Prostate Cancer Drugs Flashcards
MOA of goserelin
LHRH analogue disrupts pulsatile release of LHRH therefore causing desensitisation of receptors which results in decreased testosterone and LH after initial tumour flare (give with androgen blockers for first few weeks)
What is triptorelin
LHRH analogue disrupts pulsatile release of LHRH resulting in desensitisation and decreased levels of LH and testosterone after initial tumour flare (give with androgen blockers for first few weeks)
MOA of bicalutamide
Androgen blocker- competes with dihydrotestosterone at receptor level in prostate cancer cells
MOA of cyproterone
Androgen blocker competes with dihydrotestosterone at receptor level in prostate cancer cells
Side effects of hormonal therapies (androgen blockers and LHRH analogues)
Impotence Loss of libido Gynaecomastia Breast tenderness Hot flushes Depression/mood Fatigue
MOA of abiraterone
Irreversible inhibitor of CYP17A1 the enzyme responsible for androgen and cortisol synthesis
Place in therapy of abiraterone
Metastatic prostate cancer not yet indicated for chemo or after failure of hormonal therapies and chemo
Why do you give prednisolone with abiraterone
It reduces cortisol levels which can result in symptoms of cortisol deficiency such as increased BP, hypokalaemia, fluid retention
Side effects of abiraterone
Peripheral oedema Hypokalaemia Hypertension UTI Elevated LFTs
MOA of enzalutamide
1) inhibits binding of androgens to androgen receptors
2) inhibits nuclear translocation of activated receptors
3) inhibits association of activated androgen receptor with DNA
Place in therapy of enzalutamide
Metastatic prostate cancer not yet indicated for chemo also for metastatic prostate cancer where disease has progressed following docetaxel therapy
Side effects of enzalutamide
Headache Hot flushes Memory problems Visual hallucinations Risk of seizures
Chemo used in metastatic prostate cancer
Docetaxel + prednisolone
When do you use chemo in prostate cancer
Hormone refractory metastatic prostate cancer
