LEC7

Question 1

the desired outcome of treatment of stage 1 and 2 Lung cancer

Answer 1

Defenitive cure is the desired outcome of treatment.

Question 2

the desired outcome of treatment of stage 3 and 4 and extensive Lung cancer

Answer 2

prolongation of survival

Question 3

NSCLC Stage IA and IB treatment

Answer 3

Surgery Alone

Question 4

NSCLC Stage IIA and IIB treatment

Answer 4

primarily treated with surgery, Which should be followed by adjuvant chemotherapy Cisplatin–Vinorelbine

Question 5

NSCLC Stage IIA and IIB treatment with non squamos histology

Answer 5

1-Cisplatin with either etoposide, vinblastine, or pemetrexed (c+ pev)
2- Carboplatin with either paclitaxel or pemetrexed

Question 6

NSCLC Patients who are medically inoperable

Answer 6

Chemoradiotherapy

Question 7

Common regimens used in adjuvant treatment of NSCLC

Answer 7

1-Cisplatin+etoposide, 28Days
2-Cisplatin+vinorelbine, 28Days
3-Carboplatin+Paclitaxel 21Days
4-Cisplatinpemetrexed 21Days
(c+ pev)

Question 8

TREATMENT – NSCLC Adjuvant therapy

Stage IA (T1abc, N0) Negative (R0)

Stage based.

Answer 8

Observe

Question 9

TREATMENT – NSCLC Adjuvant therapy

Stage IA (T1abc, N0) Positive (R1, R2)

Stage based.

Answer 9

Reresection (preferred جداا مهم) or RT (radiotherapy)

Question 10

TREATMENT – NSCLC Adjuvant therapy

Stage IB (T2a, N0) Negative (R0)

Stage based.

Answer 10

**Observe or Chemotherapy for high-risk patients
followed by osimertinib (EGFR mutation لو)

Question 11

TREATMENT – NSCLC Adjuvant therapy

Stage IB (T2a, N0) Positive (R1, R2)

Stage based.

Answer 11

Reresection (preferred جداا مهم) ± chemotherapy or RT

Question 12

TREATMENT – NSCLC Adjuvant therapy

Stage IIA (T2b, N0) Negative (R0)

Stage based.

Answer 12

Observe or Chemotherapy for high-risk patients followed by atezolizumab or pembrolizumab or osimertinib (EGFR mutation) (APO)

Question 13

TREATMENT – NSCLC Adjuvant therapy

Stage IIA (T2b, N0) Positive (R1, R2)

Stage based.

Answer 13

Reresection (preferred جداا مهم) ± chemotherapy or
RT ± chemotherapy

Question 14

TREATMENT – NSCLC Adjuvant therapy

Stage IIB (T1abc–T2a, N1) Stage IIB (T3, N0;
T2b, N1) Negative (R0)

Stage based.

Answer 14

Chemotherapy (category 1 جداا مهم) followed by atezolizumab or pembrolizumab or osimertinib (EGFR mutation) (APO)

Question 15

TREATMENT – NSCLC Adjuvant therapy

Stage IIB (T1abc–T2a, N1) Stage IIB (T3, N0;
T2b, N1) Positive (R1)

Stage based.

Answer 15

Reresection + chemotherapy or
Chemoradiation (sequential or concurrent)

Question 16

TREATMENT – NSCLC Adjuvant therapy

Stage IIB (T1abc–T2a, N1) Stage IIB (T3, N0;
T2b, N1) Positive (R2)

Stage based.

Answer 16

Reresection + chemotherapy or
Concurrent chemoradiation

Question 17

TREATMENT – NSCLC Adjuvant therapy

Stage IIIA (T1–2, N2; T3, N1) Stage IIIB (T3, N2) Negative (R0)

Stage based.

Answer 17

Chemotherapy (category 1 جداا مهم) followed by atezolizumab or pembrolizumab or osimertinibp (EGFR mutation) (APO) or
Sequential chemotherapy and consider RT

Question 18

TREATMENT – NSCLC Adjuvant therapy

Stage IIIA (T1–2, N2; T3, N1) Stage IIIB (T3, N2) Positive (R1)

Stage based.

Answer 18

Chemoradiation (sequential or concurrent)

Question 19

TREATMENT – NSCLC Adjuvant therapy

Stage IIIA (T1–2, N2; T3, N1) Stage IIIB (T3, N2) Positive (R2)

Stage based.

Answer 19

Concurrent chemoradiation

Question 20

 For patients with stage III disease (large tumor [T3 or T4] or mediastinal node positive [N2 or N3]) the treatment is?

