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PHRM 864 Therapeutics > Exam 2 - Lung Cancer Weddle > Flashcards

Exam 2 - Lung Cancer Weddle Flashcards

1
Q

___-___ % of lung cancers are associated with smoking

A

85-90%

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2
Q

______ mutations can predict sensitivity to TKI therapy, and is present in 10-15% of NSCLC

a. EGFR
b. KRAS

A

a. EGFR

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3
Q

_____ mutations predict resistance to TKI’s; in adenocarcinomas, mutations are exclusive to smokers, ~10-30% of NSCLC

a. EGFR
b. KRAS
c. ALK
d. ROS-1

A

b. KRAS

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4
Q

encodes a receptor kinase related to ALK; present in 1% of NSCLC

a. EGFR
b. KRAS
c. ALK
d. ROS-1

A

d. ROS-1

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5
Q

it is recommended to test in 1st line metastatic setting for NSCLC

a. ROS-1 mutation
b. BRAF V600E mutation
c. EGFR mutations

A

b. BRAF V600E mutation

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6
Q

T or F: PD-L1 testing is not recommended for SCLC

A

T

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7
Q

adenocarcinomas, squamous and non-squamous cells, and large cells fall under which class?

a. NSCLC
b. SCLC

A

a. NSCLC

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8
Q

Which NSCLC is being described below?
-most common in non-smokers
-tend to be located peripherally in the lung

a. adenocarcinoma
b. squamous
c. large cell
d. small cell

A

a. adenocarcinoma

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9
Q

Which NSCLC is being described below?
-clearly related to smoking
-tend to be located centrally in lung

a. adenocarcinoma
b. squamous
c. large cell
d. small cell

A

b. squamous

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10
Q

which NSCLC is being described below?
-tend to be located peripherally in the lung
-tend to be a diagnosis of exclusion

a. adenocarcinoma
b. squamous
c. large cell
d. small cell

A

c. large cell

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11
Q

what is being described below?
-related to smoking
-fast growing and rapidly progressive
-can have presence of paraneoplastic syndromes

a. adenocarcinoma
b. squamous cell carcinoma
c. large cell carcinoma
d. small cell carcinoma

A

d. small cell carcinoma

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12
Q

rank these in order of how common they are in types of lung cancer?
large cell, small cell, adenocarcinoma, squamous

A

adenocarcinoma (50%) > squamous (30%) > small cell (15%) > large cell (5%)

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13
Q

which of the following about SCLC and NSCLC is TRUE?

a. NSCLC has a clear relationship to smoking
b. paraneoplastic syndromes are common in NSCLC
c. SCLC is not sensitive to radiation and chemo
d. NSCLC has a slower growth fraction

A

d. NSCLC has a slower growth fraction

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14
Q

which of the following presents more commonly with metastases?

a. SCLC
b. NSCLC

A

a. SCLC (66% vs 50%)

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15
Q

limited vs extensive stage SCLC

A

-limited = tumor is confined to hemithorax and contained in a radiation port
-extensive = not confined to hemithorax of origin, not contained in a radiation port, distant metastasis

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16
Q

what is the median survival for extensive and limited stage SCLC without therapy?

A

extensive -> 6 weeks
limited -> 12 weeks

17
Q

limited stage SCLC combo therapy

A

cisplatin + etoposide + radiation

18
Q

platinum based combo chemotherapy WITHOUT radiation is preferred in _________ stage SCLC

a. limited
b. extensive

A

b. extensive

19
Q

for extensive stage SCLC, first line regimens involve carboplatin, etoposide, plus what third drug? (2 options; slide 28-30)

A

atezolizumab, durvalumab

20
Q

T or F: pembrolizumab is an option for metastatic SCLC after platinum-based chemo and at least 1 prior line of therapy, regardless of PD-1 status

A

T

21
Q

what is the most efficacious modality for tx of NSCLC?

A

surgery

22
Q

3 types of NSCLC

A

resectable, unresectable, advanced/metastatic

23
Q

T or F: neoadjuvant chemotherapy is considered standard of care for NSCLC

A

F (adjuvant, not neoadjuvant)

24
Q

how do we decide which chemotherapy will be used for NSCLC?

A

depends on histology, squamous vs non-squamous

25
Q

which adjuvant therapy is preferred for non-squamous NSCLC?

a. cisplatin + pemetrexed
b. cisplatin + gemcitabine
c. cisplatin + docetaxel

A

a. cisplatin + pemetrexed

(non-squamous = pemetrexed)

26
Q

if pt is not able to tolerate cisplatin, what can we change it to?

A

carboplatin

27
Q

two drug options for unresectable stage II/III NSCLC after concurrent chemoradiation

A

-durvalumab
-osimertinib (if EGFR exon 19 deletion or L858R)

28
Q

immunotherapy option for stage III unresectable NSCLC in pts who aren’t candidates for surgery or definitive chemotherapy with radiation

A

pembrolizumab

29
Q

if a pt has a targetable mutation and is PD-L1 (+), it is preferred to use the _____ therapies first and then move to immunotherapy later

A

oral

30
Q

BRAF mutations are present in ___-___ of adenocarcinomas

A

1-2%

31
Q

agent for KRAS G12C mutation

A

sotorasib

32
Q

which BRAF therapy has the following toxicities: fever, rash, and secondary skin cancers?

a. dabrafenib
b. trametinib

A

a. dabrafenib

33
Q

which BRAF therapy has the following toxicities: fever, rash, visual changes, retinal detachment?

a. dabrafenib
b. trametinib

A

b. trametinib

34
Q

drug for T790M mutation

a. alectinib
b. sotorasib
c. pembrolizumab
d. atezolizumab
e. osimertinib

A

e. osimertinib

35
Q

pembrolizumab can be used in metastatic disease with PD-L1 positivity > ___ %

A

> 1%

(pembro or atez)

36
Q

squamous NSCLC standard 3 drug regimen

A

carboplatin + paclitaxel + pembrolizumab

37
Q

What laboratory values do we need monitor in patients receiving immunotherapy? (6 of them)

A

CBC, CMP, TSH, free T4, amylase, lipase

38
Q

we can consider lung cancer screening for high-risk pts:
age ___-___, have a ___-pack year history of smoking and are still smoking or have quit in the past ___ years, good health, and are willing to have curative lung surgery if detected

A

55-75; 30; 15

39
Q

What would be the preferred treatment regimen for someone with limited stage SCLC?

A

cisplatin + etoposide + radiation

PHRM 864 Therapeutics (28 decks)

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