Prostate cancer

Prostate Cancer

Prostate cancer Part 1

What treatment has category 1 indication if there are positive lymph nodes after radical prostatectomy?

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Androgen deprivation therapy +/- EBRT

Prostate cancer Part 1
Prostate cancer

Which risk strata of prostate cancer has a 20 year risk stratification ?

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Very low risk only

Prostate cancer
Prostate cancer

Which treatment has a category 1 indication for very high risk prostate cancer ?

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EBRT +2-3 years of androgen deprivation therapy

Prostate cancer
Prostate cancer

If the PSA post radiotherapy is 0 and then becomes detectable, what can you do?

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Recheck the level

Prostate cancer
Prostate cancer

What are the criteria for post radiotherapy salvage radical prostatectomy?

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T1-T2 disease, N0, life expectancy greater than 10 years, PSA less than 10

Prostate cancer
Prostate cancer

What imaging besides CT scans can be used after definitive radiotherapy to determine salvage RPR
candidacy?

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View Question

Transrectal ultrasound

Prostate cancer
Prostate cancer

What can be seen with the PSA level during docetaxel treatment in 20% of patients?

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View Question

Spurious increase, just continue with treatment

Prostate cancer
Prostate cancer

Which prostate cancer treatment is not ideal for diabetic patients?

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View Question

Abiraterone plus prednisone

Prostate cancer
Prostate cancer

Why is prednisone added to abiraterone?

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Lowers the cortisol flare

Prostate cancer
Prostate cancer

What defines T3 and T4 disease for prostate cancer?

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View Question

T3 is seminal vesicle involvement while T4 is bladder and rectum

Prostate cancer
Prostate cancer

Does denousmab results in lower skeletal related events versus zoledronic acid?

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View Question

Yes

Prostate cancer
Prostate cancer

What supplements should be given with denosumab?

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View Question

Calcium and vitamin D because hypocalcemia is a significant side effect

Prostate cancer
Prostate cancer

Which taxane used in prostate cancer has a higher incidence of neuropathy?

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Docetaxel 20%, versus cabazitaxel 10%

Prostate cancer
Prostate cancer

Is growth factor support needed for cabazitaxel?

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Yes

Prostate cancer
Prostate cancer

What are the criteria for using sipuleucel – T ?

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ECOG=0 or 1, no liver metastases, castration resistant, nonsymptomatic metastatic disease

Prostate cancer
Prostate cancer

What is the definition of high-volume disease for prostate cancer in the context of docetaxel with or
without androgen deprivation therapy?

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At least 4 metastatic sites, with at least one non-axial skeleton site

Prostate cancer
Prostate cancer

Prior to starting androgen deprivation therapy, with baseline imaging studies are required?

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Depnding on FRAX score, DEXA scan

Prostate cancer
Prostate cancer

Is radium 223 an alpha or beta emitter ?

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View Question

Alpha

Prostate cancer
Prostate cancer

How can you still use cabazitaxel in low performance status patients with prostate cancer?

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View Question

Decreased the dose from 25 mg/m2 to 20 mg/m2

Prostate cancer
prostate cancer

What radiation dose and frequency is used for symptomatic metastases treatment in prostate cancer?

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8000 cGy for 1 dose

prostate cancer
prostate cancer

Which risk strata of prostate cancer patients receive 4-6 months versus 3 years of adjuvant androgen deprivation therapy with radiotherapy?

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Intermediate risk — 4-6 months
High and very high risk — 3 years

prostate cancer
Prostate Cancer

What is the AST/ALT cut-off for using abiraterone?

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8x upper limit or normal

Prostate Cancer
Prostate Cancer

What are the minimum liver function tests required prior to using docetaxel?

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View Question

“Bilirubin

Prostate Cancer
Prostate Cancer

Can you expect to see a reduction in PSA with sipuleucil-T?

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No

Prostate Cancer
Prostate Cancer

What can be seen with the PSA level during docetaxel treatment in 20% of patients?

View Answer
View Question

“Spurious increase

Prostate Cancer
prostate cancer

Which prostate cancer treatment is not ideal for diabetic patients?

View Answer
View Question

Abiraterone plus prednisone

prostate cancer
Prostate Cancer

Why is prednisone added to abiraterone?

View Answer
View Question

Lowers the cortisol flare

Prostate Cancer
prostate cancer

What defines T3 and T4 disease for prostate cancer?

View Answer
View Question

T3 is seminal vesicle involvement while T4 is bladder and rectum

prostate cancer
Prostate Cancer

Does denousmab results in lower skeletal related events versus zoledronic acid?

