Ovarian cancer therapeutics Flashcards
describe the incessant ovulation theory
increased risk of ovarian cancer with increased # of ovulations in one’s lifetime
what are risk factors for ovarian cancer
BRCA 1/2, HNPCC
when do most ovarian cancer patient present
advanced stages
what is the first line approach for ovarian cancer
Surgery + adjuvant chemo therapy
with relapse ovarian cancer what is the treatment
palliative
what is the surgery for ovarian cancer and what are the two groups it is divided in
debulking surgery
optimally debulked < 1cm of disease
sub-optimally debulked > 1cm remaining
can you do a second surgery for ovarian cancer
no, this is not standard of care
what is the chemo regimen for ovarian cancer
paclitaxel + Carboplatin (AUC of 5-7.5)
how is carboplatin dosed in ovarian cancer
AUC x (GFR +25)
what reaction is common with chemo in ovarian cancer
hypersensitivity reactions
what is type 1 hypersensitivity
initial contact with agent (anaphylaxis)
what is type IV hypersensitivity
delayed reaction due to repeated exposure to agent
what are the standard pre-medications for paclitaxel
Dexamethasone
Diphenhydramine
Famotidine
what hypersensitivity is most common with carboplatin
type IV
what drugs can be added and continued after chemo
Bevacizumab
PARP inhibitors
what should be monitored with bevacizumab
HTN and proteinuria
what 3 PARP inhibitors are used in ovarian cancer
olaparib
rucaparib
niraparib
when to offer PARP inhibitors
-BRCA ovarian cancer in combo with other maintenance therapy
-epithelial cancer following chemo
-women treated with bevacizumab + platinum based chemo w/ high grade cancer
what is the main side effect of PARP inhibitors
anemia
what are the types of ovarian cancer recurrence
platinum sensitive: relapse > 6 months after completing platinum regimen
platinum resistance: relapse < 6 months after completing platinum regimen
platinum progressive: no response during chemo
how to treat platinum sensitive ovarian cancer
initial chemo regimen
how to treat platinum resistant ovarian cancer
liposomal doxorubicin
how to treat progressive/refractory ovarian cancer
single-agent non-platinum based chemo
