Clinical Lung Cancer Flashcards
1
Q
Differentiate between driver and passenger mutations
A
- Driver mutations
- Driver genes present in most cells and involved in cell growth
- Passenger
- Other genes not involved in cell growth
2
Q
What are the broad sub categories of lung cancer
A
Small Cell Carcinoma
Non-small cell carcinoma
Carcinoid
3
Q
What are the subtypes of Non-small cell lung cancer
A
- Adenocarcinoma (36%)
- Squamous Cell Carcinoma (22%)
- Large Cell Carcinoma
Not sensitive to chemotherapy
4
Q
What are the stages of lung cancer
A
- Stage 1 - small and no lymph node involvement
- 1A
- 1B
- Stage 2 - bit bigger +/- lymph node
- 2A
- 2B
- Stage 3
- 3A
- 3B
- Stage 4
5
Q
What are the broad treatments for the stages
A
- Stage 1 and 2 -> surery or local treatments
- Stage 3 -> multimodal treatment (chemo, redio, surgery)
- Stage 4 -> systemic treatments
6
Q
1 year survival of lung cancer is…
A
38% (increase by 7% since 2010)
7
Q
What are the benefits of early detection of lung cancer
A
- Treatment options are more limited in later stages
- Prognosis is better in the early stages
- Early detection likely to improve survival
Will Roger’s Effect
8
Q
Areas of evidence-based medicine conflict in lung cancer treatment
A
- Surgery for small cell cancers
- Luchtenborg Thorax 2014
- Patients had better survival if SCLC was resected
- Surgery vs Radiotherapy in N2 disease:
- McElnay Thorax 2015
- Surgery is better at treating N2 but we still only use chemo/radiotherapy
- Extent of resection
- SABR vs Surgery
- SABRTOOTH Lancet 2015
9
Q
What are some novel therapy approaches for lung cancer
A
- Keyhole surgery for lobar resection
- Stereotactic Ablative Body Radiotherapy (SABR)
- MR-Linac
- Proton Beam Therapy
- Targeted Treatments
- Immunocology
10
Q
Broadly outline how chemotherapy works
A
Targets and kills rapidly dividingcells
20% Response rate