View Answer
View Question

Yes

Prostate Cancer
Prostate Cancer

What supplements should be given with denosumab?

View Answer
View Question

Calcium and vitamin D because hypocalcemia is a significant side effect

Prostate Cancer
prostate cancer

Which taxane used in prostate cancer has a higher incidence of neuropathy?

View Answer
View Question

Docetaxel 20%, versus cabazitaxel 10%

prostate cancer
Prostate Cancer

Is growth factor support needed for cabazitaxel?

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View Question

Yes

Prostate Cancer
Prostate Cancer

What other criteria for usieng sipeueuicil- T ?

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“ECOG=0 or 1

Prostate Cancer
prostate cancer

What is the definition of high-volume disease for prostate cancer in the context of docetaxel with or without androgen deprivation therapy?

View Answer
View Question

At least 4 metastatic sites, with at least one non-axial skeleton site

prostate cancer
Prostate Cancer

“Prior to starting androgen deprivation therapy

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with baseline imaging studies are required?”

Prostate Cancer
Prostate Cancer

Is radium 223 and alpha or beta emitter ?

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View Question

Alpha

Prostate Cancer
prostate cancer

Can you use cabazitaxel in low performance status patients with metastatic prostate cancer?

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View Question

Yes !
decrease the dose from 25 mg/m2 to 20 mg/m2 and highly consider growth factor support

prostate cancer
prostate cancer

Can you re-challenge with docetaxel in metastatic prostate cancer?

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Yes

prostate cancer
prostate cancer

How many cycles of docetaxel should be given ideally in a patient with metastatic prostate cancer ?

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Up to 10 if the patient can tolerate it

prostate cancer
Prostate Cancer

How can you salvage a rising PSA after radiotherapy if surgery is not an option ?

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Cryosurgery

Prostate Cancer
Prostate Cancer

Which patients have improved overall survival with continuous androgen deprivation therapy versus intermittent?

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“Gleason score 8

Prostate Cancer
Prostate Cancer

With did the clinical trials for intermittent versus continuous androgen deprivation therapy for metastatic disease reveal ?

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Cannot rule out inferiority of intermittent ADT treatment

Prostate Cancer
Prostate Cancer

Which patient should be considered for intermittent androgen operation therapy ?

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PSA relapse after definitive radiotherapy without metastatic disease

Prostate Cancer
prostate cancer

How much radiotherapy should be given in the salvage setting for prostate cancer ?

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6400-7200 cGy

prostate cancer
prostate cancer

What predicts for salvage radiotherapy success in prostate cancer?

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Low PSA pretreatment, long doubling time in the pretreatment setting

prostate cancer
Prostate Cancer

Is there an improvement in overall survival with the use of radiation 223?

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Yes

Prostate Cancer
prostate cancer

Up to have many cGy of definitive XRT can be given in high risk and very high-risk prostate cancer ?

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8100 cGy

prostate cancer
prostate cancer

What life expectancy for patients with low risk prostate cancer is required to defer from further imaging?

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5 years, if low and intermediate risk and life expectancy less than 5 years, then no further imaging required

prostate cancer
prostate cancer

When would you consider a CT scan or MRI versus a bone scan for prostate cancer?

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T3 disease, T4 disease, T1-T2 and nomogram with at least a 10% lymph node metastatic probability

prostate cancer
prostate cancer

What are the indications for performing a nuclear bone scan in newly diagnosed prostate cancer ?

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T1 disease and PSA >/= 20
T2 and PSA >/=10
Gleason score >/= 8
T3, T4 disease, presence of symptoms

prostate cancer
Prostate Cancer

Which risk strata of patients can be considered for observation?

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“very low risk

Prostate Cancer
prostate cancer

Which risk strata of prostate cancer can undergo active surveillance?

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Very low risk and low risk

prostate cancer
Prostate Cancer Part 1

What treatment has a category 1 indication if there are positive lymph nodes after radical prostatectomy?

View Answer
View Question

Androgen deprivation therapy +/- EBRT

Prostate Cancer Part 1
prostate cancer

Which risk strata of prostate cancer has a 20 year risk stratification ?

View Answer
View Question

Very low risk only

prostate cancer
prostate cancer

Which treatment has a category 1 indication for very high risk prostate cancer ?

View Answer
View Question

EBRT +2-3 years of androgen deprivation therapy

prostate cancer
Prostate Cancer

“If the PSA post radiotherapy is 0 and then becomes detectable

View Answer
View Question

what can you do?”

Prostate Cancer
Prostate Cancer

What are the criteria for post radiotherapy salvage radical prostatectomy?

