Colorectal Cancer Flashcards
List the risk factors for colorectal cancer. (7)
age > 40; family history; high fat/low fiber diet; polyps; ulcerative colitis/Crohn’s disease; alcohol/tobacco use; obesity
What are the two hereditary syndromes associated with colorectal cancer? (2)
familial adenomatous polyposis (FAP); hereditary nonpolyposis colorectal cancer (HNPCC)
What other cancers are those with HNPCC at risk for? (3)
endometrial; stomach; ovarian
At what age should you begin screenings for colon cancer?
45
At what age should a person with family history of colorectal cancer begin screenings?
40 or 10 years before earliest age of family diagnosis
At what age should a person with HPNCC begin screenings?
20-25 or 10 years before earliest age of family diagnosis
True or False? The majority of colorectal cancers are adenocarcinomas?
True
What is the most common presentation of colorectal cancer? (2)
rectal bleeding and anemia
What should be included in the diagnostic workup? (3)
complete blood count; anemia work-up; colonscopy
All patients with a colon cancer diagnosis should eb tested for ____.
dMMR
In what stages do you use localized therapy?
Stage I and II
What are the chemotherapy regimens are available for Stage II colorectal cancer? (2)
FOLFOX; CapeOX
When is radiation therapy used in colorectal cancer? (2)
to alleviate pain & decrease bleeding
Is Stage IV colorectal cancer curable?
no
What is the preferred treatment option for Stage I and II colorectal cancer?
surgery (partial or total colectomy + lymph nodes)
What adjuvant chemotherapy do you use in Stage III colorectal cancer?
FOLFOX; CapeOX
What are the main toxicities associated with CapeOX? (2)
hand foot syndrome & diarrhea
What are two ways you can give local chemotherapy?
hepatic artery infusion; hepatic chemoembolism
Which chemotherapy regimen is appropriate for a patient with neuropathy?
irinotecan
Which chemotherapy regimen is appropriate for a patient with UGT1A1 deficiency?
oxaloplatin
Can dMMR status change after metastasis?
yes
What 3 biomarkers should you test colorectal patients for?
BRAF; KRAS; EGFR
KRAS mutant patients do not benefit from ____ or ____.
cetuximab; panitumumab
What are the first line chemotherapy regimens for metastatic colorectal cancer?
FOLFOX; CapeOX; FOLFIRI
What drugs are included in FOLFOX?
5-FU; leucovorin; oxaloplatin
What drugs are included in CapeOX?
capcitabine; oxaloplatin
What drugs are included in FOLFIRI?
5-FU; leucovorin; irinotecan
What regimen would you use in a patient who cannot tolerate intensive chemotherapy? (2)
5-FU + leucovorin; capecitabine
What regimen would you switch to if a patient progresses while on FOLFOX?
FOLFIRI
What regimen would you switch to if a patient progresses while on FOLFIRI?
FOLFOX
What is the common toxicity of 5-FU?
diarrhea
What subset of patients will have increased 5-FU toxicities?
patients with DPD deficiency
What drug is given with 5-FU to increase efficacy?
leucovorin
What are the dose-limiting toxicities of irinotecan? (2)
diarrhea; neutropenia
What toxicities are associated with oxaliplatin? (3)
neuropathy; cold intolerance; sensation of not being able to breathe
What toxicities are associated with capcitabine?
hand-foot syndrome; diarrhea
What does cetuximab target?
EGFR
What are the toxicities associated with cetuximab?
infusion reaction; rash; hypomagnesemia
What does panitumumab target?
EGFR
What does bevacizumab target?
VEGF
What toxicities are associated with bevacizumab? (4)
bleeding; hypertension; proteinuria; VTE
What does regorafenib target?
multiple kinases
