Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CDM 4 Exam 3 > Lecture 8 - Breast cancer > Flashcards

Lecture 8 - Breast cancer Flashcards

1
Q

Breast cancer prevention

A

chopping them off
Tamoxifen
Raloxifene (Evista) option too

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Mammography screening

A

women 50-74 every 2 years
women 40-49 not recommended to screen but discuss pro/con

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

If results show biomarker HR, options are

A

Aromatase inhibitors
SERM
SERD
CDK4/6 inhib
Steroid aromatase inactivator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

If results show biomarker for HER-2, options are…

A

Anti HER-2 monoclonal antibodies
Monoclonal antibody - cytotoxic antineoplastic conjugates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

If results show biomarker for BRCA 1/2, options are….

A

PARP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

If results show biomarker for PIK3CA activating mutation, options are

A

PI3K inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

If results show biomarker for NTRK fusion mutation, options are…

A

Neurotrophic tyrosine kinase inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

invasive cancer is when it has spread beyond the area of…

A

carcinoma in situ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Goal for Stage 1-3 =

A

cure and prevention of recurrence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Goal of Stage 4 =

A

palliation and control
not candidate for surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hormone therapy for DCIS

A

consider for 5-10yrs in pts with HR+ tumors

Pre-meno = Tamoxifen 20 QD

Post-meno = Tamoxifen 20 QD, Anastrazole 1 QD, Letrozole 2.5 QD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Factors favoring Lumpectomy

A

want to preserve breast
small tumor
single tumor
Negative Post-op margin
pts accepts long-term txm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Factors favoring Mastectomy

A

Doesn’t want to preserve breast
large tumor
multi-centric tumors
postive post-op margin
one time procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Factors favoring Mastectomy

A

Doesn’t want to preserve breast
large tumor
multi-centric tumors
positive post-op margin
one time procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pre-operative chemotherapy

A

3-4 cycles

If HER2+ = add trastuzumab +/- pertuzumab depending on tumor

Hormone therapy if ER+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

adjuvant therapy after surgery

A

can give radiation therapy after either proceudere

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

adjuvant therapy after surgery

A

can give radiation therapy after either procedure

rare in mastectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

HR+ and HER2- pts therapy is…

A

Anthracyclines + taxanes
4-6 cycles every 14-21 days based on regimen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Dose-dense AC + weekly paclitaxel for…

A

HR+ or HER2-

Doxorubicin+ cyclophosphamide and Paclitaxel 80mg/m2 every week X 12 cycles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Dose dense AC + biweekly paclitaxel for…

A

HR+ or HER2-

Doxorubicin + cyclophosphamide and Paclitael 175mg/m2 every 2 wks X 4 cycles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

TC therapy for….

A

HR+ or HER2-

Doxorubicin + cyclophosphamide Q 3wks for 4-6 cycles

22
Q

HR+ or HER2+ therapy is…

A

docetaxel (+/- carboplatin) or paclitaxel

Trastuzumab or pertuzumab given neoadjuvant or adjuvant setting

23
Q

HR+ or HER2+, post op w/ no residual disease therapy….

A

docetaxel (+/- carboplatin) or paclitaxel + Trastuzumab or pertuzumab for 1yr

24
Q

HR+ or HER2+, post op w/ residual disease therapy….

A

docetaxel (+/- carboplatin) or paclitaxel + ado-trastuzumab emtansine or combo Trastuzumab/pertuzumab

25
Q

HER2 therapies

A

Trastuzumab = needs loading dose
Pertuzumab = needs loading dose
Ado-trastuzumab emtansine (Kadcyla)
Fam-trastuzumab deruxtecan-nxki (Enhertu)

need BL echo, drugs are cardiotoxic

26
Q

Neratinib (Nerlynx) info

A

MOA: irreversible Tyrosine kinase inhibitor of EGFR, HER2,HER4

Dose: 240mg QD oral

ADE: Severe diarrhea, Hepatotoxicity, rash

no commonly used

27
Q

HR- and HER2+ therapy

A

Surgery, Chemo, Anti-HER2 therapy

Endocrine therapy not indicated

28
Q

HR- and HER2+ therapy meds

A

Docitaxel or paclitaxel w/ Trastuzumab or pertuzumab

29
Q

HR- and HER2- also known as….

