Self-Assessment Post-Test
New Directions in the Management of Advanced Prostate Cancer
RIUPost-Test(Watson)_02-14.qxd 2/22/07 2:28 AM Page S39 SELF-ASSESSMENT POST-TEST New Directions in the Management of Advanced Prostate Cancer 1. Acute adverse events associated with LHRH agonists include: a. hot flushes b. loss of libido c. erectile dysfunction d. all of the above 2. Chronic adverse events associated with advanced prostate cancer and possibly worsened by treatment with LHRH agonists include: a. osteoporosis and related fractures b. anemia resulting from indirect inhibition of erythrogenesis c. neurological impairment including decreased cognitive function d. increased cardiovascular morbidity and mortality e. all of the above 3. Intermittent therapy with LHRH, with the goal of minimizing adverse events while continuing treatment, has been shown in studies to result in: a. reduction of the morbidity and mortality related to the adverse events b. no negative impact on prostate cancer survival 4. Studies have shown a clear advantage in instituting maximum androgen blockade as part of initial androgen deprivation therapy. a. true b. false 5. Factors involved in the CALGB prognostic model for risk stratification of metastatic hormone refractory patients with metastasis include: a. condition of the host (performance status, anemia, fatigue) b. tumor burden (sites of metastatic disease, PSA level, alkaline phosphatase level) c. biologic aggressiveness of the cancer itself (LDH levels and the PSA doubling time) d. all of the above 6. A PSA doubling time of more than 10 months is associated with: a. an indolent clinical course b. a more rapidly progressive disease 7. Which of the following are true of findings of the SWOG 99-16 and TAX 327 trials? 1. The median overall survival rate was improved in patients treated with docetaxel/estramustine over the mitoxantrone/ prednisone regimen 2. The docetaxel/estramustine combination led to increases in cardiovascular, gastrointestinal, and thromboembolic toxicity 3. The estramustine was found to be an important factor in increased overall survival 4. The current preferred regimen in clinical practice is combination treatment with docetaxel and prednisone a. 1, 2, and 3 b. 1, 2, and 4 c. 2, 3, and 4 8. Fill in the blank. Bone metastasis occurs in up to _____ % of patients with hormone-refractory prostate cancer (HRPC). a. 25 b. 47 c. 70 d. 90 9. In studies, the time to first skeletal-related event for HRPC patients was delayed in groups treated with zoledronic acid. a. true b. false 10. In the studies of treatment of HRPC patients with zoledronic acid there were improvements in rate of disease progression, quality of life, and survival. a. true b. false 11. Fill in the blank. About _____ % of patients who have radical prostatectomy or radiation therapy may experience disease recurrence initially manifest by an increasing prostate-specific antigen level. a. 15 b. 23 c. 30 d. 45 12. Prostate cancer that has metastasized is initially treated with hormonal therapy. Which of the following is true? a. hormone-refractory disease will eventually develop b. hormonal therapy stops symptomatic progression of disease c. hormone-refractory disease results from cell damage related to aging 13. In the absence of the ability to replace a gene responsible for cancer initiation, which other genetic therapies are being explored? a. direct tumor injection of a gene to kill cells b. systemic gene delivery to target and kill metastases c. alteration of local gene expression to generate a systemic response d. all of the above 14. Findings of Phase I and Phase II studies of prostate cancer treatment effects of GVAX®, a GM-GSF secreting vaccine, have shown which of the following? a. PSA decline b. improved survival of patients with hormone-refractory disease c. stabilization of bone scans d. all of the above 15. The gene therapy that has progressed farthest in prostate cancer has been immunomodulatory gene therapy related to ex vivo cancer vaccines. a. true b. false 16. Which of the following characteristics indicate that a patient may be eligible for studies on immunotherapy for treatment of prostate cancer? 1. fast-progressing metastatic disease 2. minimal tumor burden 3. intact immune system 4. decreased immunocompetence a. 1 and 3 b. 1 and 4 c. 2 and 3 d. 2 and 4 17. Which of the following markers is the FDA standard for drug approval for the treatment of prostate cancer in the US? a. PSA b. prolongation of overall survival 18. Types of agents using monoclonal antibodies currently under investigation include agents: a. targeting tumor-associated antigens (TAAs) b. targeting cell surface receptors such as EGFR and HER2/neu c. directly activating T cell function d. all of the above VOL. 9 SUPPL. 1 2007 REVIEWS IN UROLOGY S39 RIUPost-Test(Watson)_02-14.qxd 2/15/07 3:52 AM Page S40 EVALUATION FORM New Directions in the Management of Advanced Prostate Cancer Project ID: 4417 ES 13 To assist us in evaluating the effectiveness of this activity and to make recommendations for future educational offerings, please take a few minutes to complete this evaluation form. You must complete this evaluation form to receive acknowledgment for completing this activity. Please answer the following questions by circling the appropriate rating: 5 Strongly Agree 4 Agree 3 Neutral 2 Disagree 1 Strongly Disagree EXTENT TO WHICH PROGRAM ACTIVITIES MET THE IDENTIFIED OBJECTIVES After completing this activity, I am now better able to: • Describe ways to more effectively use hormonal therapy for the treatment of advanced prostate cancer • Describe the rationale for gene therapy of advanced prostate cancer and demonstrate familiarity with recent clinical research and progress • Discuss how the immune response can be modulated to treat advanced prostate cancer • Review newly indicated chemotherapies for advanced prostate cancer and future trends in this area 5 5 4 4 3 3 2 2 1 1 5 5 4 4 3 3 2 2 1 1 5 5 5 5 5 5 4 4 4 4 4 4 3 3 3 3 3 3 2 2 2 2 2 2 1 1 1 1 1 1 OVERALL EFFECTIVENESS OF THE ACTIVITY The content presented: • Was timely and will influence how I practice • Enhanced my current knowledge base • Addressed my most pressing questions • Provided new ideas or information I expect to use • Addressed competencies identified by my specialty • Avoided commercial bias or influence IMPACT OF THE ACTIVITY Name one thing you intend to change in your practice as a result of completing this activity: Please list any topics you would like to see addressed in future educational activities: Additional comments about this activity: FOLLOW-UP As part of our continuous quality improvement effort, we conduct postactivity follow-up surveys to assess the impact of our educational interventions on professional practice. Please indicate if you would be willing to participate in such a survey: ❒ Yes, I would be interested in participating in a follow-up survey. ❒ No, I am not interested in participating in a follow-up survey. POST-TEST ANSWER KEY 1___ 2___ 3___ 4___ 5___ 6___ 7___ 8___ 9___ 10___ 11___ 12___ 13___ 14___ 15___ 16___ 17___ 18___ Request for Credit Name Organization Address Telephone Fax Degree Specialty City, State, Zip E-Mail If you wish to receive acknowledgment of participation for this activity, please complete the post-test by selecting the best answer to each question, complete this evaluation verification of participation, and FAX to: 303-790-4876. FOR PHYSICIANS ONLY I certify my actual time spent to complete this educational activity to be: ❒ I participated in the entire activity and claim 2.0 credits. ❒ I participated in only part of the activity and claim _____ credits. Signature S40 VOL. 9 SUPPL. 1 2007 Date REVIEWS IN UROLOGY