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7361 Hem/Onc Block 3 > Prostate Cancer > Flashcards

Prostate Cancer Flashcards

1
Q

Prostate specific antigen (PSA) is specific for cancer

a. true
b. false

A

b. false

specific to the prostate, not for cancer

glycoprotein produced by epithelial cells of the prostate

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2
Q

Normal PSA level is < __ ng/mL

A

4

Levels > 10 ng/mL has 67% positive biopsy

levels 4-10 ng/mL have 30-35% positive

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3
Q

The ___ score ranges from 1-5 and describes how much the cancer from a biopsy looks like healthy tissue or abnormal tissue (higher score)

A

Gleason

most cancers score a grade of 3 or higher

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4
Q

What oral antiandrogen is for both castrate sensitive and castrate-resistant metastatic prostate cancer?

A

enzalutamide

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5
Q

Which BRCA drug requires renal dosing

A

olaparib

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6
Q

What chemotherapy agent is only used in prostate cancer?

A

cabazitaxel

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7
Q

___ is radiation delivered directly to the prostate

A

brachytherapy

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8
Q

___ is the most common first generation antiandrogen

A

bicalutamide

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9
Q

What drug has the brand names Lupron or Eligard?

A

leuprolide

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10
Q

What is the newest FDA approved drug for prostate cancer?

A

Relugolix

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11
Q

What is the preferred initial therapy for low risk disease with life expectancy < 10 years?

A

observation

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12
Q

Radium 223 is useful in pts with __ disease to the bones.

A

metastatic

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13
Q

Abiraterone, docetaxel, cabazitaxel, and mitoxantrone are given along with ___

A

prednisone

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14
Q

Which drug has less risk for falls?

A

darolutamide

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15
Q

__ is a tumor marker monitored during active surveillance

A

PSA

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16
Q

What drug is only for MSI-H/dMMR?

A

pembrolizumab

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17
Q

LHRH ___ avoid tumor flares

a. agonists
b. antagonists

A

b. antagonists

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18
Q

What drug is taken on an empty stomach?

A

abiraterone

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19
Q

Triptorelin is a LHRH ___

a. agonist
b. antagonist

A

a. agonist

20
Q

___ is preferred in very low risk disease with life expectancy > 20 years, and low risk with life expectancy > 10 years

a. observation
b. active surveillance

A

b. active surveillance

actively monitor disease; if cancer progresses potentially curative therapy considered

PSA every 6 months
DRE every 12 months
repeat biopsies every 12 months

21
Q

With observation if symptomatic use ___ therapy

a. curative
b. palliative

A

b. palliative

repeat biopsy not recommended

PSA and DRE every 6 months

Advantage: avoid immediate morbidity associated with treatment

22
Q

4 LHRH agonists:

A

goserelin
leuprolide
triptorelin
histrelin

23
Q

Most commonly used first generation antiandrogen?

A

bicalutamide

3 first gen anti androgens:

  • flutamide
  • bicalutamide
  • nilutamide

not used as monotherapy

24
Q

2 LHRH antagonists:

A
  • degarelix
  • relugolix

faster drop of testosterone levels: < 50 by 7 days

avoids tumor flare, no need for anti-androgen therapy
lower risk of CV incidents

25
Q

Preferred regimens for metastatic castration naive include ___

A

androgen deprivation therapy + apalutamide, enzalutamide, abiraterone, or docetaxel 75mg/m2 x 6 cycles

26
Q

Docetaxel is given every __ days

A

21

M-phase cell cycle specific

27
Q

3 first generation anti androgens?

A
  • bicalutamide
  • flutamide
  • nilutamide
28
Q

3 second generation anti androgens?

A
  • apalutamide
  • enzalutamide
  • darolutamide

inhibit androgen biosynthesis: CYP17 inhibitors

29
Q

Which 2nd generation anti-androgen should be taken on an empty stomach?

A

abiraterone

Toxicities:

  • LFT elevations
  • increased blood pressure
  • edema
30
Q

What is preferred Tx for non-metastatic castrate resistant prostate cancer on PSADT > 10 months?

A

observation

31
Q

What drug class is used to Tx non-metastatic castrate resistant prostate cancer with PsADT <= 10 months ?

A

2nd generation anti-androgens

apalutamide
enzalutamide
darolutamide

32
Q

What Tx is preferred for metastatic castrate resistant prostate cancer with prior docetaxel use and NHT?

A

cabazitaxel

33
Q

What Tx is preferred for metastatic CRPC if no prior docetaxel or novel hormone therapy?

A

docetaxel, abiraterone, enzalutamide

34
Q

4 novel hormone therapies?

A

abiraterone
enzalutamide
apalutamide
darolutamide

35
Q

Which novel hormone therapy should be taken with food?

A

darolutamide

36
Q

Which novel hormone therapy inhibits androgen synthesis?

a. abiraterone
b. enzalutamide
c. apalutamide
d. darolutamide

A

a. abiraterone

37
Q

What is a biomarker for resistance to NHT (enzalutamide and abiraterone)?

A

androgen receptor splice variant 7 (AR-V7)

AR-VT + mCRPC will have better outcomes if treated with taxanes

38
Q

2 immunotherapies for metastatic castrate resistant prostate cancer (mCRPC)?

A

sipuleucel-T

pembrolizumab

39
Q

Which mCRPC immunotherapy is indicated if asymptomatic/minimally symptomatic?

a. sipuleucel-T
b. pembrolizumab

A

a. sipuleucel-T

40
Q

Which mCRPC immunotherapy is indicated if MSI-H or dMMR?

a. sipuleucel-T
b. pembrolizumab

A

b. pembrolizumab

41
Q

What Tx is used for symptomatic bone metastasis?

A

radium 223

regardless if prior docetaxel or not

42
Q

___ is a taxane derivative that binds to tubulin and inhibits microtubule depolymerization

A

cabazitaxel

reserved for after failing docetaxel

43
Q

What drug is used for palliation of symptoms in pts who cannot tolerate other therapies?

A

mitoxantrone

cardiotoxicity
no improvement in survival

44
Q

Cabazitaxel causes significant __ and diarrhea

A

neutropenia

45
Q

Which PARP inhibitor is used for HRR gene mutated mCRPC?

a. olaparib
b. rucaparib

A

a. olaparib

46
Q

Which PARP inhibitor is used for BRCA + mCRPC?

a. olaparib
b. rucaparib

A

b. rucaparib

7361 Hem/Onc Block 3 (9 decks)

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