colorectal cancer Flashcards

1
Q

risk factors for colorectal cancer

A

age (>50)
Ashkenazi Jewish highest risk, African American
History of bowel disease/polyps (UC, Crohn’s)
Diet (high fat, low fiber, alcohol, low antioxidant/calcium/Vitamin D)
obesity, physical inactivity
diabetes
HNPCC, FAP

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2
Q

inherited conditions giving you high risk of colorectal cancer

A
  1. Hereditary non-polyposis colorectal cancer (HNPCC): 80% risk of developing colon cancer by age 44
  2. Familial adenomatous polyposis (FAP): 100% risk of developing colon cancer (average age 39)
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3
Q

specific screening guidelines for colorectal cancer

A

beginning at age 45 (earlier if high risk)
-yearly blood stool test (FOBT) or fecal immunochemical test (FIT) AND one of the following: flexible sigmoidoscopy, double contrast barium enema, CT colonography every 5 years, or colonoscopy every 10 years

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4
Q

when do you screen at a younger age?

A

family history of HNPCC: age 30
family history of FAP: puberty

UC or Crohn’s: 8 years after onset of pancolitis

Colorectal cancer or polyps in a 1st degree relative: age 40 or 10 years before youngest case in family, whichever is earlier

personal history of adenoma w/ polypectomy: 3 years after initial

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5
Q

importance of KRAS mutational status

A

if wild type: may respond to anti-EGFR therapy
if mutant: will be unresponsive, and worse prognosis

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6
Q

KRAS vs BRAF implications in therapy?

A

KRAS mutation= resistance to EGFR inhibitors
BRAF mutation= resistance to chemotherapy

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7
Q

1st line combo therapy for colorectal cancer

A

FOLFOX: fluorouracil, leucovorin, oxaliplatin

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8
Q

agents that target EGFR
what is the CRC marker?

A

cetuximab
panitumumab
CRC marker is KRAS wild-type

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9
Q

agents that target VEGF

A

bevacizumab
ramucirumab
Ziv-Aflibercept (a decoy receptor)

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10
Q

agents that target PD1 with CRC marker microsatellite instability high (MSI-h)

A

pembrolizumab
nivolumab

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11
Q

agents that target CTLA-4
what is the CRC marker?

A

ipilimumab
CRC marker is microsatellite instability high (MSI-h)

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12
Q

agents that target PD1 with CRC marker deficient mismatch repair (dMMR)

A

dostarlimab

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13
Q

agent that is a VEGF receptor inhibitor

A

regorafenib

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14
Q

agent that is a BRAF inhibitor
what is the CRC marker?

A

encorafenib
CRC marker is BRAF V600E mutation

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15
Q

agents that target HER2 and what is the CRC marker

A

trastuzumab
lapatinib
tucatinib
pertuzumab
CRC marker is HER2 positive tumors

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