Ovarian Cancer Flashcards

1
Q

In 58% of cases the cancer has metastasized

a. true
b. false

A

a. true

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2
Q

Age >= __ is a risk factor for ovarian cancer

A

70

also menopause is a risk factor

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3
Q

Late pregnancy >= __ years old is a risk factor for ovarian cancer

A

35

also nulliparity and ovarian stimulation with in-vitro fertilization are risk factors

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4
Q

A family history of breast cancer is a risk factor for ovarian cancer

a. true
b. false

A

a. true

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5
Q

Estrogen without progesterone for >= __ years is a risk factor for ovarian cancer

A

10

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6
Q

Which makes up most ovarian cancer?

a. epithelial adenocarcinoma
b. germ cell tumors
c. sex cord stromal tumors
d. metastatic

A

a. epithelial adenocarcinoma

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7
Q

What grade is poorly differentiated?

a. grade 1
b. grade 2
c. grade 3

A

c. grade 3

Grade 1: well differentiated
Grade 2: moderately differentiated
Grade 3: poorly differentiated

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8
Q

There is no effective screening for ovarian cancer

a. true
b. false

A

a. true

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9
Q

Use of oral contraceptives >= __ years is preventative for ovarian cancer

A

5

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10
Q

Breastfeeding for how long is preventative for ovarian cancer?

A

> 1 year

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11
Q

What laboratory marker is indicative of ovarian cancer?

A

CA-125

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12
Q

Optimal cytoreduction with surgery is < __cm residual

A

1

suboptimal is > 1cm residual

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13
Q

When to consider neoadjuvant chemotherapy?

A

for bulky stage III-IV if optimal cytoreduction not likely or poor surgical candidate

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14
Q

Ovarian cancer chemo consists of what taxanes and platinums?

A

paclitaxel or docetaxel + carboplatin or cisplatin

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15
Q

___ may be added to paclitaxel + carboplatin for stage I-IV adjuvant?

A

bevacizumab

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16
Q

Pegylated liposomal doxorubicin frequency?

A

q4 weeks

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17
Q

Regimens with paclitaxel or docetaxel + carboplatin frequency?

A

q3 weeks

18
Q

What AUC is moderate emetic risk with carboplatin?

A

< 4

> = 4 is high

19
Q

How is carboplatin dosed?

A

using Calvert formula (AUC)

total dose = target AUC x (GFR + 25)

20
Q

Up to 44% of pts on carboplatin have hypersensitivity reactions.

a. true
b. false

A

a. true

21
Q

Bevacizumab dosing is by __

a. AUC
b. mg/kg

A

b. mg/kg

first dose infused over 90 mins; 2nd dose 60mins; 3rd dose 30mins

22
Q

Hold bevacizumab for __ weeks before debunking to decrease post-op complications

A

6

23
Q

Bleeding and decreased wound healing is initiated in which cycle of bevacizumab?

A

cycle 2

24
Q

Monitor what throughout bevacizumab therapy?

A

urine protein

25
Q

Intraperitoneal chemo is used for what age?

A

<=65

26
Q

Intraperitoneal chemo is used for what stage ovarian cancer?

A

stage III (< 1cm residual)

27
Q

Aggressive __ regimens should be given before intraperitoneal therapy

a. oral/IV hydration
b. anti-emetic
c. a and b

A

c. a and b

aggressive hydration is given before and after

28
Q

IP chemo schedule modification to __ hours decreases toxicity

A

3

29
Q

Olaparib is given with what other drug if utilized in primary maintenance therapy?

A

bevacizumab

30
Q

Bevacizumab should not be continued if utilized in primary therapy if no progression

a. true
b. false

A

b. false

may be continued

31
Q

What is recurrent treatment dictated by?

A

duration of first remission

duration of first remission
platinum sensitivity
prior toxicities
convenience 
QOL
insurance

first remission is always the longest

32
Q

Recurrent ovarian cancer:

Platinum sensitive pts need platinum free interval of > __ months

A

6

platinum resistant < 6 months
platinum refractory: no response on platinum therapy

33
Q

Tumor molecular testing is recommended prior to initiation of recurrent ovarian cancer therapy

a. true
b. false

A

a. true

BRCA 1/2 and micro satellite instability (MSI) or DNA mismatch repair (MMR)

34
Q

Treatment for platinum resistant/refractory recurrent ovarian cancer?

A

liposomal doxorubicin +/- bevacizumab

Also:

  • paclitaxel +/- bevacizumab
  • topotecan +/- bevacizumab
  • docetaxel
  • etoposide oral
  • gemcitabine
35
Q

Treatment for platinum sensitive recurrent ovarian cancer?

A

carboplatin/gemcitabine +/- bevacizumab

Also:

  • carboplatin/paclitaxel +/- bevacizumab
  • carboplatin/liposomal doxorubicin +/- bevacizumab
36
Q

The PARP inhibitors are targeted therapy for both platinum sensitive and resistant ovarian cancer

a. true
b. false

A

a. true

37
Q

Recurrent Tx options:

Olaparib is FDA indicated after >= __ lines of prior chemotherapy BRCA germline

A

3

Rucaparib >= 2
niraparib >= 3

38
Q

Patients who achieve partial response or complete response to platinum based therapy should receive a PARP inhibitor regardless of BRCA status

a. true
b. false

A

a. true

olaparib
rucaparib
niraparib

39
Q

___ is olaparib toxicity

a. hypertension
b. palpitations
c. hypercholesterolemia
d. pneumonitis

A

d. pneumonitis

40
Q

___ is niraparib toxicity

a. hypertension
b. palpitations
c. hypercholesterolemia
d. pneumonitis

select two

A

a, b

41
Q

__ is rucaparib toxicity

a. hypercholesterolemia
b elevates AST/ALT
c. pneumonitis
d. hypertension

select two

A

a, b

42
Q

Surgery is standard of care for all stages of ovarian cancer

a. true
b. false

A

a. true