVAC and then cystectomy. Develops metastatic disease 8 months later. Treatment?

A

EV+Pembro
Pembro (preferred)
Nivo

33
Q

Characteristic toxicity of erdafitinb (3)

A

Retinopathy, retinal pigment detachment
Elevated Phosphate
Teratogen