Prostate Cancer Flashcards

1
Q

What are the 5 main Prostate cancer trials? some basics about the trials

A

PLCO, 76000, 55-74
ERSPC 180,000 55-69
Goteborg trial( subgroup analysis of Gottenberg) 20,000- 50-64 years old
CAP 400,000

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2
Q

Findings of PLCO?

A

annual PSA x 7 years

no difference in cancer specific survival

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3
Q

findings of ERSPC?

What about Goteberg?

A

-PSA q 4 years. 20% Relative risk of reduction in mortality
40% difference in mortality
PSA q 2 years

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4
Q

Findings of CAP?

A

no difference in mortality

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5
Q

Criticisms of PLCO

A

high levels of contamination in between arms.

high rates of pre-screening, non-adherence to biopsies

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6
Q

What 2 genes increase overall risk of prostate ca?

A

BRCA 1,2( particularly 2)
HOXB13
lynch syndrome MSH2
HPC( heridatry prostate cancer)

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7
Q

What are some of the risk factors of prostate cancer?

A

Family history, smoking,

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8
Q

What enzymes do finasteride and dutasteride affect?

A

finasteride: blocks type 2 ARI ( skin and prostate )
dutasteride blocks type 1 and 2 ARI
type 1 affects liver and other organs

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9
Q

What are some regulatory genes that are dmanged in prostate ca patients?

A

TP53, SPOP, and more

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10
Q

Describe PCPT trial?

A
Finasteride vs placebo
Examine effects of finasteride in preventing pca
19,000
25% decrease in prostate ca
1.3% increase in high risk porstate ca
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11
Q

Describe REDUCE trial?

A

Dutasteride vs placebo
Examine effects of dutasteride in preventing Pca
8,200
25% decrease in Pca
1% or so increase in high risk prostate ca

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12
Q

Is 5-ARI recommended for prevention of Pca?

A

no, as per FDA it is not . currently no drugs are recommended for chemo-prevention.

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13
Q

Is 5-ARI recommended for prevention of Pca?

A

no, as per FDA it is not . currently no drugs are recommended for chemo-prevention.

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14
Q

What is PSA and What does PSA do ?

A

it is a serum protease that causes seminal fluid liquification. located on long arm of chrmosome 19. humal kalkrein 3. it is produced by prostatic luminal epithelial cells

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15
Q

What is PSMA?

A

prostate specific membrane antigen

on short arm of chromosme 11, deferentially expressed in cancer cells

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16
Q

What is PCA3?

A

prostate cancer antigen 3

found on chromosome 9. it is a urine based test. it is an mRNA.

17
Q

What genes fusions can be assessed to diagnose prostate ca?

A

TMPRSS2, ERG, ETV1. measured in urine. 100% successful at detecting prostate cancer.

18
Q

What is AMACR?

A

alpha-methacyl coenzyme a Racermase
located on chromosome 5. upregulated in prostate cancer tissue. immunostaining is commmonly done on this in pathological analysis.

19
Q

List 3 proteases ti which PSA binds

A

ACT- alpha-1 antichymotrypsin
API- alpha-1 protease inhibitor
A2M- alhpha -2 macroglobulin

20
Q

List 5 blood based prostate cancer biomarkers

A
Total PSA 
Free PSA
PSMA
hK2
Endoglin