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Question 1

Primary treatment for colon cancer appropriate for resection

Resectable non obstructing colon cancer treatment

Answer 1

colectomy with removal of regional lymph nodes

Question 2

Primary treatment for colon cancer appropriate for resection

Resectable, obstructing colon cancer treatment

Answer 2

1- One-stage colectomy with removal of regional lymph nodes
2- Resection with diversion
3-Diversion
4- Stent

Question 3

Primary treatment for colon cancer appropriate for resection

Bulky nodal disease colon cancer treatment

Answer 3

neoadjuvant
FOLFOX or CAPEOX

Question 4

Primary treatment for colon cancer appropriate for resection

Clinical T4b colon cancer treatment

Answer 4

1- FOLFOX or CAPEOX
2- (Nivolumab ± ipilimumab) or pembrolizumab (dMMR/MSI-H)

Question 5

Locally unresectable or medically inoperable colon cancer treatment

Answer 5

1-Systemic Therapy
2-Infusional 5-FU + RT
3-Capecitabine + RT

Question 6

Colon Cancer adjuvant treatment accurding to stage

Tis; (T1, N0, M0); (T2, N0, M0)

Answer 6

Observation

Question 7

Colon Cancer adjuvant treatment accurding to stage

(T3 , N0, M0)
(No high-risk features)

Answer 7

1- Observation
2- capecitabine (6 months)
3- 5-FU/leucovorin (6 months)

Question 8

Colon Cancer adjuvant treatment accurding to stage

T3, N0, M0 (at high risk for systemic recurrence)
or T4, N0, M0

Answer 8

1-Capecitabine (6 months)
2-5-FU/leucovorin (6months)
3- FOLFOX (6 months)
4-CAPEOX (3 months)

Question 9

Colon Cancer adjuvant treatment accurding to stage

T1–3, N1 (low-risk stage III)

Answer 9

1-CAPEOX (3 months)
2-FOLFOX (3–6 months)
3-Capecitabine (6 months)
4- 5-FU (6 months)

Question 10

Colon Cancer adjuvant treatment accurding to stage

(T4, N1–2); (T Any, N2) = (high-risk stage III)

Answer 10

1-CAPEOX (3–6 months)
2-FOLFOX (6months)
3-Capecitabine (6 months)
4- 5-FU (6 months)

Question 11

which drug is considered as a replacement for fluorouracil in an attempt to improve the safety and ease of administration of the chemotherapy regimen

Answer 11

Capecitabine

Question 12

What is the most effective approuch to giving fluorouracil

Answer 12

giving Leucovorin prior to fluorouracil

Question 13

why do we give Preoperative (neoadjuvant) chemoradiation to colon cancer patients

Answer 13

to improve resectability

Question 14

what is the primary treatment modality for unresectable metastatic colorectal cancer

Answer 14

Chemotherapy

Question 15

what is the use of surgery and radiation in metastatic Colon cancer

Answer 15

used to manage isolated sites (one place) of
tumor

Question 16

who is a candidate for multimodality therapy in colon cancer

Answer 16

Patients with resectable metastases

Question 17

Resectable Metastatic Colorectal Cancer

what is the adjuvant treatment

Answer 17

1- No previous chemotherapy
FOLFOX or CAPEOX (preferred) or Capecitabine or 5-FU/leucovorin.

2-Previous chemotherapy
Observation (preferred for previous oxaliplatin-based therapy).
Systemic therapy ± biologic therapy.

Question 18

Resectable Metastatic Colorectal Cancer

what is the Treatments used in Hepatic Therapy

Answer 18

1- Drugs: – Floxuridine with dexamethasone and fluorouracil with or without leucovorin.
2- XRT.
3- Cryoablation.

Question 19

Unresectable Metastatic Colorectal Cancer Primary treatment

if the patient took Previous adjuvant FOLFOX/CAPEOX within past 12 months (1 year) what is the treatment?

Based on gene mutation Only

Answer 19

1- KRAS/NRAS/BRAF WT )wild-type= not mutated gene only:
* FOLFIRI or irinotecan ± bevacizumab
* (FOLFIRI or irinotecan) ± (cetuximab or panitumumab)

2- – dMMR/MSI-H only:
* Nivolumab ± (ipilimumab or pembrolizumab)

3- – BRAF V600E mutation positive:
* Encorafenib + (cetuximab or panitumumab)

Question 20

Unresectable Metastatic Colorectal Cancer Primary treatment

if Previous adjuvant FOLFOX/CAPEOX >12 months or Previous 5-FU/LV or capecitabine or No previous chemotherapy what is the treatment?

Based on gene mutation and intentsity

Answer 20

If Intensive therapy recommended:
1- FOLFOX or CAPEOX or FOLFIRI or FOLFIRINOX ± bevacizumab.
2- KRAS/NRAS/BRAF WT: FOLFOX or FOLFIRI + (cetuximab or panitumumab).
3-* dMMR/MSI-H only: ([Nivolumab ± ipilimumab] or pembrolizumab)

If Intensive therapy NOT recommended:
1- 5-FU ± leucovorin ± bevacizumab or Capecitabine ± bevacizumab
2- KRAS/NRAS/BRAF WT: Cetuximab or panitumumab
3- dMMR/MSI-H only: Nivolumab or pembrolizumab
4- HER2-amplified and RAS and BRAF WT: Trastuzumab + (pertuzumab or lapatinib).

just Remove ChemoTherapy in non intensive :D

Question 21

Why do we wait 6 weeks before doing surgery after giving bevacizumab

Answer 21

Because of the bleeding Risk

Question 22

Mention VEGF Inhibitors

2r zb

Answer 22

1-bevacizumab,
2-ramucirumab,
3-ziv-aflibercept
4-the multikinase inhibitor regorafenib (Limited to 3rd line)

Question 23

What is the 2nd line treatment for metastatic colon cancer with disease progression on first line treatment

اعكس :]

Answer 23

1- Irinotecan should be considered standard second-line therapy.
2- (FOLFOX) : for patients who received primary treatment with irinotecan plus fluorouracil.

Question 24

Salvage therapy for metastatic colon cancer

Answer 24

• The combination of oxaliplatin plus fluorouracil and leucovorin (FOLFOX) or (FOLFIRI)

Question 25

Which drug is FDA approved for treatment of metastatic colorectal cancer patients that has activity in RAS wild-type tumors

RAS = R

Answer 25

• Trifluridine/tipiracil

Question 26

mention EGFR Inhibitors used in colon cancer

Answer 26

1-cetuximab
2-panitumumab
3-irinotecan
4-FOLFIRI

Question 27

mention Drugs for colon cancer in patients with BRAF V600E mutations and thier target

they are 3

Answer 27

1- Encorafenib (a BRAF inhibitor),
2- Binimetinib (a MEK inhibitor)
3-Cetuximab (an EGFR inhibitor)

Question 28

Metastatic Disease: Second-Line and Subsequent Therapy

Immunotherapy used in dMMR who have progressed through 2-4 regimens

Answer 28

1-Pembrolizumab
2-Nivolumab