Biliary and CUP 2 Flashcards

1
Q

Most common risk factors for biliary tract cancer (5)

A

PSC
Lynch syndrome
HCV
Diabetes
Obesity

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2
Q

Best adjuvant treatment for biliary tract cancer?

A

Capecitabine

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3
Q

1L for metastatic biliary tract cancers?

A

Gem Cis +/- Durva or Pembro

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4
Q

Difference in local therapy options for hilar vs intrahepatic cholangiocarcinoma?

A

Hilar cholangio cannot get TACE, RFA, Y90, etc. because of increased risk of abscess or complications

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5
Q

Patient undergoes routine cholecystectomy and finds a T1a gallbladder cancer. Management?

A

Observation

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6
Q

Patient undergoes a routine cholecystectomy and finds a T2 gallbladder cancer. Management?

A

Surgical resection of gallbladder fossa and lymphadenectomy

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7
Q

Which patients can be cured with orthotopic liver transplant?

A

Hilar cholangio
Intrahepatic cholangio with PSC or cirrhosis
strict transplant criteria

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8
Q

Best adjuvant therapy for cholangiocarcinoma?

A

Capecitabine
Only use radiation for R1 resection

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9
Q

Benefit of adjuvant radiation in biliary tract cancers?

A

Improves PFS, but no OS

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10
Q

Which BTC has the highest likelihood of having targetable mutation?

A

Intrahepatic cholangiocarcinoma

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11
Q

4 most common targetable mutations in biliary tract cancer

A

IDH1/2
FGFR1-3
BRAF
HER2

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12
Q

Treatment options for advanced BTC with FGFR2 fusions? (3)

A

Pemigatinib
INfigratinib
Futibatinib
all in second line*

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13
Q

Treatment option for advanced BTC with IDH1 mutation?

A

Ivosidenib
2L

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14
Q

Treatment option for advanced BTC with BRAF V600E mutation

A

Dabrafenib + Trametinib
second line*

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15
Q

Treatment option for advanced BTC with HER2 amplification?

A

None are FDA approved.
Trastuzumab + Pertuzumab is in NCCN guidelines

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16
Q

Woman with isolated axillary LN. What work-up?

A

Breast US, Mammo, MRI

17
Q

Middle aged man with tobacco and alcohol use history with cervical LN that shows SCCa. What workup?

A

Pan endoscopy
PET
Bilateral tonsillectomies