A

TNBC

Triple negative breast cancer

30
Q

TNBC therapy….

A

HER2 and endocrine therapy not recommended

Left with surgery and chemo

31
Q

Recommended regimen for TNBC

A

Dose dense AC + wkly paclitaxel
Dose dense AC + biweekly paclitaxel
TC (Docetaxel + cyclophosphamide)

if residual disease present, adjuvant capecitabine for 6-8 cycles

32
Q

Capecitabine (Xeloda) info

A

MOA: prodrug of Fluorouracil
Dose: 1000-1250 mg/m2 BID, 14 day on/7 days off
ADE: Handfoot syndrome, diarrhea, hyperbilirubinemia

33
Q

Olaparib (Lynparza) info

A

BRCA1/BRCA2, HER2- cancers

ADE: inc N/Fatigue/anemia/vomiting/HA/D/Dec neuropathic count

34
Q

HR+ HER- therapy

A

Hormonal therapy +/- targeted agents
mTOR inhibitors
CDK4/6 inhibitors
Chemo

35
Q

HR+ HER2+ therapy

A

Hormonal therapy and HER2 directed therapy

36
Q

HR- HER2 therapy

A

chemo and HER2 directed therapy

37
Q

HR- HER2 therapy

A

chemo

38
Q

Hormone therapy info

A

slower onset than chemo
may benefit pts without visceral disease
better tolerated than chemo

39
Q

SERM drugs

A

Tamoxifen
Toremifine
Raloxifene = only prevention

40
Q

SERD drugs

A

Fuvestrant
Elacestrant

41
Q

Drug for pre-menopausal…..

A

Leuprolide
(ovarian ablation or suppression)

42
Q

Drug for post-menopausal…..

A

letrozole

43
Q

CDK4/6 inhibitors…..

A

Palbocciclib (Ibrance)
Ribociclib (Kisqali)
abemaciclib (Verzenio)

44
Q

1st line HR+ disease

A

1.Aromatase inhib + CDK4/6 inhibitors
2. Fulvestrant + exemestane
3. Fulvestrant + CDK4/6 inhibitor

** if premenopausal, req ovarian ablation or suppression **

45
Q

Tamoxifen indications

A

adjutant therapy after surgery
metastatic breast cancer
DCIS- adjuvant to dec risk of invasive disease
Breast cancer prophylaxis in high-risk women

46
Q

Fulvestrant (Faslodex) dosing info

A

Loading dose and then once monthly after

47
Q

Elacestrant (Orserdu) dosing info

A

QD with food

48
Q

Drugs for Ovarian ablation/supression

A

Goserelin (Zoladex) = LHRH agonist
Luprolide = LHRH agonist

or option is surgery

49
Q

Aromatase inhibitor drugs

A

Anastrozole
Letrozole
Exemestane

choose based on safety profile

50
Q

HR+ and HER2+ therapy category 1

A
  1. Pertuzumab + trastuzumab + docetaxel
  2. Trastuzumab + tucatinib + capecitabine
  3. Ado-trastuzumab emtansine
51
Q

Sacituzumab goviteca-hziy (Trodelvy) indication

A

unresectable locally advanced or metastatic TNBC who received 2+ therapies and atleast 1 in metastatic setting

52
Q

Fam-trastuzumab (Enhertu) info

A

txm of unresectable or metastatic HER2+ BC who received 2 or more prior anti HER2 based regimens in metastatic settings

high emetic potential
req ECHO monitoring

CI w/ pneumonitis or ISLD

CDM 4 Exam 3 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions