E2 melanoma Flashcards
dendritic pigmented cells that arise from the neural-crest tissue during early fetal development and migrate to sites within the body
melanocytes
T or F:
being male is a risk factor for melanomas
yes, for the first time ever
70% of cases, lesions arise from a pre-existing nevus over 1 to 5 years
superficial spreading melanoma
Clinical presentation acronym:
ABCDE
Asymmetric
have irregular Borders
variety of Colors
Diameter >6mm
Evolution of mole
gold standard of diagnostic work up
biopsy of suspected lesion
when should the tumor tissue be tested for BRAF V600E and K mutations?
stage IV
T or F:
Adjuvant therapy is recommended in melanoma
true, based on stage tho
clinical trial or observation:
A. Stage IB or IIA
B. Stage IIB or IIC
C. Stage III
A
clinical trial, observation, pembro
A. Stage IB or IIA
B. Stage IIB or IIC
C. Stage III
B
Nivolumab, pembro, or dabra/tramet (if BRAF mutant), +/- radiation
A. Stage IB or IIA
B. Stage IIB or IIC
C. Stage III
C. duh bro
Unresectable stage III with in-transit lesions
Talimogene Laherparapvec (T-VEC), topical imiquimod, consider radiation, isolated limb perfusion
what the fuck is any of that shit
T or F:
In the checkmate trial, toxicities were higher in ipilimumab arm compared to nivolumab
true
if you see keynote trial what drug is on your mind (because youre so smart :))
pembro
preferred immunotherapy in adjuvant setting
ipilimumab
T or F:
Adjuvant dabraf/tramet is used in unresectable stage III disease with BRAF V600E or K mutations
false, completely resected (adjuvant)
3 most common toxicities of dabraf/tramet
pyrexia (fever) *
fatigue
nausea
first line metastatic treatment options: (3 main choices, many drugs tho)
- anti PD-1 monotherapy (nivolumab, pembro)
- combo targeted tx BRAF mutation (dabraf/tramet)
- certain circumstances (nivolumab/ipilimumab)
T or F:
if you fail one PD1 drug you can try a combination and still see effect *
true, she said that was important so lookout for exam question
T or F:
chemo is 1st line in metastatic treatment
false, 2nd line
what are some of the chemo options in 2nd line metastatic treatment (this is just to familiarize with myself)
dacarbazine
temozolomide
paclitaxel *
albumin bound paclitaxel
carboplatin/paclitaxel
Which has a quicker onset of action, targeted therapy or immunotherapy?
targeted (oral)
which kind of therapy can take weeks to see effect *
immunotherapy (-mabs)
Vemurafenib:
MOA:
Unique toxicities
BRAF kinase inhibitor
Development of squamous cell carcinoma
Cobimetinib:
indicated in:
used in combo with:
treatment of unresectable or metastatic melanoma in patients with BRAF mutations
combo with Vemurafenib
