Oncology Types/Tx Flashcards
1
Q
Complete vs Partial Response
A
- Complete: elimination of all known tumors
- Partial: at least 30% of tumor was eliminated
2
Q
Types of Treatment
A
- Primary: often surgery, focused locally on main tumor
- Neoadjuvant: before surgery to shrink tumor (radiation or chemo)
- Adjuvant: given after surgery to eradicate residual disease (radiation or chemo)
3
Q
Breast Cancer Risk Factors
A
- Being female
- Overweight
- Low Physical Activity
- Poor Nutrition
- Tobacco Use
4
Q
Breast Cancer Tx Options
A
- Premenopausal women: Tamoxifen (SERM) is first-line
- AI: block conversion of androgens to estrogen, only an option for postmenopausal women
- Raloxifene: SERM for breast cancer prophylaxis (also osteoporosis benefits
- Some premenopausal women will be put into menopause by GnRH agonists to make AI a reasonable tx option
5
Q
Tamoxifen
A
- Oral SERM used for breast cancer in premenopausal women
- Metabolized by CYP2D6, caution in slow metabolizers (less effective) and don’t use with inhibitors
- Venlafaxine preferred for hot flashes/night sweats relief
- Decreases bone density, supplement with Vitamin D/Calcium
- Teratogenic
- Take w/o regards to food
6
Q
Raloxifene
A
- Oral SERM used for breast cancer prophylaxis in POSTmenopausal women
- Also indicated for osteoporosis
7
Q
SERM Information
A
- Box warning: increased risk for uterine/endometrial cancer, thromboembolic events
- SE: Hot flashes, night sweats, vaginal bleeding/spotting, vaginal discharge, dryness, pruritis, decreased libido
8
Q
Fulvestrant
A
- IM SERD (selective estrogen receptor degrader)
- Receptor degradation/downregulation
- SE: Increased LFT, inj site pain, hot flashes
9
Q
Arimidex
A
- Anastrozole
- Aromatase Inhibitor
- Higher risk of osteoporosis and CVD
- SE: hot flashes, night sweats, arthralgia, myalgia
- Take w/o regards to food
10
Q
Prostate Cancer Treatment
A
- Primary therapy: androgen deprivation therapy by hormonal tx
- Can be with a GnHR antagonist alone or an agonist+antagonists combination regimen
- AE: Impotence, weakness, hot flashes, loss of bone density
11
Q
Antiandrogens
A
- First generation are ONLY used in combination with GnHR agonist
- Second generations can be used monotherapy
- GnHR antagonists also have an osteoporosis risk (supplement), but no tumor flare (no antiandrogen needed)
12
Q
GnHR Agonist
A
- Leutinizing hormone-releasing hormone (LHRH) agonists that decreases testosterone production
- Can cause initial sxs of “tumor flare” (bone pain, difficulty urinating), therefore give with antiandrogen for first few weeks
- SE: Hot flashes, impotence, gynecomastia, bone pain
13
Q
Lupron Depot
A
- Leuprolide
- GnHR Agonist
- Decreases bone density: supplement with Vitamin D/Calcium
- Give with antiandrogen to reduce tumor flare
14
Q
Zoladex
A
- Goserelin
- GnHR Agonist
- Decreases bone density: supplement with Vitamin D/Calcium
- Give with antiandrogen to reduce tumor flare
15
Q
Cell-Cycle Independent Agents
A
- Alkylating agents: cyclophosphamide, ifosfamide, carmustine, busulfan
- Platinum-based compounds: “-platin”
- Anthracyclines: doxorubicin, mitoxatrone
