Lung Cancer Flashcards
In what patient population should you consider lung cancer screenings?
high risk
What are some factors that would put a patient at high risk for lung cancer?
age 55-74; 30 pack per year history; still smoking or quit in the last 15 years
What is the benefit of smoking cessation in relation to lung cancer?
decreases risk of secondary cancers developing
EFGR mutations predict sensitivity to ____.
tyrosine kinase inhibitors
KRAS mutations predict resistance to ____.
tyrosine kinase inhibitors
KRAS mutations are exclusive to what patient population?
heavy smokers
ROS-1 mutations are present in what patient population?
never smoked/light smokers
Do you test for PD-L1 in NSCLC or SCLC?
NSCLC
What are the two most common types of NSCLC?
adenocarcinoma; squamous
NSCLC adenocarcinoma is most common in ____.
non-smokers
Squamous NSCLC is clearly related to ____.
smoking
Which is more rapidly progressive? NSCLC or SCLC?
SCLC
What are the mainstays of treatment for SCLC?
chemotherapy & radiation
What is the mainstay of treatment for NSCLC?
surgery
What stage of lung cancer do most patients present with?
metastatic
Definition: tumor is confined to the hemithorax and contained in one radiation port
limited stage SCLC
Definition: tumor not confined to the hemithroax, not contained in one radiation port, distant metastasis
extensive stage SCLC
What is the goal of therapy in limited stage SCLC?
cure
What chemotherapy regimen is used in limited stage SCLC?
cisplatin + etoposide
What should be given along with chemotherapy in limited stage SCLC?
radiation
Does surgery play a role in limited stage SCLC?
no
What is used to prevent brain metastases in SCLC?
prophylactic cranial radiation
Is radiation used as curative therapy in extensive stage SCLC?
no, just chemotherapy
What are the two first line therapies for extensive stage SCLC?
atezolizumab + carboplatin + etoposide OR durvalumab + carboplatin + etoposide
Is maintenance therapy recommended after chemotherapy cycles are completed in extensive stage SCLC?
yes
What drugs are used as maintenance therapy for extensive stage SCLC?
atezolizumab & durvalumab
Which is preferred in SCLC? Cisplatin or carboplatin?
cisplatin
Why would you choose carboplatin over cisplatin?
the patient requires a less toxic therapy
What is the preferred regimen in non-squamous NSCLC?
cisplatin + pemetrexed
What is the preferred regimen in squamous NSCLC?
cisplatin + docetaxel OR cisplatin + paclitaxel
What maintenance therapy is given to patients with unresectable NSCLC?
durvalumab
Is treatment considered palliative or curative in unresectable NSCLC?
palliative
What therapy is available for PD-L1+ patients with unresectable NSCLC?
pembrolizumab
What is the first line EGFR targeted therapy?
osimeritinib
What is the first line ALK targeted therapy?
alectinib
What is the first line ROS-1 targeted therapy?
crizotinib
What is the first line BRAF targeted therapy? Hint: includes a MEK inhibitor
dabrafenib + trametinib
What is the first line NTRK gene fusion therapy?
larotrectinib
What is the first line RET rearrangement therapy?
selpercatinib
What is the first line MET targeted therapy? (2)
capmatinib OR tepotinib
What is the first line KRAS targeted therapy?
sotorasib
What regimen is recommended for patients with mutation negative non-squamous NSCLC?
carboplatin + pemetrexed + pembrolizumab
What regimen is recommended for patients with mutation negative squamous NSCLC? (immunotherapy is not contraindicated)
pembrolizumab + carboplatin + paclitaxel
What regimen is recommended for patients with mutation negative squamous NSCLC if immunotherapy is contraindicated?
carboplatin + etoposide
When would you give a patient albumin-bound paclitaxel instead of regular paclitaxel?
if they have a contraidication to steroids
