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PHRM 864 Therapeutics > Exam 2 - Melanoma Weddle > Flashcards

Exam 2 - Melanoma Weddle Flashcards

1
Q

melanocytes synthesize ________ to protect tissues from UV radiation induced damage

A

melanin

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2
Q

70% of melanoma cases; initally appears flat but subsequently becomes irregular and asymmetrical

a. superficial spreading melanoma
b. nodular melanoma
c. lentigo maligna melanoma
d. acral lentiginous melanoma
e. uvual melanoma

A

a. superficial spreading melanoma

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3
Q

15% melanoma cases; appears dark blue-black in color; appears on head, neck and trunk

a. superficial spreading melanoma
b. nodular melanoma
c. lentigo maligna melanoma
d. acral lentiginous melanoma
e. uvual melanoma

A

b. nodular melanoma

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4
Q

-presents on the face of elderly pts
-tan lesion with areas of brown and black
-low propensity to metastasize

a. superficial spreading melanoma
b. nodular melanoma
c. lentigo maligna melanoma
d. acral lentiginous melanoma
e. uvual melanoma

A

c. lentigo maligna melanoma

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5
Q

-frequently presents on the palms, soles, or under nail beds
-lesions often have irregular, convoluted borders
-more common in African-Americans, Asians, and Hispanics

a. superficial spreading melanoma
b. nodular melanoma
c. lentigo maligna melanoma
d. acral lentiginous melanoma
e. uvual melanoma

A

d. acral lentiginous melanoma

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6
Q

-arises from pigmented epithelium of the choroid
-most common ocular melanoma
-often metastasis in liver

a. superficial spreading melanoma
b. nodular melanoma
c. lentigo maligna melanoma
d. acral lentiginous melanoma
e. uveal melanoma

A

e. uveal melanoma

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7
Q

clinical presentation of melanoma acronym

A

ABCDE
-Asymmetric
-irregular Borders
-wide variety of Colors
-Diameter of > 6 mm
-Evolution of a mole

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8
Q

gold standard diagnostic work up of melanoma

A

biopsy of suspected lesion

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9
Q

purpose of a sentinel-node biopsy in melanoma diagnostics

A

determines if the melanoma has invaded lymph node beds

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10
Q

if a melanoma is a clinical or pathologic stage IV, the tumor tissue should be tested for what mutations?

A

BRAF V600E and K mutations

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11
Q

T or F: radiation is used in all melanoma pts

A

F (could be offered in adjuvant setting for select pts with positive lymph nodes and high risk of relapse)

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12
Q

look at melanoma tx overview (slide 20)

A

okay

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13
Q

the Checkmate 238 trial found that toxicities were higher with which adjuvant drug?

a. nivolumab
b. ipilimumab

A

b. ipilimumab

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14
Q

adjuvant dabrafenib/trametinib is used in which stage of melanoma?

a. IB or IIA
b. IIB or IIC
c. III
d. unresectable stage III with in-transit lesions

A

c. III

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15
Q

how long should adjuvant dabrafenib/trametinib be used in stage III melanoma pts?

a. one month
b. three months
c. six months
d. one year
e. for life

A

d. one year

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16
Q

SE of adjuvant dabrafenib/trametinib (3 of them)

A

-fever
-fatigue
-nausea

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17
Q

T or F: immunotherapy can take weeks to see effect

A

T

18
Q

for metastatic melanoma, what are the 3 combination targeted therapy if BRAF V600 mutant is present?

A

-dabrafenib/trametinib
-vemurafenib/cobimetinib
-encorafenib/binimetinib

19
Q

unique toxicity of vemurafenib

A

development of squamous cell carcinoma (up to 26%)

20
Q

encorafenib and binimetinib have less occurrence of which common side effect?

A

less fevers

21
Q

match these 6 drugs to its partner in combination therapy for BRAF V600 mutation:

vemurafenib
binimetinib
trametinib
encorafenib
dabrafenib
cobimetinib

A

dabrafenib/trametinib
vemurafenib/cobimetinib
encorafenib/binimetinib

22
Q

BRAF resistance to single agent therapy typically occurs around ___-___ months

A

6-7 months (so combo therapy preferred)

23
Q

two PD-1 inhibitors for melanoma (slide 39)

A

nivolumab, pembrolizumab

24
Q

two CTLA-4 inhibitors for melanoma (slide 39)

A

ipilimumab, tremelimumab

25
Q

two PD-L1 inhibitor drugs for melanoma (slide 39)

A

atezolizumab, durvalumab

26
Q

T or F: all pts should receive all 4 doses of ipilimumab unless experiencing life threatening toxicities

A

T (typically the tumor might get worse initially, but will get better over time)

27
Q

immunotherapy response is measured by what? (slide

A

immune related response criteria (irRC)

28
Q

_____ and _____ toxicities are the most common with ipilimumab

A

skin; GI

29
Q

which toxicities of ipilimumab take the LONGEST to reverse (and may not reverse)?

a. skin
b. GI
c. liver
d. endocrine

A

d. endocrine

30
Q

T or F: chemo usually cures any pt in the metastatic setting, either single agent or combo therapy

A

F (rarely cures; response rate ~10%)

31
Q

interleukin 2 role in melanoma (fallen out of favor)

A

stimulator of cytotoxic T cells, has activity against melanoma cells

32
Q

drug associated with life threatening capillary leak syndrome

a. interferon alfa
b. interleukin 2
c. pembrolizumab
d. dabrafenib/trametinib

A

b. interleukin 2

33
Q

what is another immunotherapy drug for melanoma that is not IL-2?

A

interferon alfa

34
Q

melanoma screening: the American Academy of Dermatology recommends a self-exams to check for melanoma how often (not a high risk pt)?

a. weekly
b. biweekly
c. monthly
d. yearly

A

c. monthly

35
Q

how often should high-risk pts be receiving a clinical exam for melanoma?

a. weekly
b. biweekly
c. monthly
d. yearly

A

d. yearly

36
Q

T or F: pts with a strong family history of melanoma should have a clinical exam by a physician

A

T

37
Q

melanoma prevention: what SPF sunscreen should be used?

A

15 or greater

38
Q

which drug can be used in stage IIB or IIC melanoma pts?

a. nivolumab
b. dabrafenib/trametinib
c. pembrolizumab
d. pemetrexed

A

c. pembrolizumab

39
Q

T-VEC, topical imiquimod and radiation can be used in this stage of melanoma tx

a. IB or IIA
b. IIB or IIC
c. III
d. unresectable stage III with in-transit lesions

A

d. unresectable stage III with in-transit lesions

40
Q
A

PHRM 864 Therapeutics (22 decks)

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