Lung Cancer

Question 1

Adenocarcinoma of lung IHC (3)

Answer 1

TTF-1 +, CK7+, CK20-

Question 2

IHC of squamous cell carcinoma of lung (2)

Answer 2

p63+ p40+

Question 3

What stage is adjacent chest wall invasion or multiple lesions in the same lobe with negative LNs?

Answer 3

Stage II

Question 4

What stage is a lung cancer with multiple nodules in same or ipsilateral lobe with N1 disease?

Answer 4

Stage III

Question 5

Size cutoff for stage I lung cancer

Answer 5

> /= 5cm

Question 6

Contraindications for Operability in lung cancer (3)

Answer 6

• • Hoarse Voice
• • elevated hemidiaphragm
• • post op predicted FEV1 of >40%

Question 7

What size primary tumor can benefit from post-op chemotherapy?

Answer 7

> 7 cm

If N0 this is a T4 tumor, stage IIIa by AJCC staging

Question 8

What chemo is used for adjuvant chemo in stage IB-IIIA resected tumors?

Answer 8

Cisplatin based doublet
Squam-> Cis/Gem or Cis/Docetaxel
Non-Squam-> Cis/pem

Both x4

Question 9

Indications for PORT (3)

Answer 9

Positive margin
inadequate LN dissection (<10 sampled)
N2 disease

Question 10

What is the benefit of adding bevacizumab to pemetrexed maintenance in nonsquamous histology ineligible for IO therapy in metastatic setting

Answer 10

Bevacizumab improved PFS only (not OS)

Pemetrexed prolongs PFS and OS

Question 11

Which ALKi has best CNS penetration?

Answer 11

Alectinib

Question 12

Major side effects of lorlatinib (3)

Answer 12

Hypercholesterolemia
Edema
Weight gain

Question 13

What line of therapy is chemotherapy incorporated in alk mutated lung cancer

Answer 13

3rd line

Question 14

Therapies for ROS-1 fusions in lung cancer

Answer 14

Crizotinib

Entrectinib

Question 15

Thearpies for RET Fusions in lung cancer

Answer 15

Selpercatinib

Pralsetinib

Question 16

MET exon 14 splice mutation drugs (2)

Answer 16

Capmatinib
Tepotinib
(c/b peripheral edema)

Question 17

Which PD-1 therapy is limited to those with PDL1% >1 in second line setting

Answer 17

Pembro

Question 18

What is best regimen for Met Lung cancer with PDL1 >50%?

Answer 18

Pembro alone. Equal to combination ICI, Chemo/ICI in terms of 1 year OS.

Add chemo if need quick response