GI Flashcards
1st mutation seen in development of pancreas cancer
KRAS
What is the degree cutoff for resectability in pancreas cancer
<180 degrees of major artery/vein or celiac plexus
What was the benefit of olaparib in pancreas cancer
Platinum sensitive disease resonding/stable after 16 weeks on treatment. Olaparib prolonged PFS by 3.6 months over placebo
What is adjuvant therapy for completely resected GB cancer
Cape x 8 cycles. Proven PFS benefit. No statistically significant OS benefit
What kind of drug is Pemigatinib?
When is it indicated?
FGFR2 inhibitor
2nd line therapy for biliary tract cancer
Which nodes are end point for local nodes in EGJ cancer?
Celiac nodes. Included in D2 resection
Preferred treatment locally advanced Esophageal SCC, Esophageal Adeno and GEJ adeno?
Chemo/RT-> Surgery
NO GASTRIC
Which locally advanced Gastro-Esophageal cancer group is not included in FLOT trial
Squamous
When do you need adjuvant chemo/RT in stomach/EGJ adenocarcinoma?
When there was a D1 resection (5FU based)
What are two aspects of imaging seen with HCC?
Arterial hypervascularity
Delayed Venous phase washout
In CIRRHOTIC livers
What are transplant qualifications for HCC (4)
Non-metastatic
No vein involvement
1 tumor up to 5 cm
3 tumors all less than 3 cm
Exclusion criteria for RFA (3)
Lesion >4cm
Child Pugh C
Near major vessel
NOT the case for TACE
Starting dose for Sorafenib in HCC
200 mg BID and titrate up
Cutoffs for +3 in ChildsPugh Score:
Albumin->
Bilirubin->
INR->
Albumin-> <2.8
Bilirubin-> >3
INR-> >2.2
Which Lynch mutation is mutually exclusive with BRAF mutation
MLH1. If MLH1 loss, check BRAF. If BRAF present, MLH1 is methylated, not mutated
What is high risk stage II colon cancer (5)
T4 tumor <12 LNs removed Obstructed/perforated LVI/PNI Poorly differentiated
Who does well with 3 mos of CAPOX as adjuvant therapy with colon cancer? (e.g. can be spared 6 months of FOLFOX)
Low Risk (t1-3n1)
Which stage II colorectal tumors should NOT get adjuvant treatment
MMR-D
Who can be spared Oxaliplatin in adjuvant space for colorectal cancer?
Age >70
What chemo is used with neoadjuvant RT in rectal cancer
Cape or 5-FU, no oxaliplatin needed
Which side colon cancer is more likely to benefit from cetuximab/panitumumab?
LEFT sided
RAS wild type
What is combo regimen for BRAF mutated colon cancer in second line?
Encorafenib + Cetuximab
What systemic treatment should be avoided in patients going for resection of liver met in colon cancer?
Cetuximab. It is harmful
Who gets adjuvant chemotherapy following Chemo/RT for anal cancer?
No one
