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Therapeutics IV > Colorectal Cancer > Flashcards

Colorectal Cancer Flashcards

1
Q

List the risk factors for colorectal cancer. (7)

A

age > 40; family history; high fat/low fiber diet; polyps; ulcerative colitis/Crohn’s disease; alcohol/tobacco use; obesity

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2
Q

What are the two hereditary syndromes associated with colorectal cancer? (2)

A

familial adenomatous polyposis (FAP); hereditary nonpolyposis colorectal cancer (HNPCC)

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3
Q

What other cancers are those with HNPCC at risk for? (3)

A

endometrial; stomach; ovarian

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4
Q

At what age should you begin screenings for colon cancer?

A

45

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5
Q

At what age should a person with family history of colorectal cancer begin screenings?

A

40 or 10 years before earliest age of family diagnosis

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6
Q

At what age should a person with HPNCC begin screenings?

A

20-25 or 10 years before earliest age of family diagnosis

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7
Q

True or False? The majority of colorectal cancers are adenocarcinomas?

A

True

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8
Q

What is the most common presentation of colorectal cancer? (2)

A

rectal bleeding and anemia

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9
Q

What should be included in the diagnostic workup? (3)

A

complete blood count; anemia work-up; colonscopy

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10
Q

All patients with a colon cancer diagnosis should eb tested for ____.

A

dMMR

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11
Q

In what stages do you use localized therapy?

A

Stage I and II

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12
Q

What are the chemotherapy regimens are available for Stage II colorectal cancer? (2)

A

FOLFOX; CapeOX

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13
Q

When is radiation therapy used in colorectal cancer? (2)

A

to alleviate pain & decrease bleeding

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14
Q

Is Stage IV colorectal cancer curable?

A

no

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15
Q

What is the preferred treatment option for Stage I and II colorectal cancer?

A

surgery (partial or total colectomy + lymph nodes)

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16
Q

What adjuvant chemotherapy do you use in Stage III colorectal cancer?

A

FOLFOX; CapeOX

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17
Q

What are the main toxicities associated with CapeOX? (2)

A

hand foot syndrome & diarrhea

18
Q

What are two ways you can give local chemotherapy?

A

hepatic artery infusion; hepatic chemoembolism

19
Q

Which chemotherapy regimen is appropriate for a patient with neuropathy?

A

irinotecan

20
Q

Which chemotherapy regimen is appropriate for a patient with UGT1A1 deficiency?

A

oxaloplatin

21
Q

Can dMMR status change after metastasis?

A

yes

22
Q

What 3 biomarkers should you test colorectal patients for?

A

BRAF; KRAS; EGFR

23
Q

KRAS mutant patients do not benefit from ____ or ____.

A

cetuximab; panitumumab

24
Q

What are the first line chemotherapy regimens for metastatic colorectal cancer?

A

FOLFOX; CapeOX; FOLFIRI

25
Q

What drugs are included in FOLFOX?

A

5-FU; leucovorin; oxaloplatin

26
Q

What drugs are included in CapeOX?

A

capcitabine; oxaloplatin

27
Q

What drugs are included in FOLFIRI?

A

5-FU; leucovorin; irinotecan

28
Q

What regimen would you use in a patient who cannot tolerate intensive chemotherapy? (2)

A

5-FU + leucovorin; capecitabine

29
Q

What regimen would you switch to if a patient progresses while on FOLFOX?

A

FOLFIRI

30
Q

What regimen would you switch to if a patient progresses while on FOLFIRI?

A

FOLFOX

31
Q

What is the common toxicity of 5-FU?

A

diarrhea

32
Q

What subset of patients will have increased 5-FU toxicities?

A

patients with DPD deficiency

33
Q

What drug is given with 5-FU to increase efficacy?

A

leucovorin

34
Q

What are the dose-limiting toxicities of irinotecan? (2)

A

diarrhea; neutropenia

35
Q

What toxicities are associated with oxaliplatin? (3)

A

neuropathy; cold intolerance; sensation of not being able to breathe

36
Q

What toxicities are associated with capcitabine?

A

hand-foot syndrome; diarrhea

37
Q

What does cetuximab target?

A

EGFR

38
Q

What are the toxicities associated with cetuximab?

A

infusion reaction; rash; hypomagnesemia

39
Q

What does panitumumab target?

A

EGFR

40
Q

What does bevacizumab target?

A

VEGF

41
Q

What toxicities are associated with bevacizumab? (4)

A

bleeding; hypertension; proteinuria; VTE

42
Q

What does regorafenib target?

A

multiple kinases

Therapeutics IV (21 decks)

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