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*Pharmacotherapy 5270 > 28. Lung Cancer > Flashcards

28. Lung Cancer Flashcards

1
Q

true or false: lung cancer is the most common cause of cancer mortality

A

true

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2
Q

what are some risk factors for lung cancer

A
  • smoking!!!!!!
  • personal hx of lung cancer
  • family history of lung cancer
  • asbestos
  • age (> 40)
  • second hand smoke
  • radiation exposure
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3
Q

true or false: women are more susceptible to tobacco effects

A

true

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4
Q

what are the early symptoms of lung cancer

A
  • cough
  • dyspnea
  • hemoptysis
  • recurrent infections
  • chest pain
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5
Q

what are the most common sites of metastases in lung cancer (+ their symptoms)

A

brain (seizures, confusion, personality changes, h/a, n/v), bones (pain), liver (weight loss, weakness) and adrenals (asymptomatic)

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6
Q

what % of lung cancers are small cell carcinomas

A

15%

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7
Q

what % of lung cancers are non-small cell carcinomas

A

85%

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8
Q

this type of lung cancer has the most aggressive clinical course of all lung tumors if left untreated

A

small cell lung cancer

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9
Q

true or false: small cell lung cancers are related to smoking

A

true

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10
Q

true or false: small cell lung cancers are located centrally

A

true

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11
Q

what are the 3 types of non-small cell lung cancer

A
  1. adenocarcinoma (45-50%)
  2. squamous cell carcinoma (25-30%)
  3. large cell carcinoma (5-10%)
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12
Q

this type of non-small cell lung cancer usually arises from the mucus-producing cells in the lung

A

adenocarcinoma

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13
Q

true or false: adenocarcinomas are mainly centrally located

A

false - 2/3 in outer part of lung, 1/3 develop in central part of lung

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14
Q

true or false: adenocarcinomas are related to smoking

A

false

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15
Q

true or false: adenocarcinomas are more common in women

A

true

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16
Q

this non-small cell carcinoma is slower growing and often causes bronchial obstruction

A

squamous cell carcinoma

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17
Q

true or false: squamous cell carcinoma is related to smoking

A

true

18
Q

true or false: squamous cell carcinomas are located centrally

A

true

19
Q

true or false: squamous cell carcinomas are more common in women

A

false

20
Q

this non-small cell carcinoma tends to spread/metastasize early

A

large cell carcinoma

21
Q

true or false: large cell carcinomas are related to smoking

A

false

22
Q

true or false: large cell carcinomas are located centrally

A

false

23
Q

what are some negative prognostic factors for lung cancer

A
  • weight loss
  • poor performance status
  • mediastinal lymph node involvement
  • male gender
  • elevated LDH
  • bone or liver metastasis
  • adeno and large cell
24
Q

know the stages of small cell lung cancer

A

limited - one side of the chest
extensive - both sides of the chest

25
Q

know the stages of non-small cell lung cancer

A

stage 1 - small tumor that has not spread to lymph nodes or any other structures in the chest
stage 2 - tumor is bigger than stage 1 or it has spread to nearby lymph nodes or it has spread into the large bronchial tubes
stage 3a - tumor has spread to the lymph nodes or other structures in the middle of the chest
stage 3b - tumor has spread to the other side of the chest or mediastinal lymph nodes
stage 4 - BBLA involvement

26
Q

what is the treatment for NSCLC stage Ia

A

surgery
(+ rads if surgical resection markers are positive)

27
Q

what is the treatment for NSCLC stage Ib

A

surgery + adjuvant chemo
(+ rads if surgical resection markers are positive)

28
Q

what is the treatment for NSCLC stage II

A

surgery + adjuvant chemo +/- immunotherapy
(+ rads if surgical rescetion markers are positive)

29
Q

what is the treatment for NSCLC stage IIIa

A

surgery + adjuvant chemo +/- immunotherapy
(+ rads if surgical rescetion markers are positive)

30
Q

what is the treatment for NSCLC stage IIIb

A

combined chemo/rads + maintenance Durvalumab x 12 months

31
Q

what is the treatment for NSCLC stage IV

A

chemo or TT or immunotherapy or rads

32
Q

how many cycles of chemo is used in all stages of NSCLC

A

4-6 cycles

33
Q

what treatment is given if your patient has stage 4 NSCLC, PD-L1 > 50%, and the disease is not rapidly progressive/very extensive

A

Pembrolizumab

34
Q

what treatment is given if your patient has stage 4 NSCLC, PD-L1 < 50%, and they have squamous histology

A

Pembrolizumab, Carboplatin & Paclitaxel

35
Q

what treatment is given if your patient has stage 4 NSCLC, PD-L1 < 50% and they have adenocarcinoma histology

A

Pembrolizumab, Carboplatin & Pemotrexed

36
Q

this mutation accounts for about 15% of NLCSC

A

EGFR

37
Q

what is the most common EGFR inhibitor used

A

Osimertinib

38
Q

this mutation accounts for about 5-7% of NSCLC

A

ALK

39
Q

what are examples of ALK inhibitors

A

crizotinib, alectinib and lorlatinib

40
Q

true or false: if a patient fails one ALK inibitor, they can try another one

A

true

41
Q

how is the limited stage of small cell lung cancer treated

A

radiation + chemo (4-6 cycles of chemo)

42
Q

how it the extensive stage of small cell lung cancer treated

A

4 cycles of chemotherapy with durvalumab then durvalumab monotherapy

*Pharmacotherapy 5270 (12 decks)

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