Therapeutics - Breast Cancer 1

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  1. What is the generic name for Arimidex?
  2. What is the generic name for Femara?
  3. What is the generic name for Aromasin?
  4. What are the SE of Aromatase inhibitors?
    Hot flashes, arthralgias, myalgias, headaches, diarrhea, mild nausea, DECREASED BONE DENSITY, increased risk of fracture
  5. What is the dose for Anastrazole (Arimidex) and Letrozole (Femara)?
    • Anastrazole: 1 mg PO QD
    • Letrozole: 2.5 mg PO QD
  6. What special information should you know about Aromatase inhibitors?
    • Give: Ca and Vit D
    • No effect on the endometrium
    • May cause increased Cholesterol
  7. How often are LH-RH agonists used in Breast Cancer?
  8. When should ER/PR and HER2/neu status be re-tested?
    Once the disease becomes metastatic
  9. What is the goal of treatment for metastatic breast cancer?
    Provide the most benefit with the least amount of toxicity
  10. What treatment is recommended for Pre-menopausal Stage IV breast cancer?
    • Antiestrogen (Tamoxifen or toremifene)
    • If progresses: Surgical hysterectomy and oophorectomy or LHRH agonist, followed by post-menopausal protocols
  11. Do not use _______________ in pre-menopausal stage IV breast cancer because it does not block ovary production of estrogen.
    Aromatase inhibitors
  12. What treatment is recommended for POST-menopausal Stage IV breast cancer (1st line)?
    • Letrozole + palbociclib – unknown if effects survival
    • OR
    • Anastrozole, Letrozole
    • OR
    • Anastrazole + fulvestrant
  13. When are Palbociclib and Everolimus indicated in Breast cancer treatment?
    Metastatic, post-menopausal ER+/PR+, HER2/neu negative breast cancer
  14. What special instructions should you give patients taking Palbociclib?
    • Take with food
    • Avoid Grapefruit
  15. What special instructions should you give a patient taking everolimus?
    • PO
    • CYP3A4 metabolism– dose adjust as necessary
  16. What are the SE of Palbociclib?
    • Neutropenia
    • Thromboembolism
    • Severe infections
  17. What are the SE of Everolimus?
    • HLD
    • Hyperglycemia
    • Stomatitis
  18. What is the brand name for Everolimus?
    Afinitor (Zortress for renal transplant)
  19. What is the brand name for Palbociclib?
  20. What is the generic name for Ibrance?
  21. What is the generic name for Afinitor?
  22. When is Chemotherapy used in Metastatic breast cancer?
    When there is no longer a response to endocrine therapy
  23. In metastatic breast cancer when is Trastuzumab indicated?
    Upfront in Her2/neu positive patients
  24. How does Ado-trastuzumab (Kadcycla) compare to Trastuzumab?
    • Not interchangeable
    • Higher myelosupression and PH
  25. What are the SE of Trastuzumab?
    Arthalgias, ventricular dysfunction and PN
  26. What are the preferred regimens for HER2/neu positive treatment of metastatic breast cancer that is refractory to hormone therapy?
    • Pertuzumab, trastuzumab, docetaxel
    • OR
    • Pertuzumab, trastuzumab, paclitaxel
  27. What should you know before starting a chemo regimen for HER2/neu positive treatment of metastatic breast cancer?
    Get ejection fraction
  28. What are the AE of Pertuzumab (Perjeta)?
    • Neutrpenia
    • Anemia
    • CHF – check ejection fraction before each dose
  29. What is the dosing strategy for Pertuzumab (Perjeta)?
    • Flat doses
    • Give loading dose then maintenance, if on for more than 6 weeks repeat the loading dose
  30. What is the brand name for Pertuzumab?
  31. What is the generic name for Perjeta?
  32. What is the brand name for Lapatinib?
  33. What is the generic name for Tykerb?
  34. Lapatinib (Tykerb®) delays disease progression, but has unknown effects on ___________.
  35. What are the SE of Lapatinib (Tykerb®)?
    • Diarrhea
    • Decreased LVF
  36. When is radiation not indicated postoperatively?
    > or = to 70 years old, then get Tamoxifen instead
  37. When is Postoperative Adjuvant radiation indicated?
    • Partial mastectomy performed
    • Positive/close margins
    • Skin involvement
    • > 5cm tumor
    • > or = to 4 axillary lymph nodes ( may consider with 1-3)
    • Neoadjuvant chemotherapy
    • Local recurrence treated with chemo
    • Palliation
  38. How can you treat bone mets in Breast Cancer?
    • Zoledronic acid (preferred) or Pamidronate
    • Denosumab
Card Set:
Therapeutics - Breast Cancer 1
2015-05-02 02:16:31
Therapeutics Breast Cancer
Therapeutics - Breast Cancer
Therapeutics - Breast Cancer
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