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7361 Hem/Onc Block 3 > Colorectal > Flashcards

Colorectal Flashcards

1
Q

Deadliest cancer in 2021?

a. breast
b. lung
c. prostate
d. colorectal
e. urinary bladder

A

b. lung

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2
Q

Highest incidence in 2021?

a. breast
b. lung
c. prostate
d. colorectal
e. urinary bladder

A

a. breast

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3
Q

> __ year pack history of smoking is risk factor for colorectal cancer

A

35

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4
Q

__ syndrome is risk factor for colorectal cancer

A

Lynch

Genetic:

  • 20% associated with familiar clustering
  • Lynch syndrome, familial adenomatous polyposis
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5
Q

Colorectal screening per NCCN guidelines is recommended at what age?

A

> = 50

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6
Q

Colorectal screening per ACS guidelines is recommended at what age?

A

> = 45

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7
Q

3 labs for colorectal cancer diagnosis?

A

CBC
LFTs
CEA

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8
Q

Tumor invades the submucosa or muscular propia

a. stage I
b. stage II
c. stage III
d. stage IV

A

a. stage I

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9
Q

Tumor invades through the muscular propia in to the pericolorectal tissues, or the visceral peritoneum or adheres to adjacent organ or structure

a. stage I
b. stage II
c. stage III
d. stage IV

A

b. stage II

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10
Q

Lymph node involvement occurs during what stage?

a. stage I
b. stage II
c. stage III
d. stage IV

A

c. stage III

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11
Q

Metastases present in what stage?

a. stage I
b. stage II
c. stage III
d. stage IV

A

d. stage IV

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12
Q

Radiation is common in metastatic setting

a. true
b. false

A

b. false

rare in metastatic setting

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13
Q

Radiation has minimal role in colon cancer.

a. true
b. false

A

a. true

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14
Q

Radiation is utilized in __ cancer in combo with neoadjuvant, adjuvant Tx in localized setting

A

rectal

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15
Q

What does FOLFOX treatment consist of?

A

folinic acid (leucovorin) + 5FU + oxaliplatin

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16
Q

What does FOLFIRI treatment consist of?

A

folinic acid (leucovorin) + 5FU + irinotecan

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17
Q

What does CAPOX treatment consist of?

A

capecitabine + oxaliplatin

18
Q

What does FOLFOXIRI treatment consist of?

A

folinic acid (leucovorin) + 5FU + oxaliplatin + irinotecan

19
Q

What stage receives surgery + observation?

a. stage I
b. stage II
c. stage III
d. stage IV

select all that apply

A

a, b

20
Q

High risk stage II receives what treatment ?

A

surgery + adjuvant chemotherapy

21
Q

Stage III receives what treatment?

A

surgery + adjuvant chemotherapy

CAPOX or FOLFOX for 3-6 months

22
Q

Which stage receives chemotherapy?

A

stage IV

23
Q

Metastatic chemotherapy regimens:

5FU/leucovorin +/- ___

A

bevacizumab

24
Q

Metastatic chemotherapy regimens:

FOLFOX +/- ___

A

cetuximab

25
Q

Metastatic chemotherapy regimens:

CAPOX +/- ___

A

panitumumab

26
Q

What is the goal of surgically resectable stage IV?

A

cure

27
Q

Important labs for colorectal cancer?

A 
CBC
CMP
 - calcium
 - magnesium
 - SCr
 - hepatic panel
CEA
28
Q

What is the rate limiting enzyme in 5FU catabolism?

A

dihydropyrimidine dehydrogenase (DPD)

DPD deficiency leads to accumulation of 5FU and toxicity

29
Q

5FU dose reduction for partial DPD deficiency?

A

50%

30
Q

5FU dose reduction for complete DPD deficiency?

A

90%

31
Q

What is the irinotecan active metabolite?

A

SN-38

UGT1A1 glucuronidates SN-38 in the liver to sN38G

SN-38G is eliminated via biliary excretion

32
Q

Irinotecan:

There is decreased activity of UGT1A1 with what polymorphism?

A

*28

33
Q

Irinotecan dose reduction is recommended for pts who are ___ homozygous

A

UGT1A1*28

accumulation of SN-38 causes significant neutropenia and diarrhea

34
Q

Oral chemotherapy:

capecitabine dose?

A

1000mg/m2 PO BID x 14 days (21 day cycle)

take with food or 30 mins after food

150mg and 500mg tablets

35
Q

Oral chemotherapy:

Capcetiabine AE hand foot syndrome treatment?

A

lotion/urea based cream

avoid friction and extremes in temp

36
Q

Oral chemotherapy:

trifluridine + tipiracil dose?

A

35mg/m2 PO BID

37
Q

Oral chemotherapy:

What is the reason to check CBC with trifluridine + tipiracil?

A

to check for toxicity

38
Q

How to manage trifluridine + tipiracil myelosuppression AE?

A

dose adjustment

ANC < 0.5
platelets < 50

39
Q

Oral chemotherapy:

Regorafenib dose?

A

160mg PO daily x 21 days (28 days)

40
Q

Oral chemotherapy:

Avoid co-administration with strong inducers/inhibitors of what CYP with regorafenib?

A

3A4

41
Q

Oral chemotherapy:

Regorafenib is a ___ inhibitor, and will increase exposure to fluvastatin and atorvastatin

A

BCRP

42
Q

Colorectal cancer is the ___ leading cause of cancer death in the US

a. 1st
b. 2nd
c. 3rd
d. 4th

A

b. 2nd

7361 Hem/Onc Block 3 (9 decks)

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