Answer 20

• Radiation in the adjuvant or neoadjuvant setting
• With or without chemotherapy is recommended

Question 21

 Patients with operable Stage 3 lung cancer disease treatment

Answer 21

• Should be considered for surgery Preceded or followed by systemic
  هنا مفيش عالج اشعاعى مهم جداا chemotherapy

Question 22

what is the point of Adjuvant chemotherapy after surgery in selected patients in Stage 3 Lung cancer?

Answer 22

improves overall survival.

Question 23

 Patients with stage IIIA disease who are not surgical candidates or have a tumor that cannot be resected, and nearly all stage IIIB patients are treated with?

Answer 23

• Treated with both an active platinum containing regimen and concurrent radiotherapy

Question 24

Patients with tumors that cannot fit safely in a radiation port treatment in lung cancer

Answer 24

• May receive induction chemotherapy (to shrink the tumor) followed by chemoradiotherapy

Question 25

stage 3 lung cancer who are  Responding to treatment may then become

Answer 25

• Surgical candidates.

Question 26

Patients who respond to chemotherapy in stage 3 lung cancer (CR+PR+SD, (CR = complete response; PR = partial response; SD = stable disease about 80% of patients) should recieve?

Answer 26

maintenance therapy with durvalumab, a PD-L1 inhibitor

Question 27

how to treat Patients with stage III disease who are not candidates for radiation

Answer 27

are treated like those with stage IV disease

Question 28

primary treatment for Advanced (Stage IV) and Relapsed Disease

General answer

Answer 28

systemic therapy is the primary treatment

Question 29

First-line therapy for patients with NSCLC with PD-L1+ tumors is?

Answer 29

Pembrolizumab

Question 30

Advanced lung cancer (Stage IV)

Stage 4 with EGFR mutation treatment

e.g. a,o

Answer 30

1-erlotinib
2-gefitinib
3-afatinib
4-Osimertinib (a third-generation EGFR tyrosine kinase inhibitor)

Question 31

Advanced lung cancer (Stage IV)

Stage 4 with ALK mutation treatment

AB2C+L

Answer 31

1-Crizotinib (first-line therapy)
2-Ceritinib (first-line therapy)
3-Alectinib
4-brigatinib
5-lorlatinib, (a third-generation ALK inhibitor)

Question 32

Advanced lung cancer (Stage IV)

Stage 4 with ROS1 mutation treatment

3C

Answer 32

1- EntreCtinib(1st line)
2- Crizotinib(1st line)
3-Ceritinib(2nd line)

Question 33

Advanced lung cancer (Stage IV)

Stage 4 with BRAFV600E mutation treatment

Answer 33

1-trametinib (MEK inhibitor)
2-dabrafenib (inhibitor of mutated BRAF kinases)

Question 34

Advanced lung cancer (Stage IV)

Stage 4 with 5. NTRK mutation treatment

Answer 34

Larotrectinib

Question 35

Advanced lung cancer (Stage IV)

Stage 4 lung cancer non mutation driven treatment

Answer 35

cisplatin or carboplatin combined with paclitaxel (or nab-paclitaxel) docetaxel ,gemcitabine, pemetrexed, or vinorelbine

Question 36

rules for using bevacizumab in stage 4 lung cancer

Answer 36

– advanced NSCLC of nonsquamous cell histology,
– no history of recent significant hemoptysis,
– no CNS metastasis, and not receiving therapeutic anticoagulation

Question 37

SCLC (Small cell lung cancer) treatment

Limited Disease: When a single SCLC mass is found treatment

Answer 37

– local therapy with radiation or surgery is considered

Question 38

SCLC (Small cell lung cancer) treatment

One of the differences between SCLC and NSCLC is

Answer 38

– that radiation is preferred for treatment of local disease over surgery

Question 39

SCLC (Small cell lung cancer) treatment (limited)

• Radiation is …………. with ……………… in limited-
  stage SCLC, and the regimen of choice ……….?

Answer 39

1-Always combined with
2-Chemotherapy
3-Etoposide and Cisplatin (EP)

If Cisplating is causing side effects then switch to Carboplatin

Question 40

SCLC (Small cell lung cancer) treatment (extensive)

SCLC (Small cell lung cancer) treatment (extensive)

EP EC IP T N

Answer 40

1st line: 1-Etoposide/cisplatin
2-Etoposide/carboplating
3-cisplatin/irinotecan

2nd line: 1-Topotecan
2-Nivolumab

Question 41

Small cell lung cancer Relapsed Disease treatment <3months

Answer 41

Should receive best supportive care or be enrolled in a clinical trial

Question 42

Small cell lung cancer Relapsed Disease treatment >3months

Answer 42

The expected response rate to treatment is about 25%, and Second-line therapy should be considered