Sweatman Bladder Cancer and Ovarian Cancer

Question 1

serum marker used to monitor the course (activity/progression) of ovarian cancer

Answer 1

CA 125

–> not very good diagnostically

Question 2

unique mode of delivery of drug available for ovarian cancer with peritoneal seeding

Answer 2

IntraPeritoneal instillations

_decrease rate of buildup of the ascites

Question 3

first options for ovarian cancer with/without seeding

Answer 3

High volume IP cisplatin

Question 4

IP admin benefits

Answer 4

allows higher dose

• more frequent administration
• appears more effective

Question 5

adjuvant therapy following cisplatin
STAGE 1 and 2
(confined to one or both ovaries/ spread to pelvis)

Answer 5

IV Carboplatin/cisplatin

include Cyclophosphamide
and or Doxorubicin

Question 6

Adjuvant therapy stage 3-4

Answer 6

IV carboplatin/cisplatin with paclitaxel

Question 7

targetted therapies for ovarian CA

Answer 7

none

Question 8

Administration of IP dosing

Answer 8

• only for locally confined disease
• > 1-2 L retained for 2 hours then drained off
• pateint supine rotated from side to side to ensure adequate coverage

Question 9

bladder cancer mutations

Answer 9

FGFR3
HRAS
Chromosome 9 (with a shit tone of shit)

Question 10

highest risk factor for developing bladder cancer

Answer 10

long history of smoking

Question 11

most common presenting symptom of bladder cancer

Answer 11

hematuria

*likely microscopic not gross)

Question 12

main cell type incolved in 70% of bladder cancers

Answer 12

urothelial

70% are superficial on presentation

Question 13

drugs most commonly used for intravesical instillation

Answer 13

Mitomycin
BCG
Thiotepa (less common)

Question 14

progression of therapy in Bladder cancer pt.’s

Answer 14

1. TURBC
2. Intravessicular Mitomycin/ IVe BCG/other
3. Chemo-radiation or systemic therapy
4. cystectomy

Question 15

activity of BCG requires

Answer 15

intact immune system

Question 16

MOA for BCG (bacillus calmette Guerin)

Answer 16

Binds urothelium, activates APC’s, Induces host CTLs, NK’s, AK,’s, BAK’s
>for 6 weeks
>immune response detected wihtin hours and lassts for days

Question 17

lipophillic small MW drug that can penetrate urothelial tissue

Answer 17

Thiotepa

Question 18

most drugs in tx of bladder cancer are….

Answer 18

alkylating agents

Question 19

forms DNA intrastrand corss links

Answer 19

Cisplatin and Carboplatin

Question 20

Pro-Drug of alkylating moiety

Answer 20

Cyclophosphamide

Question 21

intercolator, free radical generator and topo II inhibitor

Answer 21

Doxorubicin

Question 22

Mono and Bi functional alkylating agents

Answer 22

mitomycin C

Question 23

microtubule stabilizer inhibiting depolymerization

Answer 23

Paclitaxel

Question 24

polyfunctional alkylator with loss of aziridine moeity

Answer 24

Thiotepa

remaininig moeity forms DNA cross links

Question 25

nephrotoxicity

Answer 25

cisplatin

Question 26

ototoxicity (tinnitis and occasional defaness)

Answer 26

cisplatin

Question 27

dose limiting myelosupression

Answer 27

cisplatin and carboplatin

doxorubicin

Question 28

hemorrhagic cysititis, anemia/infection, amenorrhea/infertility,

Answer 28

cyclophosphamide

Question 29

monitor for secondayr malignancies

Answer 29

cyclophosphamide

doxorubicin

Question 30

Blood dyscrasias

Answer 30

cyclophosphamide

Question 31

mesna is protective

Answer 31

cyclophosphamide

Question 32

CHF

Answer 32

doxorubicin

Question 33

extravasational necrosis

Answer 33

doxorubicin

Question 34

IVe issues with Mitomycin

Answer 34

• chemical cystitis

- dermatitis & palmar/plantar erythema

Question 35

IVe issues with Thiotepa

Answer 35

dysuria, urinary retention, chemical/hemorrhagic cystitis

Question 36

IVe drug also capable of causing pulmonary infiltrates, Dyspnea, dry cough

Answer 36

Mitomycin