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PHRM 864 Therapeutics > Exam 2 - Prostate Cancer Weddle > Flashcards

Exam 2 - Prostate Cancer Weddle Flashcards

1
Q

prostate cancer is the ____ most common cause of cancer related death in men

a. 1st
b. 2nd
c. 3rd

A

b. 2nd

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2
Q

Most risk factors associated with prostate cancer
are related to increased exposure to __________

A

testosterone

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3
Q

T or F: risk of PC is more common in Asians than African-Americans

A

F (more common in African-Americans)

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4
Q

metastasis to the ______ is the most common natural progression of PC?

a. lung
b. liver
c. bone

A

c. bone

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5
Q

which Gleason Scores are slow-growing and well-differentiated?

a. 2-4
b. 5-7
b. 8-10

A

a. 2-4

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6
Q

which Gleason Scores are aggressive and poorly differentiated?

a. 2-4
b. 5-7
b. 8-10

A

b. 8-10

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7
Q

normal PSA range

A

0-4 ng/mL

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8
Q

PSA of > _____ ng/mL is highly suspicious for malignancy

a. 0
b. 4
c. 10

A

c. 10

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9
Q

what do HSPC and CRPC stand for?

A

HSPC = hormone sensitive prostate cancer
CRPC = castrate resistant prostate cancer

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10
Q

for the localized tx of prostate cancer, observation involves monitoring the course of disease with the expectation to deliver _________ therapy for development of sx or a change in exam or PSA that suggests sx are imminent

A

palliative

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11
Q

localized tx of PC: in active surveillance, if cancer progressing, will initiate potentially ________ therapy

a. curative
b. palliative

A

a. curative

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12
Q

which of the following is a disadvantage of active surveillance of PC?

a. ~2/3rds of pts eligible for surveillance will avoid therapy
b. avoids possible SE
c. QOL less affected
d. periodic follow up and tests necessary

A

d. periodic follow up and tests necessary

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13
Q

tx overview for localized tx of PC (3 of them)

A

-active surveillance
-radiation therapy
-surgery

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14
Q

radiation therapy for localized tx of PC (2)

A

external beam vs brachytherapy

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15
Q

for locally advance/high risk pts for PC, what is used in combo with EBRT (external beam radiation therapy)?

A

ADT (androgen deprivation therapy)

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16
Q

radical prostatectomy + PLND is a ________ therapy

a. palliative
b. curative

A

b. curative

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17
Q

the goal of ADT is to induce castrate levels of __________

A

testosterone

18
Q

ADT involves what two things?

A

LHRH agonist +/- anti-androgen or orchiectomy

19
Q

which drug class blocks androgen receptors and inhibits androgen uptake and binding in target tissues?

A

antiandrogens (part of ADT)

20
Q

examples of LHRH agonists

A

leuprolide; -relins

21
Q

look at toxicities of LHRH agonists (slide 25)

A

ok

22
Q

which drug, compared to LHRH agonists, has less CV events?

A

relugolix

23
Q

examples of anti-androgens (just the ending)

A

-lutamides

24
Q

which anti-androgen has the longest half-life?

a. flutamide
b. bicalutamide
c. nilutamide

A

b. bicalutamide

(longest half-life; once daily dosing)

25
Q

first line therapy for metastatic PC:
-goal is to suppress testosterone production < ____ ng/dL
-need to determine whether this is a _____ recurrence or overt metastatic disease
-determine PSA ________ time

A

< 50 ng/dL
PSA
doubling

26
Q

for m0HSPC, if pSA doubling time < 6 months:

a. can give ADT
b. can observe

A

a. can give ADT

27
Q

what is an orchiectomy?

A

removal of testes

28
Q

which drug class has risk of disease flare in the first weeks of therapy due to initial release of testosterone?

A

LHRH agonists (resolves in 2 weeks)

29
Q

m0CRPC tx

A

ADT (leuprolide probably) and add enzalutamide, apalutamide, or darolutamide (least SE)

30
Q

T or F: abiraterone is used in the M0 setting

A

F

31
Q

low volume m1HSPC tx (2 things)

A

-ADT
-add one of the 3:
abiraterone + prednisone
enzalutamide
apalutamide

32
Q

why is abiraterone given with prednisone?

A

to help prevent renal insufficiency

33
Q

high volume m1HSPC tx differs from low volume because of what?

A

in high volume we add chemo (docetaxel) + ADT

34
Q

look at m1CRPC tx, there are many things we can add to ADT (slide 53)

A

alrighty

35
Q

m1CRPC first and second line tx includes ?

A

1st line: docetaxel + prednisone
2nd line: cabazitaxel + prednisone

36
Q

drug with FDA approval for dMMR/MSI-H cancers

a. pemetrexed
b. apalutmide
c. mitoxantrone
d. pembrolizumab

A

d. pembrolizumab

37
Q

what isotope is used for bone metastases?

A

radium 223 dichloride

38
Q

drug used for PSMA positive mCRPC

A

Pluvicto (Lu-177)

39
Q

what exam is used for prostate cancer screening?

a. DRE
b. PSA
c. MRI
d. CT scan

A

a. DRE (digital rectal exam)

40
Q

for men aged 50 or older, PSA level 2.5 or higher, how often should they be screened for PC?

a. every 6 months
b. every year
c. every 5 years
d. every 10 years

A

b. every year

41
Q

for men aged 50 or older, PSA < 2.5, how often should they be screened for PC?

A

every 2 years

42
Q

drug for prostate cancer prevention

A

finasteride

PHRM 864 Therapeutics (22 decks)

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