Ovarian Cancer

Question 1

What genetic mutation is associated with increased risk for ovarian cancer?

Answer 1

BRCA

Question 2

What factors can lead to decreased risk for ovarian cancer? (3)

Answer 2

multiple pregnancies; prolonged use of oral contraceptives; prophylactic oophorectomy

Question 3

Is there an effective screening tool for ovarian cancer?

Answer 3

no

Question 4

How do most patients present with ovarian cancer?

Answer 4

with advanced disease

Question 5

What is the most common presenting symptom for ovarian cancer?

Answer 5

ascites (fluid in the abdomen)

Question 6

What is the general standard first line treatment approach?

Answer 6

surgery + adjuvant chemotherapy

Question 7

What classifies a tumor as optimally debulked?

Answer 7

< 1 cm of disease left

Question 8

What classifies a tumor as sub-optimally debulked?

Answer 8

> 1 cm of disease left

Question 9

What is the adjuvant chemotherapy regimen used in ovarian cancer?

Answer 9

paclitaxel; carboplatin

Question 10

What is the Calvert equation used for?

Answer 10

carboplatin dosing

Question 11

What is the Calvert equation?

Answer 11

AUC x (GFR + 25)

Question 12

When does type I hypersensitivity occur?

Answer 12

after initial contact with the agent

Question 13

When does type IV hypersensitivity occur?

Answer 13

after repeated exposure to the agent

Question 14

How do you treat hypersensitivity reactions to the drug itself?

Answer 14

desensitization

Question 15

How do you treat infusion related reactions?

Answer 15

decrease the infusion rate

Question 16

How do you avoid hypersensitivity reactions due to paclitaxel? (3)

Answer 16

dexamethosone; diphenhydramine; famotidine

Question 17

Is carboplatin hypersensitivity classified as type 1 or type IV?

Answer 17

type IV

Question 18

What medications are used as maintenance therapy after first-line chemotherapy?

Answer 18

PARP inhibitors

Question 19

Which PARP inhibitor is used in patients with a BRCA mutation?

Answer 19

olaparib

Question 20

Which PARP inhibitor is used in patients regardless of BRCA status?

Answer 20

niraparib

Question 21

What are the common toxicities of PARP inhibitors? (2)

Answer 21

fatigue; anemia

Question 22

What should you give a patient who is taking maintenance PARP inhibitors? (2)

Answer 22

supplemental iron; multivitamin

Question 23

Definition: patient relapses > 6 months following completion of their initial platinum regimen.

Answer 23

platinum sensitivie

Question 24

Definition: patient relapses < 6 months following completion of their initial platinum regimen.

Answer 24

platinum resistant

Question 25

What would you give a patient who relapses and is platinum sensitive?

Answer 25

treat with their initial chemotherapy regimen again; most likely platinum + paclitaxel

Question 26

What would you give a patient who relapses and is platinum resistant?

Answer 26

lipsomal doxorubicin