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PHAR211 > Breast Cancer > Flashcards

Breast Cancer Flashcards

1
Q

What is the most common type of cancer in women?

A

breast cancer
-1 in 8 Canadian females are expected to be diagnosed in their lifetime

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2
Q

How do we screen for breast cancer?

A

mammogram

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3
Q

What are some considerations when determining breast cancer treatment plan?

A

stage
menopausal status
hormone receptor status
HER2 status
risk factors of recurrence
overall health condition
other breast cancer biomarkers

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4
Q

What is the treatment for stage I breast cancer?

A

surgery (primary)
radiation therapy
hormonal therapy
chemotherapy (usually not offered)
targeted therapy (HER2+ and high risk of recurrence)

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5
Q

What is the treatment for stage II breast cancer?

A

surgery (standard)
radiation therapy (including lymph nodes)
chemotherapy (adjuvant and neoadjuvant)
hormonal therapy
targeted therapy (HER2+ and high risk of recurrence)

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6
Q

What is the treatment for stage III breast cancer?

A

chemotherapy (adjuvant and neoadjuvant)
targeted therapy (HER2+, ER+, or BRCA mutations)
surgery (before or after chemotherapy)
radiation therapy (after breast-conserving surgery)
hormonal therapy

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7
Q

What is breast-conserving surgery?

A

removing cancer while leaving as much normal breast as possible

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8
Q

What is the treatment for stage IV breast cancer?

A

hormonal therapy
chemotherapy (reducing cancer growth within patients tolerance level of side effects)
-monotherapy: common, fewer side effects
-combo: can be used if tolerable
targeted therapy

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9
Q

What are the surface receptors used to classify breast cancer?

A

estrogen receptor (ER)
progesterone receptor (PR)
human epidermal growth factor receptor 2 (HER2)

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10
Q

Differentiate the following:
-luminal A
-luminal B
-HER2
-triple negative
-normal like

A

luminal A: ER+ and/or PR+, HER2-
luminal B: ER+ and/or PR+, HER2+
triple negative: ER-, PR-, HER2+
normal like: similar to luminal A

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11
Q

What are some antibodies used to treat cancer?

A

trastuzumab
pertuzumab
margetuximab

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12
Q

What are some antibody-drug conjugates used to treat cancer?

A

ado-trastuzumab emtansine (T-DM1)
fam-trastuzumab deruxtecan

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13
Q

What is the MOA of trastuzumab?

A

monoclonal antibody binds to subdomain IV of HER2 protein

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14
Q

What is the MOA of pertuzumab?

A

monoclonal antibody binds to subdomain II of HER2 protein
block homodimerization of HER2 and heterodimerization of HER2-HER3
inhibit HER2-signaling pathway and decrease cell growth

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15
Q

What is a combination therapy for metastatic and recurrent HER2+ breast cancer?

A

trastuzumab + pertuzumab + docetaxel

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16
Q

What is the MOA of margetuximab?

A

chimeric IgG monoclonal antibody binds to the extracellular domain of HER2 receptor
-trastuzumab and margetuximab bind to the same epitope on HER2 receptor

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17
Q

What is the use of margetuximab?

A

adults with metastatic HER2+ breast cancer who have received two or more prior anti-HER2 regimens

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18
Q

Describe T-DM1.

A

conjugate of trastuzumab and emtansine
emtansine:
-cytotoxic agent cleaved from T-DM1 and released inside breast cancer cells

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19
Q

What is the use of T-DM1?

A

HER2+ metastatic breast cancer and early-stage HER2+ breast cancer after surgery

20
Q

Describe fam-trasutuzumab deruxtecan.

A

conjugate of trastuzumab and deruxtecan
deruxtecan:
-topoisomerase I inhibitor
-cleaved from antibody-drug conjugate by lysosomal enzymes and released inside breast cancer cells

21
Q

What is the use of fam-trasutuzumab deruxtecan?

A

unresectable or metastatic HER2+ breast cancer who have received two or more prior anti-HER2 regimens

22
Q

What are examples of tyrosine kinase inhibitors?

A

lapatinib
neratinib
tucatinib

23
Q

What is the MOA of lapatinib?

A

dual tyrosine kinase inhibitor that can reversibly bind to the ATP-binding pockets of both EGFR and HER2

24
Q

What are some combo options with lapatinib?

A

with capecitabine for advanced and metastatic HER2+ breast cancer
with letrozole for hormone receptor + metastatic breast cancer that overexpress HER2

25
Q

What is the MOA of neratinib?

A

irreversible pan-HER tyrosine kinase inhibitor

26
Q

What is the use of neratinib?

A

early stage HER2+ breast cancer for an extended period after surgery

27
Q

What is the MOA of tucatinib?

A

reversible tyrosine kinase inhibitor with exception selectivity to HER2 receptor

28
Q

What is the use of tucatinib?

A

in combo with trastuzumab and capecitabine for advanced unresectable or metastatic HER2+ breast cancer who have one or more prior anti-HER2 regimens

29
Q

What are examples of CDK4/6 inhibitors?

A

palbociclib
ribociclib
abemaciclib

30
Q

What is an example of an mTOR inhibitor?

A

everolimus

31
Q

What is an example of a PI3K inhibitor?

A

alpelisib

32
Q

What is the first CDK4/6 inhibitor?

A

palbociclib

33
Q

What is the MOA of palbociclib?

A

inhibit cyclin-dependent kinases CDK4 and CDK6
-block the phosphorylation of Rb
-prevent cancer cells to pass the R point
-arrest cancer cells in G1 phase

34
Q

What is the use of palbociclib?

A

in combo with an aromatase inhibitor and fulvestrant to treat HR+, HER2- advanced or metastatic breast cancer

35
Q

What is the MOA of ribociclib?

A

CDK4/6 inhibitor
inhibit cyclin-dependent kinases CDK4 and CDK6

36
Q

What is the use of ribociclib?

A

same as palbociclib

37
Q

What is the MOA of abemaciclib?

A

inhibit cyclin-dependent kinases CDK4 and CDK6

38
Q

What is the use of abemaciclib?

A

same as palbociclib
can be used as monotherapy

39
Q

What is the MOA of everolimus?

A

mTOR inibitor
-bind mTORC1

40
Q

What is the use of everolimus?

A

combo with exemestane for advanced HR+, HER2- breast cancer

41
Q

What is the MOA of alpelisib?

A

a-specific PI3K inhibitor
-approximately 40% of pts diagnosed with HR+, HER2- breast cancer have PIK3CA activating mutations

42
Q

What are BRCA1 and BRCA2?

A

tumor suppressors
-mutations can cause cancer cells significantly relying on PARP for DNA repairs
-PARP inhibitors block DNA repairs in cancer cells, leading to apoptosis of cancer cells (normal cells have a backup DNA repair system)

43
Q

What are examples of PARP inhibitors?

A

olaparib
talazoparib

44
Q

What is the MOA of olaparib?

A

PARP inhibitor

45
Q

What is the MOA of talazoparib?

A

PARP inhibitor
-~100 fold more efficient than olaparib

46
Q

Describe sacituzumab govitecan.

A

conjugate of sacituzumab and govitecan
sacituzumab:
-monoclonal antibody targeting Trop-2 protein
govitecan:
-topoisomerase I inhibitor

47
Q

What is Trop-2 protein?

A

trophoblast cell surface antigen 2, a tumor-associate antigen overexpressed in a large variety of solid tumor cells

PHAR211 (16 decks)

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