View Answer
View Question

“T1-T2 disease

Prostate Cancer
Prostate Cancer

What imaging besides CT scans can be used after definitive radiotherapy to determine salvage RPR candidacy?

View Answer
View Question

Transrectal ultrasound

Prostate Cancer
prostate cancer

What role does abiraterone have for first line therapy in prostate cancer?

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View Question

Category 1 indication for metastatic castration resistant prostate cancer prior to chemotherapy use

prostate cancer
Prostate Cancer

What PSA doubling time should be used when deciding to add oral antiandrogen such as bicalutamide therapy to androgen deprivation therapy?

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10 months

Prostate Cancer
prostate cancer

how can you manage a patient with a rising PSA while on ADT + bicalutamide for castration resistant prostate cancer ?

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Bicalutamide withdrawal

prostate cancer
Prostate Cancer

Which enzymes does abiraterone inhibit ?

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“17

Prostate Cancer
prostate cancer

What are some examples of anti-androgens used in prostate cancer?

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Bicalutamide, nilutamide, flutamide

prostate cancer
Prostate Cancer

“In the castration resistant setting

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what 2 criteria are used to determine treatment ?”

Prostate Cancer
Prostate Cancer

What doubling time cut off in the context of biochemical failure warrants observation?

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12 months

Prostate Cancer
Prostate Cancer

Which patients can be considered for intermittent androgen deprivation therapy ?

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“Intermediate risk

Prostate Cancer
Prostate Cancer

What is the difference in overall survival between intermittent versus continuous androgen deprivation therapy from meta-analyses?

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No difference in overall survival

Prostate Cancer
prostate cancer

How can you manage N1 patients after radical prostatectomy?

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Continuous androgen deprivation therapy

prostate cancer
prostate cancer

What are the indications for postoperative radiotherapy for prostate cancer ?

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“Positive margins

prostate cancer
Prostate Cancer

What bone marrow reserve is required prior to treating with radiation 223?

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“Hemoglobin greater than 10 g/dL

Prostate Cancer
prostate cancer

What are the mechanisms of action for ketoconazole in prostate cancer management ?

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Inhibits steroid synthesis as well as a cytotoxic effect on prostate cancer cells

prostate cancer
prostate cancer

What formally defines biochemical failure after radiotherapy for prostate cancer?

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2 ng/mL above the nadir

prostate cancer
Prostate Cancer Part 2

Has an OS been demonstrated with Radium-223 for metastatic prostate cancer ?

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Yes, ALSYMPCA trial

Prostate Cancer Part 2
Prostate cancer

Which risk strata of prostate cancer has a 20 year risk stratification ?

View Answer
View Question

Very low risk only

Prostate cancer
Prostate cancer

Which treatment has a category 1 indication for very high risk prostate cancer ?

View Answer
View Question

EBRT +2-3 years of androgen deprivation therapy

Prostate cancer
Prostate cancer

If the PSA post radiotherapy is 0 and then becomes detectable, what can you do?

View Answer
View Question

Recheck the level

Prostate cancer
Prostate cancer

What are the criteria for post radiotherapy salvage radical prostatectomy?

View Answer
View Question

T1-T2 disease, N0, life expectancy greater than 10 years, PSA less than 10

Prostate cancer
Prostate cancer

What imaging besides CT scans can be used after definitive radiotherapy to determine salvage RPR
candidacy?

View Answer
View Question

Transrectal ultrasound

Prostate cancer
Prostate cancer

What can be seen with the PSA level during docetaxel treatment in 20% of patients?

View Answer
View Question

Spurious increase, just continue with treatment

Prostate cancer
Prostate cancer

Which prostate cancer treatment is not ideal for diabetic patients?

View Answer
View Question

Abiraterone plus prednisone

Prostate cancer
Prostate cancer

Why is prednisone added to abiraterone?

View Answer
View Question

Lowers the cortisol flare

Prostate cancer
Prostate cancer

What defines T3 and T4 disease for prostate cancer?

View Answer
View Question

T3 is seminal vesicle involvement while T4 is bladder and rectum

Prostate cancer
Prostate cancer

Does denousmab results in lower skeletal related events versus zoledronic acid?

View Answer
View Question

Yes

Prostate cancer
Prostate cancer

What supplements should be given with denosumab?

View Answer
View Question

Calcium and vitamin D because hypocalcemia is a significant side effect

Prostate cancer
Prostate cancer

Which taxane used in prostate cancer has a higher incidence of neuropathy?

