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703 > Prostate Cancer > Flashcards

Prostate Cancer Flashcards

1
Q

Which major cell type is responsible for a vast majority of prostate cancer cases?

A

Adenocarcinoma

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2
Q

What are risk factors for prostate cancer?

A
  • African American
  • Age >65
  • Men with 1st generation relative who had prostate cancer
  • BRCA-2 mutation
  • Lynch syndrome
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3
Q

What are some advanced disease complications of prostate cancer?

A
  • Back pain
  • Cord compression
  • Lower-extremity edema
  • Pathologic fractures
  • Anemia
  • Weight loss
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4
Q

What are prognostic factors of prostate cancer?

A
  • PSA
  • Tumor size
  • Histologic grade (Gleason score)
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5
Q

T/F: A high PSA is diagnostic of prostate cancer

A

FALSE: other markers are required

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6
Q

What are the three parts of the staging system for prostate cancer testing?

A
  • Tumor
  • Node
  • Metastasis
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7
Q

After trying castration, what treatment options do we have for metastatic adenocarcinoma prostate cancer?

A
  • Abiraterone
  • Docetaxel x 6 cycles
  • Enzalutamide
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8
Q

What is the gold standard for advanced prostate cancer?

A

Androgen deprivation therapy
- Surgical castration (bilateral orchiectomy)
- Medical castration (luteinizing hormone receptor modulators)

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9
Q

What is the goal serum testosterone of LHRH therapy after 1 month?

A

<50 ng/dL

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10
Q

What are the LHRH agonists?

A
  • Goserelin
  • Leuprolide
  • Triptorelin
  • Histrolin
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11
Q

What are acute ADEs of LHRH agonists?

A
  • Tumor flare
  • Hot flashes
  • ED
  • Edema
  • Gyno
  • Injection site reactions
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12
Q

What are long-term ADEs of LHRH agonists?

A
  • Osteoporosis
  • Fracture
  • Obesity
  • Diabetes
  • CV events
  • HLD
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13
Q

What supplementation should be given with LHRH agonists?

A
  • Vitamin D
  • Calcium
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14
Q

What are the LHRH antagonist drugs?

A
  • Degarelix
  • Relugolix
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15
Q

What are the first generation antiandrogens?

A
  • Bicalutamide
  • Flutamide
  • Nilutamide
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16
Q

What should be monitored while a patient is on antiandrogens?

A
  • LFTs*
  • Testosterone
  • PSA
  • Pulmonary function
17
Q

What are the second generation antiandrogens?

A
  • Apalutamide
  • Enzalutamide
  • Darolutamide
18
Q

T/F: Patients on androgen blockade therapy typically relapse within 2-4 years

A

TRUE

19
Q

Which treatment has significant benefit for patients with high-risk castration-sensitive prostate cancer?

A

ADT + Abiraterone or Apalutamide or Enzalutamide

20
Q

Which treatment improves survival for patients with high-volume castration-sensitive metastatic prostate cancer fit for chemotherapy?

A

ADT + Docetaxel + Abiraterone or Darolutamide

21
Q

What defines castration-resistant prostate cancer?

A

Serum testosterone <50 ng/dL with continued disease progression

22
Q

When is hormonal therapy strongly recommended in castration-resistant non-metastatic prostate cancer?

A

If PSA doubling time is <10 months

23
Q

What treatment can be used for M1 CRPC (PSADT <10mo) and involves an androgen metabolism inhibitor?

A

Abiraterone with prednisone or methylprednisolone

24
Q

When does apalutamide need to be IMMEDIATELY discontinued?

A

If a seizure occurs during treatment

25
Q

Which 2nd generation antiandrogen needs to be given with food?

A

Darolutamide

26
Q

What are the preferred regimens for M1 CRPC with no prior docetaxel and no prior hormone therapy?

A
  • Abiraterone
  • Docetaxel
  • Enzalutamide
27
Q

What are the preferred regimens for M1 CRPC with no prior docetaxel, but prior novel hormonal therapy?

A
  • Docetaxel
  • Olaparib or rucaparib (BCRA mutation)
28
Q

What are the preferred regimens for M1 CRPC with no prior novel hormonal therapy, but prior docetaxel?

A
  • Abiraterone
  • Cabazitaxel
  • Enzalutamdie
29
Q

What are the preferred regimens for M1 CRPC with prior novel hormonal therapy and prior docetaxel?

A
  • Cabazitaxel
  • Docetaxel rechallenge
30
Q

What treatment can be considered for patients with visceral metastases?

A

Docetaxel

31
Q

What treatment can be considered for patients with minimal-to-no symptoms, no liver metastases, life expectancy >6 months, and ECOG performance status

A

Sipuleucel-T

32
Q

What are ADEs of docetaxel?

A
  • Alopecia
  • Edema
  • Peripheral neuropathy
  • Hypersensitivity reaction
  • Myelosuppression
33
Q

Why are steroids used with abiraterone?

A

To minimize the mineralocorticoid excess

34
Q

T/F: Zytiga and Yonsa have a 1:1 dose conversion

A

FALSE

35
Q

Which CRPC treatment is a PARP inhibitor that can cause neutropenia and cancer?

A

Olaparib

36
Q

When is radium-223 used?

A

Symptomatic bone metastases WITHOUT visceral metastases prior to and after docetaxel therapy

37
Q

What is Lu-177 approved for?

A

PSMA-positive M1 CRPC

38
Q

What drugs can be used to prevent skeletal-related events in PC due to metastases?

A
  • Zoledronic acid
  • Denosumab

703 (12 decks)

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