Therapeutics - Prostate Cancer 2

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Author:
kyleannkelsey
ID:
301921
Filename:
Therapeutics - Prostate Cancer 2
Updated:
2015-05-01 15:00:24
Tags:
Therapeutics Prostate Cancer
Folders:
Therapeutics - Prostate Cancer
Description:
Therapeutics - Prostate Cancer
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  1. What are the SE of LH-RH antagonists (Degarelix/Firmagon)?
    • Injection site reactions
    • Increased LFTs
    • OP
  2. What are the benefits of LH-RH antagonists?
    • Castrate levels of testosterone achieved in 7 days
    • No tumor flare
  3. How long does it take to achieve Castrate levels of testosterone with an LH-RH AGONIST?
    28 days
  4. What is the biggest problem with LH-RH ANTagonists?
    Cost
  5. Should you suggest combined androgen blockade?
    • Only modest benefit for large expense
    • Those that are most likely to benefit:
    • Minimal disease
    • Prevention of tumor flare desired
    • If testosterone is not <50 ng/mL after several months on LH-RH monotherapy
  6. In what part of the disease process are LH-RH ANTagonists used?
    Castrate sensitive metastatic disease
  7. What is the initial therapy for Castrate-resistant metastatic prostate cancer?
    • Abiraterone (Zytiga)
    • Docetaxel
    • Enzalutamide (Xtandi)
    • Sipuleucel-T (Provenge)
  8. What is the brand name for Abiraterone?
    Zytiga
  9. What is the brand name for Enzalutamide?
    Xtandi
  10. What is the brand name for Sipuleucel-T?
    Provenge
  11. What is the generic name for Zytiga?
    Abiraterone
  12. What is the generic name for Xtandi?
    Enzalutamide
  13. What is the generic name for Provenge?
    Sipuleucel-T
  14. When is Abiraterone (Zytiga) used in prostate cancer?
    Castrate-RESISTANT metastatic prostate cancer
  15. When is Docetaxel used in prostate cancer?
    Castrate-RESISTANT metastatic prostate cancer
  16. When is Enzalutamide (Xtandi) used in prostate cancer?
    Castrate-RESISTANT metastatic prostate cancer
  17. When is Sipuleucel-T (Provenge) used in prostate cancer?
    Castrate-RESISTANT metastatic prostate cancer
  18. What are the SE of Abiraterone (Zytiga)?
    • Fatigue
    • Edema
    • HTN
    • Hypokalemia
    • Atrial fibrillation
    • HF
  19. What are the benefits of use for Abiraterone (Zytiga)?
    • Used before Docetaxel: 15.8-11.2 months survival
    • Used after docetaxel: No survival benefit but QOL benefit
  20. What special instructions should you tell patients taking Abiraterone (Zytiga)?
    • No food 2 hours before or 1 hour after admin
    • Take 1000 mg PO QD with prednisone 5 mg BID to prevent CV effects due to increased mineralocorticoid activity
  21. What are the SE of Enzalutamide (Xtandi)?
    • Diarrhea
    • Hot flashes
    • Severe infections
  22. What special instructions should you tell patients taking Enzalutamide (Xtandi)?
    Avoid CYP drugs,e specially co-admin with CYP2C8 inhibitors
  23. What drugs interact with Enzalutamide (Xtandi)?
    Phenytoin, Carbamazepine, Glucocorticoids, Rifampin, Pioglitazone, Nafcillin, Phenobarbitol, Cyclosporine, Fentanyl, Midazolam, Omeprazole, Warfarin
  24. What are the SE of Docetaxel?
    Fluid retention, complete hair loss, bone marrow suppression
  25. What are the benefits of use for Doectaxel?
    • 18.9 – 16.5 month survival benefit
    • Preferred agent for symptomatic patients
  26. What special instructions should you tell patients taking Enzalutamide (Xtandi)?
    • 75 mg/m2 Q3weeks
    • Add prednisone 5 mg BID
  27. When is Sipuleucel-T used (Provenge)?
    Asymptomatic or minimally symptomatic castrate-resistant metastatic prostate cancer
  28. What is the benefit of Sipuleucel-T (Provenge)?
    • Survival of 25.8-21.7 months
    • First vaccine approved for treatment
  29. What special instructions should you tell patients taking Sipuleucel-T (Provenge)?
    Premedicate with diphenhydramine and APAP
  30. When is Cabazitaxel (Jevtana) used?
    Castrate-resistant Metastatic prostate cancer previously treated with docetaxel-containing regimen
  31. What is the benefit of using Cabazitaxel (Jevtana) for Castrate-resistant Metastatic prostate cancer?
    4 months survival vs. mitoxantrone
  32. What are the SE of Cabazitaxel (Jevtana)?
    • Febrile Neutropenia
    • Neutropenia
    • Diarrhea
  33. What special information should you know prior to administering Cabazitaxel (Jevtana)?
    • NO PVC
    • Premed with diphenhydramine, dexa and H2 antagonist
    • CYP3A4
  34. What drugs are used to stabilize bone when bone mets present with metastatic prostate cancer?
    • Pamidronate (Aredia)
    • Zolendronic acid (Zometa)
    • Denosumab (Xyvega)
    • QMonthly
  35. What should you advise the patient to do if they are taking bisphosphonates or denosumab for bone mets in prostate cancer?
    • Ca: 1200-1500 mg QD + Vit D 400-800 IU QD
    • Good oral hygiene and no dental procedures

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