Prostate Cancer

Question 1

What is the Gleason score?

Answer 1

-grades of the growth pattern of the tumor; chance of recurrance
2-4 are slow growing, well differentiated
8-10 are aggressive, poorly differentiated

Question 2

What is the treatment of choice for localized prostate cancer?

Answer 2

-external beam radiation therapy
+/- ADT if higher risk
-surgery (radical prostatectomy or orchiectomy)

Question 3

what are the LHRH agonist toxicities?

Answer 3

cv events, osteoporosis, insulin resistance

Question 4

What are the anti-androgen medications?

Answer 4

Darolutamide, Abiraterone, Enzalutamide, apolutamide
-AE’s include diarrhea, hematuria

Question 5

What is the treatment for m1 HSPC low volume metastatic disease?

Answer 5

LHRH agonist (leuprolide, goserelin, triptorelin, histerelin) or antagonist
- can add in either enzalutamide, apalutamide, abiraterone + Prednisone (CYP17 inhibitor)

Question 6

What agent has the least toxicities between enzalutamide, apalutamide, or darolutamide?

Answer 6

Darolutamide
-less fractures, seizures, weight loss

Question 7

What is the treatment for m1HSPC high volume metastatic disease?

Answer 7

docetaxel + ADT + abiraterone/darolutamide
-2nd line consider Cabazitaxel +prednisone

Question 8

What can help treat bone metastases?

Answer 8

radium 223 dichloride, Lu-177 PSMA

Question 9

When is pembrolizumab indicated in prostate cancer?

Answer 9

dMMR or MSI-H characteristics

Question 10

What is the treatment indicated for M0 CRPC?

Answer 10

ADT + enzalutamide, apalutamide, darolutamide

Question 11

What medication does not have an indication for M0 CRPC?

Answer 11

Abiraterone