Miscellaneous Treatments for Breast Cancer Flashcards
What is the MOA of Goserelin?
Goserelin is a GnRH agonist.
Why is a GnRH agonist used for Estrogen+ breast cancer?
Normally pulsatile GnRH stimulates estrogen production. However, continuous GnRH will downregulate pituitary GnRH receptors. This will in turn cause a decrease of FSH and LH –> decreased estrogen.
What is the timeframe of effects with goserelin?
There is an initial disease flare followed by reduction of estrogen in about 2-4 weeks.
What is the ADME of Goserelin?
Well tolerated
SC injection 1x per month
What adverse effects are associated with Goserelin?
PM like Sx: HA, N/V, edema, lethargy, anorexia
Decreased bone density
What is mTOR?
mTOR is a transcription factor that regulates cell proliferation, angiogenesis, and cell metabolism
What is MOA Everolimus?
Everolimus is an mTOR inhibitor that blocks the binding of mTOR to FKBP-12 thus blocking downstream signaling.
When is Everolimus used?
Everolimus is used in advanced ER+, HER2- tumors.
How is Everolimus metabolized?
Doesn’t say specifically but it does inhibit
CYP 3A4
CYP 2D6
P-gp
What is the BBW for Everolimus?
Opportunistic infections
Secondary malignancy
What are the adverse effects associated with Everolimus?
Pneumonitis
Blood dyscrasias
Hyperglycemia, Hyperlipidemia
Increased LFTs and Creatinine
What should be monitored in a patient taking everolimus?
CBC
LFTs, bilirubin
Creatinine
Lipids, phosphate,
What is the prognosis for triple negative breast cancer?
Very poor because there are no targeted treatments
What is the general treatment plan for Triple negative breast cancer?
Typically some combination of Cyclophosphamide, doxorubicin, docetaxel, and 5-FU.
What is the prognosis for PR+ breast cancer?
PR+ breast cancer has a good prognosis
