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Spring Pharm 2 > Breast Cance > Flashcards

Breast Cance Flashcards

1
Q

Which breast cancer classification has the best prognosis?

A

ER+
PR+
HER2-

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2
Q

Worst prognosis classification?

A

Triple negative

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3
Q

SERM: tamoxifen, toremifene

Pre or post?

A

Tamoxifen: pre and post
Toremifene: post only

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4
Q

GnRH agonists: Leuprolide

Pre or post?

A

Pre menopausal

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5
Q

Aromatase inhibitors: anastrozole, exemestane

Pre or post

A

Post

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6
Q

Tamoxifen MOA, AE, BBW

A

SERM, pre and post
Antagonist breast, partial endometrium
AE: menopausal sx
BBW: DVT, PE, endometrial cancer, SSRIs

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7
Q

Toremifene

A

SERM, post only
Does not require CYP2D6
Similar to tamoxifen

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8
Q

Goserelin

A

GnRH agonist, pre only
Desensitizes pituitary receptors with constant stimulation (may have inc in cancer sx first)
AE: hot flashes, osteoporosis

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9
Q

First line for breast cancer tx

A

Pre meno: tamoxifen

Post meno: aromatase inhibitors +/- SERM

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10
Q

Why aren’t aromatase inhibitors useful in pre menopause?

A

functional ovaries in HPG acids overcomes AI effects (only low amts of estrogen coming from adipose tissue in post menopause)

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11
Q

Aromatase inhibitors

MOA, AE

A

Anastrozole (reversible), exemestane (suicide)
Prevents conversion of testosterone to estrogen
AE: hot flashes, osteoporosis

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12
Q

How do diagnose HER2+ breast cancer?

A

FISH mapping

Immunohistochemistry

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13
Q

FISH mapping

A

positive screen is 6+ copies of HER2 gene

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14
Q

Immunohistochemisty

A

Antibody and brown stain

>30+% of stained cells is positive screen

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15
Q

First line for HER2+

A

Trastuzumab + lapatinib

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16
Q

Trastuzumab MOA, AE, BBW

A

MOA: acts on domain IV to prevent dimerization
Sensitizes to chemo, recruits immune
AE: hypersensitivity, nephrotic, ILD
BBW: cardiomyopathy, ARDS, preg

17
Q

Pertuzumab

A

used with trastuzumab

Targets extracellular domain 2

18
Q

Mammaprint

A

70 gene expression
pts: <61, early cancer with <5 cm node negative
ER/PR/HER2 independent

19
Q

Oncotype DX

A

21 genes, 0-100 score

Pt: ER+/HER2- up to 3 nodes, receiving tamoxifen

20
Q

Oncotype DX scoring

A

> 31: tamoxifen + chemo

<18: just tamoxifen

Spring Pharm 2 (5 decks)

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