Cancer & Tumor Markers Flashcards
What is the clinical utility for Prostate Specific Antigen (PSA)?
Prostate Cancer (PC)
What is the non-age related range for PC screening?
< 4 ng/mL
When is a biopsy recommended for a PSA? [Hint: think of the range]
PSA ranging 4-9 ng/mL
What is PSA density (PSAD)?
This is when you divide PSA by prostate volume
If PSAD is increased, what would that mean?
That would mean the patient is a greater risk of having PC then BPH (PSA»_space; BPH)
What are the two common types (not all inclusive) of molecular forms of PSA?
free PSA (fPSA) [ranging from 30-40%] complexed PSA (cPSA) [ranging from 50-70%]
What is PSA velocity?
Refers to rate of increase in PSA levels over time
- Faster rate of rise could suggest PC
How would cPSA affect PC?
If cPSA has a linear relationship, it would signify PC (cPSA increased, PC would be more at risk)
How would fPSA affect PC?
If fPSA has an inverse relationship, it would signify PC
fPSA decreased, PC would be more at risk
Which of the following is true regarding a PSA statement?
a. Slower rate of PSA velocity is suggestive of PC
b. PSA screening for PC is < 4 ng/mL
c. The majority of serum PSA is unbound to plasma proteins
d. A reduced PSA density is associated with PC
b. PSA screening for PC is < 4 ng/mL
What is carcinoembryonic antigen (CEA) helpful for?
It's helpful for monitoring treatment in: - Colon cancer - Breast cancer It's helpful for staging/prognosis in: - Colon cancer
What is cancer antigen 15-3 (CA 15-3) helpful for?
It’s helpful for staging/prognosis & monitoring treatment in:
- Breast cancer
What is cancer antigen 27.29 (CA 27.29) helpful for?
It’s helpful for staging/prognosis & monitoring treatment in:
- Breast cancer
What is cancer antigen 125 (CA 125) helpful for?
It is helpful for staging/prognosis & monitoring treatment in:
- Ovarian cancer
What is human chronic gonadotropin (hCG) helpful for?
It is helpful for staging/prognosis, monitoring AND diagnosis in:
- Germ cell tumors (ovaries/testis)
What is cancer antigen 19-9 (CA 19-9) helpful for?
It is helpful for staging/prognosis & monitoring treatment in:
- Pancreatic cancer
What is alpha fetoprotein helpful for? HINT: two things
It is helpful for staging/prognosis, monitoring treatment and diagnosis in: - Hepatocellular carcinoma - Testicular cancer It is also helpful for screening in" - Hepatocellular carcinoma
What is Beta-2 Microglobulin (B2M) helpful for?
It is helpful for staging/prognosis, monitoring treatment in:
- Multiple myeloma
Which of the following serum tumor markers are used to stage and monitor treatment in breast cancer?
a. CA 15-3 and CA 125
b. CA 15-3 and CA 27.29
c. CA 27.29 and CA 125
d. CA 27. 29 and CA 19-9
b. CA 15-3 and CA 27.29
Which of the following is utilized in the diagnosis of germ cell tumors of the ovaries and testes?
a. CEA
b. B2M
c. CEA
d. hCG
d. hCG
What is the clinical utility of estrogen (ER) and Progesterone (PR)?
Breast cancer
What would be needed if ER and PR become positive in breast cancer?
Treatment would be needed, such as:
- tamoxifen
What is the clinical utility of human epidermal growth factor receptor 2 (HER2)?
Breast cancer
What would be needed if HER2 becomes positive?
Treatment would be needed, specifically anti-HER2 such as:
- trastuzumab
What is the clinical utility of BCR-ABL?
Chronic myelogenous leukemia
If BCR-ABL is positive, what would be needed?
Treatment would be needed, such as a TK inhibitor:
- imatinib
Which of the following predicts the likelihood that breast cancer will respond to hormonal therapies?
a. HER2
b. EGFR
c. BCR-ABL
d. ER & PR
d. ER & PR
What is the clinical utility for epidermal growth factor receptor (EGFR)?
Pulmonary Adenocarcinoma (PA)
What would be needed if mutation occurs in response to EGFRs?
TK inhibitors would needed for treatment
- eroltinib
What is the clinical utility for V-Ki-Ras2 Kirsten Rat Sarcoma Viral Oncogene Homolog (KRas)?
Colorectal cancer
What would be needed if a wild-type (nonmutated) occurs in response to KRas?
anti-EGFR treatment would be needed
- cetuximab
What is the clinical utility for V-Raf Murine Sarcoma Viral Oncogene Homolog B1 (BRAF)?
Melanoma
What would be needed if mutation occurs in response to BRAF?
BRAF inhibitors would be needed, such as:
- vemurafenib
Are BRAF inhibitors recommended for wild-type tumors (nonmutated tumors)?
No, they are not recommended
What is the clinical utility for anaplastic lymphoma kinase (ALK)?
Pulmonary Adenocarcinoma (PA)
If abnormal fusion protein (EML4-ALK) occurs in response to the ALK, what treatment would be needed?
ALK inhibitors would be needed, such as:
- crizotinib
Which mutation predicts lung cancer responsiveness to therapy with erlotinib?
EGFR
RS, is a 61 yo male, diagnosed with colorectal cancer. Genetic testing reveals a wild-type tumor. Which treatment would be recommended?
Cetuximab
