Ovarian Cancer Flashcards
What genetic mutation is associated with increased risk for ovarian cancer?
BRCA
What factors can lead to decreased risk for ovarian cancer? (3)
multiple pregnancies; prolonged use of oral contraceptives; prophylactic oophorectomy
Is there an effective screening tool for ovarian cancer?
no
How do most patients present with ovarian cancer?
with advanced disease
What is the most common presenting symptom for ovarian cancer?
ascites (fluid in the abdomen)
What is the general standard first line treatment approach?
surgery + adjuvant chemotherapy
What classifies a tumor as optimally debulked?
< 1 cm of disease left
What classifies a tumor as sub-optimally debulked?
> 1 cm of disease left
What is the adjuvant chemotherapy regimen used in ovarian cancer?
paclitaxel; carboplatin
What is the Calvert equation used for?
carboplatin dosing
What is the Calvert equation?
AUC x (GFR + 25)
When does type I hypersensitivity occur?
after initial contact with the agent
When does type IV hypersensitivity occur?
after repeated exposure to the agent
How do you treat hypersensitivity reactions to the drug itself?
desensitization
How do you treat infusion related reactions?
decrease the infusion rate
How do you avoid hypersensitivity reactions due to paclitaxel? (3)
dexamethosone; diphenhydramine; famotidine
Is carboplatin hypersensitivity classified as type 1 or type IV?
type IV
What medications are used as maintenance therapy after first-line chemotherapy?
PARP inhibitors
Which PARP inhibitor is used in patients with a BRCA mutation?
olaparib
Which PARP inhibitor is used in patients regardless of BRCA status?
niraparib
What are the common toxicities of PARP inhibitors? (2)
fatigue; anemia
What should you give a patient who is taking maintenance PARP inhibitors? (2)
supplemental iron; multivitamin
Definition: patient relapses > 6 months following completion of their initial platinum regimen.
platinum sensitivie
Definition: patient relapses < 6 months following completion of their initial platinum regimen.
platinum resistant
What would you give a patient who relapses and is platinum sensitive?
treat with their initial chemotherapy regimen again; most likely platinum + paclitaxel
What would you give a patient who relapses and is platinum resistant?
lipsomal doxorubicin
