Exam 2 - Ovarian Cancer Weddle

Question 1

goal for initial tx for OC

a. cure
b. palliative

Answer 1

a. cure

Question 2

current standard of therapy adjuvant chemo for OC

Answer 2

carboplatin + paclitaxel every 3 weeks

Question 3

what is the Calvert equation for carboplatin dosing?

Answer 3

dose = AUC * (GFR + 25)

Question 4

drug allergic rxn

a. sx persist after stopping infusion
b. sx resolve quickly after stopping infusion

Answer 4

a. sx persist after stopping infusion

Question 5

infusion related rxns

a. sx persist after stopping infusion
b. sx resolve quickly after stopping infusion

Answer 5

b. sx resolve quickly after stopping infusion

Question 6

which drug often causes infusion related rxns due to cremophor EL?

a. carboplatin
b. paclitaxel
c. cisplatin
d. etoposide

Answer 6

b. paclitaxel

Question 7

premedicate paclitaxel 30 minutes prior with what 3 drugs/classes?

Answer 7

dexamethasone, benadryl, famotidine

Question 8

if OC pt has a BRCA mutation, what drug class should be used?

Answer 8

PARP inhibitors

Question 9

most common adverse effect of PARP inhibitors

a. neutropenia
b. anemia
c. fatigue
d. vomiting

Answer 9

b. anemia

Question 10

if “platinum sensitive”, what regimen should be used?

Answer 10

initial chemo regimen again (carboplatin + paclitaxel)

Question 11

if “platinum resistant”, what salvage agents can be used? (there are a lot)

Answer 11

cyclophosphamide, docetaxel, gemcitabine, …

Question 12

T or F: there is no effective screening tool for OC

Answer 12

T

Question 13

What would be the 1st line chemotherapy regimen of choice for someone with stage III ovarian cancer?

Answer 13

carboplatin + paclitaxel

Question 14

What would be the 1st choice for treatment for recurrent, ovarian cancer? What do you need to ask yourself to determine therapy?

Answer 14

when did cancer re-occur? if > 6 months can reuse same regimen, if < 6 months do salvage regimen

Question 15

two maintenance therapy options for ovarian cancer

Answer 15

-PARP inhibitors (3 of them ORN)
-bevacizumab (angiogenesis inhibitor)

Question 16

pt relapses > 6 months following completion of initial platinum containing regimen

a. platinum sensitive
b. platinum resistant
c. platinum progressive

Answer 16

a. platinum sensitive

Question 17

pt relapses < 6 months after receiving a platinum containing regimen

a. platinum sensitive
b. platinum resistant
c. platinum progressive

Answer 17

b. platinum resistant

Question 18

No response or progression of disease during primary therapy with paclitaxel/carboplatin

a. platinum sensitive
b. platinum resistant
c. platinum progressive

Answer 18

c. platinum progressive (aka platinum refractory)

Question 19

optimally debulked

a. < 1 cm of disease
b. > 1 cm of disease

Answer 19

a. < 1 cm of disease

Question 20

sub-optimally debulked

a. < 1 cm of disease
b. > 1 cm of disease

Answer 20

b. > 1 cm of disease

Question 21

from which stage of ovarian cancer and beyond can we use carboplatin and paclitaxel?

Answer 21

stage IC

(1A and 1B only need observation and follow up in 3 months)

Question 22

“incessant ovulation” theory

Answer 22

the more ovulation cycles a woman has means the more likely they are to have cancer due to constant repairing of epithelial lining of the ovaries