Ovarian cancer therapeutics Flashcards

1
Q

describe the incessant ovulation theory

A

increased risk of ovarian cancer with increased # of ovulations in one’s lifetime

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2
Q

what are risk factors for ovarian cancer

A

BRCA 1/2, HNPCC

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3
Q

when do most ovarian cancer patient present

A

advanced stages

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4
Q

what is the first line approach for ovarian cancer

A

Surgery + adjuvant chemo therapy

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5
Q

with relapse ovarian cancer what is the treatment

A

palliative

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6
Q

what is the surgery for ovarian cancer and what are the two groups it is divided in

A

debulking surgery
optimally debulked < 1cm of disease
sub-optimally debulked > 1cm remaining

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7
Q

can you do a second surgery for ovarian cancer

A

no, this is not standard of care

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8
Q

what is the chemo regimen for ovarian cancer

A

paclitaxel + Carboplatin (AUC of 5-7.5)

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9
Q

how is carboplatin dosed in ovarian cancer

A

AUC x (GFR +25)

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10
Q

what reaction is common with chemo in ovarian cancer

A

hypersensitivity reactions

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11
Q

what is type 1 hypersensitivity

A

initial contact with agent (anaphylaxis)

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12
Q

what is type IV hypersensitivity

A

delayed reaction due to repeated exposure to agent

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13
Q

what are the standard pre-medications for paclitaxel

A

Dexamethasone
Diphenhydramine
Famotidine

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14
Q

what hypersensitivity is most common with carboplatin

A

type IV

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15
Q

what drugs can be added and continued after chemo

A

Bevacizumab
PARP inhibitors

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16
Q

what should be monitored with bevacizumab

A

HTN and proteinuria

17
Q

what 3 PARP inhibitors are used in ovarian cancer

A

olaparib
rucaparib
niraparib

18
Q

when to offer PARP inhibitors

A

-BRCA ovarian cancer in combo with other maintenance therapy
-epithelial cancer following chemo
-women treated with bevacizumab + platinum based chemo w/ high grade cancer

19
Q

what is the main side effect of PARP inhibitors

A

anemia

20
Q

what are the types of ovarian cancer recurrence

A

platinum sensitive: relapse > 6 months after completing platinum regimen
platinum resistance: relapse < 6 months after completing platinum regimen
platinum progressive: no response during chemo

21
Q

how to treat platinum sensitive ovarian cancer

A

initial chemo regimen

22
Q

how to treat platinum resistant ovarian cancer

A

liposomal doxorubicin

23
Q

how to treat progressive/refractory ovarian cancer

A

single-agent non-platinum based chemo