Tumor Markers (F)
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Provide the ff for the given tumor marker: 1) Type of CA for w/c marker is most often used 2) Clinical use 3) Comments Given tumor marker: α-Fetoprotein (AFP)
1) Liver 2) Aid dx, monitor therapy, and detect recurrence 3) Produced by fetal liver; re-expressed in certain tumors; also increased / high in hepatitis and pregnancy
Provide the ff for the given tumor marker: 1) Type of CA for w/c marker is most often used 2) Clinical use 3) Comments Given tumor marker: Cancer antigen 15-3 (CA 15-3) and cancer antigen 27.29 (CA 27.29)
1) Breast 2) Stage disease, monitor therapy, and detect recurrence 3) 2 different assays for same marker; can be increased / high w/ other CAs and non-cancerous conditions
Provide the ff for the given tumor marker: 1) Type of CA for w/c marker is most often used 2) Clinical use 3) Comments Given tumor marker: Cancer antigen 19-9 (CA 19-9)
1) Pancreatic 2) Stage disease, monitor therapy, and detect recurrence 3) Can be increased / high w/ other CAs and non-cancerous conditions
Provide the ff for the given tumor marker: 1) Type of CA for w/c marker is most often used 2) Clinical use 3) Comments Given tumor marker: Cancer antigen 125 (CA 125)
1) Ovarian 2) Aid dx, monitor therapy, and detect recurrence 3) Can be increased / high w/ other CAs and gynecological conditions
Provide the ff for the given tumor marker: 1) Type of CA for w/c marker is most often used 2) Clinical use 3) Comments Given tumor marker: Carcinoembryonic antigen (CEA)
1) Colorectal 2) Monitor therapy and detect recurrence 3) Fetal Ag re-expressed in tumors; can be increased / high w/ other CAs, non-cancerous conditions, and in smokers
Provide the ff for the given tumor marker: 1) Type of CA for w/c marker is most often used 2) Clinical use 3) Comments Given tumor marker: Human chorionic gonadotropin (hCG)
1) Ovarian and testicular; also gestational trophoblastic diseases 2) Aid dx, monitor therapy, and detect recurrence 3) Increased / high in pregnancy
Provide the ff for the given tumor marker: 1) Type of CA for w/c marker is most often used 2) Clinical use 3) Comments Given tumor marker: Prostate specific antigen (PSA)
1) Prostate 2) Screening, aid dx, monitor therapy, and detect recurrence 3) Currently most widely used tumor marker; screening asymptomatic men is controversial; some men w/ prostate CA don’t have increased / high PSA; PSA can be increased / high in other conditions; measurement of free PSA may be helpful when PSA is borderline
Provide the ff for the given tumor marker: 1) Type of CA for w/c marker is most often used 2) Clinical use 3) Comments Given tumor marker: Thyroglobulin
1) Thyroid 2) Monitor therapy and detect recurrence 3) Increased / high in other thyroid diseases; antithyroglobulin Abs should be measured at same time; can interfere w/ assays
True or False Tumor markers alone cannot diagnose CA
True
True or False All tumor markers are not useful for screening
False, because most tumor markers are not useful for screening
What are the characteristics of tumor markers?
1) These are non-specific 2) These can be elevated in non-cancerous conditions
True or False All pts w/ CA do not have elevated tumor markers
False, because some pts w/ CA do not have elevated tumor markers
True or False Serial testing is more useful > a single test
True
True or False W/ successful treatment, tumor marker lvls should decline and return to normal
True
True or False Increasing lvls of tumor markers following treatment might indicate a recurrence
True
How are AFP, CA 15-3 & CA 27.29, CA 19-9, CA 125, CEA, hCG, PSA, and thyroglobulin measured?
By / via immunoassay
In relation to therapeutic drug monitoring, what is minimum effective concentration (MEC)?
It is the lowest concentration of drug in blood that will produce desired effect
In relation to therapeutic drug monitoring, what is minimum toxic concentration (MTC)?
It is the lowest concentration of drug in blood that will produce adverse response
In relation to therapeutic drug monitoring, what is therapeutic index?
It is the ratio of MTC to MEC
In relation to therapeutic drug monitoring, what is trough?
It is the lowest conc. of drug measured in blood
When is trough reached?
It is reached just before next scheduled dose
What should observed for trough?
It shouldn’t fall below MEC
In relation to therapeutic drug monitoring, what is peak?
It is the highest concentration of drug measured in blood
When is peak drawn?
It is drawn immediately on achievement of steady state