Treatment of prostate cancer

Question 1

GnRH agonists

Answer 1

Goserelin, Histrelin, leoprolide, triptorelin

Question 2

GnRH agonist adverse effects

Answer 2

decreases bone density, increases serum lipids, weight gain, HTN, diabetes, increased risk of CVD; sexual dysfunction, gynecomastia, and loss of libido
surge in bone pain for a short period if there are bony metastases

Question 3

Degarelix moa

Answer 3

GnRH antagonism, reducing FSH and LH secretion

Question 4

degarelix adverse effects

Answer 4

QT prolongation and increased hepatic enzymes; hypoandrogenic - hot sweats, weight gain, fatigue, impotence

Question 5

estramustine moa

Answer 5

binds EMBP on prostate cancer and delivers the alkylator which function as a microtubule inhibitor

Question 6

estramustine adverse effects

Answer 6

estrogenic effects - gynecomastia, mastalgia, impotence,

edema, thromboembolims, MI, PE, and stroke, increased hepatic enzymes

Question 7

androgen receptor blockers

Answer 7

bicalutamide, enzalutamide, flutamide, nilutamide

Question 8

prostate > central AR block

Answer 8

bicalutamide

Question 9

Prostate and central AR block

Answer 9

enzalutamide and nilutamide

Question 10

prostate only AR block

Answer 10

flutamide

Question 11

enzalutamide adverse effects

Answer 11

CNS effects and URTI

Question 12

flutamide adverse effects

Answer 12

BBW: hepatotoxicity

blood dyscrasias

Question 13

nilutamide adverse effects

Answer 13

BBW: respiratory problems

heart failure, hypertension, blood dyscrasia, increased transit time from light to dark

Question 14

Sipuleucel-T moa

Answer 14

autologous cellular immunotherapy designed to stimulate T cell immunity against prostatic acid phosphatase

Question 15

sipuleucel-T adverse effects

Answer 15

paresthesias, infusion reaction, citrate toxicity

Question 16

abiraterone moa

Answer 16

inhibitor of 17-alpha hydroxyls (CYP17)

Question 17

abiraterone adverse effects

Answer 17

increased hepatic enzymes, Category X, produces an increased mineralocorticoid state, leading to HTN, fluid retention, and hypokalemia