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Oncology > GU CA > Flashcards

GU CA Flashcards

1
Q

What high-risk features may prompt early initiation of ADT for biochemical recurrence? (3)

A
  • Gleason 8 to 10 disease
  • PSA doubling time less than one year
  • Biochemical relapse less than 18 months following local therapy
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2
Q

Name treatment options for high-volume mCSPC. (3)

A

1) ADT, docetaxel
2) ADT, docetaxel, darolutamide
3) ADT, docetaxel, abiraterone

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3
Q

Name the treatment options for low volume mCSPC (3)

A

1) ADT +Abi
2) ADT + enza
3) ADT + apalutamide

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4
Q

What are treatment options for nmCRPC?

A

1) ADT + Enzalutamide
2) ADT + Apalutamide
3) ADT + Darolutamide

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5
Q

What are common genes implicated in homologous recombination repair that may indicate PARP inhibitor responsiveness (7)

A

BRCA1, BRCA2, PALB2,CHEK2,RAD51B, ATM, FANCA

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6
Q

What defines Stage III RCC (2)

A
  • node positive
  • T3
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7
Q

What defines high risk mRCC? (5)

A
  • KPS <80
  • time from dx to tx <12m
  • Hb<12
  • PLT >400
  • WBC >12
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8
Q

what are preferred tx for first line mRCC (4)

A

IPI / nivo (High risk)
Nivo / Cabo
Pembro / Axi
Pembro / lenvatinib

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9
Q

What is the benefit of adjuvant pembrolizumab in stage III RCC?

A

Improved DFS only

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10
Q

Who is a candidate for TMT for bladder CA?

A

T2-3a
N0
Low grade
No CIS
Unifocal

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11
Q

What defines high Vs low risk non muscle invasive bladder CA (3)

A

Multiple lesions
Size >3cm
T1 (vs Ta)

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12
Q

Tx of low risk non muscle invasive bladder cancer

A

TURBT

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13
Q

Tx of high risk non muscle invasive bladder cancer

A

BCGx6 > TURBT > BCG x 3y

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14
Q

What defines cisplatin eligibility in muscle invasive bladder CA? (4)

A
  • EGFR > 60
  • no hearing loss
  • PS < 2
  • NYHA CHF 2 or less
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15
Q

Who should get adjuvant chemo for bladder cancer

A
  • T2+ or n+ upstaged at cystectomy
  • cisplatin eligible

Cisplatin Gemcitabine or ddMVAC

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16
Q

What neoadjuvant regimens are used in bladder cancer?

A

Cisplatin - gemcitabine
ddMVAC

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17
Q

When is adjuvant Nivolumab recommended in bladder CA?

A

Residual disease at cystectomy

18
Q

Metastatic urothelial cell tx (4)

A
  • gem - cis (no prior platinum or >12m)
    • consider avelumab maintenance
  • pembrolizumab
  • Erdafitinib (FGFRmut)
  • Enfortumab vedotin
  • Sacituzumab govitecan
19
Q

What are the two biggest principles in muscle invasive bladder CA

A

1) cisplatin based regimens are the only option
2) neoadjuvant is preferred

20
Q

What is total medical therapy TMT for muscle invasive bladder cancer

A

Maximal TURBT
Rads
Cis or taxol

21
Q

Three factors needed to stratify risk for non metastatic prostate cancer

A
  • grade group
  • PSA
  • T stage
22
Q

nmPC - define favorable prognosis

A
  • grade group 1 (3+3=6)
  • PSA < 10
  • T1 or T2a
23
Q

nmPC - define high risk

A

Grade group 4/5
- Gleason 4+4
- Gleason 4+5 / 5+5
PSA > 20
T3 or T4

24
Q

nmPC - what defines intermediate risk? (Fav and unfav)

A

Grade group 2-3
PSA 10-20
T2b-3
Fav - <50% cores
Unfav - >50% cores

25
Q

Prostate cancer T staging

A

1 - imaging
2 - palpable
3 - extraprostatic ext
4 - invasion of other structures

26
Q

ADJ prostate cancer treatment

A

FAV - observation
FAV-INT - obs or ADT x 6m
UnFAV-INT - ADT x 6m
HIGH - ADT x 18m

27
Q

Penile cancer treatment by stage
- CIS
- I/II (node negative)
- III (node positive)
- IV or recurrent

A
  • topical
  • resection
  • resection w ILND (consider adj TIP but no data)
  • TIP or CRT with cisplatin
28
Q

How to evaluate an adrenal module

A

1) is it likely to be a met? If so stop here
2) if not, is it large or secretory? - evaluate for aldosteronism, bushings, pheo
3) if large, secretory, and unilateral respect

29
Q

Tx of pheocheomocytoma

A

Resection or cytoreductive subtotal resection if unresectable

30
Q

Tx or adrenocortical carcinoma

A

1) resection, consider mitotatne ( no OS benefit)
2) Mitotane based systemic therapy

31
Q

Tx for mCSPC

A

ADT with
- doce
- doce abi
- doce dara

  • abi
  • apa
  • enza
32
Q

treatment for mCRPC (ASIs)

A

ADT with

Enza
Abi

33
Q

Define high volume metastatic prostate cancer

A

> 4 lesions
1 extra axial lesion
Visceral lesions

34
Q

What questions should you ask about every testis cancer?

A

1) seminoma or NSGCT
2) nodal status? I, IIA, IIB+
3) risk
Sem - m0-1
NSGCT - non pulm Mets, biomarker levels

35
Q

What defines favorable vs intermediate seminoma risk

A

Favorable
Intermediate - non pulm Mets

36
Q

Define fav/int/high risk for NSGCT

A

FAV -
INT - AFP>1k, hcg > 5k
HIGH- mediastinal primary, non pulm Mets, AFP>10k, hcg>50k

37
Q

Treatment for stage I seminoma

A

Surgery then

Obs > carbo x2 > RT

38
Q

Treatment for stage IIA seminoma

A

Surgery then
1) RT
2) BEPx3 or EPx4

39
Q

Treatment for stage IIB+ seminoma

A

Surgery then

Fav risk - BEPx3 or EPx4
Int risk - BEPx4 or VIP x4

40
Q

Treatment for stage I NSGCT

A

Surgery then
1) observation
2) RPLND (esp if teratoma)
3) BEP x 1

41
Q

Treatment for stage IIA NSGCT

A

Surgery then

1) RPLND
2) BEP x3 or EPx 4

42
Q

What is residual disease after frontline treatment for seminoma and NSGCT? What are tx options

A

S >3cm mass - RT or RPLND
NSGCT >1cm - RPLND

Oncology (10 decks)

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