View Answer
View Question

Docetaxel 20%, versus cabazitaxel 10%

Prostate cancer
Prostate cancer

Is growth factor support needed for cabazitaxel?

View Answer
View Question

Yes

Prostate cancer
Prostate cancer

What are the criteria for using sipuleucel – T ?

View Answer
View Question

ECOG=0 or 1, no liver metastases, castration resistant, nonsymptomatic metastatic disease

Prostate cancer
Prostate cancer

What is the definition of high-volume disease for prostate cancer in the context of docetaxel with or
without androgen deprivation therapy?

View Answer
View Question

At least 4 metastatic sites, with at least one non-axial skeleton site

Prostate cancer
Prostate cancer

Prior to starting androgen deprivation therapy, with baseline imaging studies are required?

View Answer
View Question

Depnding on FRAX score, DEXA scan

Prostate cancer
Prostate cancer

Is radium 223 an alpha or beta emitter ?

View Answer
View Question

Alpha

Prostate cancer
Prostate cancer

How can you still use cabazitaxel in low performance status patients with prostate cancer?

View Answer
View Question

Decreased the dose from 25 mg/m2 to 20 mg/m2

Prostate cancer
prostate cancer

What radiation dose and frequency is used for symptomatic metastases treatment in prostate cancer?

View Answer
View Question

8000 cGy for 1 dose

prostate cancer
prostate cancer

Which risk strata of prostate cancer patients receive 4-6 months versus 3 years of adjuvant androgen deprivation therapy with radiotherapy?

View Answer
View Question

Intermediate risk — 4-6 months
High and very high risk — 3 years

prostate cancer
Prostate Cancer

What is the AST/ALT cut-off for using abiraterone?

View Answer
View Question

8x upper limit or normal

Prostate Cancer
Prostate Cancer

What are the minimum liver function tests required prior to using docetaxel?

View Answer
View Question

“Bilirubin

Prostate Cancer
Prostate Cancer

Can you expect to see a reduction in PSA with sipuleucil-T?

View Answer
View Question

No

Prostate Cancer
Prostate Cancer

What can be seen with the PSA level during docetaxel treatment in 20% of patients?

View Answer
View Question

“Spurious increase

Prostate Cancer
prostate cancer

Which prostate cancer treatment is not ideal for diabetic patients?

View Answer
View Question

Abiraterone plus prednisone

prostate cancer
Prostate Cancer

Why is prednisone added to abiraterone?

View Answer
View Question

Lowers the cortisol flare

Prostate Cancer
prostate cancer

What defines T3 and T4 disease for prostate cancer?

View Answer
View Question

T3 is seminal vesicle involvement while T4 is bladder and rectum

prostate cancer
Prostate Cancer

Does denousmab results in lower skeletal related events versus zoledronic acid?

View Answer
View Question

Yes

Prostate Cancer
Prostate Cancer

What supplements should be given with denosumab?

View Answer
View Question

Calcium and vitamin D because hypocalcemia is a significant side effect

Prostate Cancer
Prostate Cancer Part 3

Did the STAMPEDE trial show an improvement in OS in prostate cancer ?

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View Question

Yes

Prostate Cancer Part 3
Prostate Cancer

What did the CHAARTED trial assess in prostate cancer ?

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Improvement in OS of docetaxel added to ADT for first line metastatic prostate cancer

Prostate Cancer
Prostate Cancer

What did the ARCHES trial show in prostate cancer ?

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Superior OS with enzalutamide versus ADT in first line metastatic prostate cancer

Prostate Cancer
Prostate Cancer

What did the ENZAMET trial show in prostate cancer ?

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Superior OS with enzalutamide versus ADT + bicalutamide in first line metastatic prostate cancer

Prostate Cancer
Prostate Cancer

Which 2 phase 3 trials shown an improvement in OS for enzalutamide in metastatic CRPC after progression on chemo ?

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PREVAIL

Prostate Cancer
Prostate Cancer

What did the CARD trial determine in metastatic prostate cancer ?

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Cabazitaxel improved OS in patients previously treated with docetaxel and anti-androgen therapy versus second line anti-androgen therapy

Prostate Cancer
Prostate Cancer

What did the PROSELICA trial assess in metastatic prostate cancer ?

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Non-inferiority of cabazitaxel 20mg/m2 versus 25mg/m2

Prostate Cancer
Prostate Cancer

Which trial assessed the Q2 week cycle for docetaxel in metastatic prostate cancer ?

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PROSTY

Prostate Cancer
Prostate Cancer

What is used to activate leukocytes for sipuleucel ?

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PAP-GM-CSF

Prostate Cancer
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