Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PHRM 864: Therapeutics IV > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

What is important to know about the cases and the deaths related to Lung Cancer?

A
  • 2nd most common
  • MOST common cause of death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the main risk factor that affects Lung Cancer?

A
  • SMOKING: can be basically preventable
  • 85-90% of Lung Cancer is from Smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some of the other risk factors for Lung Cancer?

A
  • RISK decrease after smoking cessation
  • Heavy Metals
    -?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the etiology of Lung Cancer?

A
  • The Chronic exposure of carcinogens causing inflammation causing genetic changes = carcinogenesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some of the mutations that are associated with Lung Cancer?

A
  • EGFR [10-15%; common in AA & less in Asian; T790M]
  • K-RAS [10-30% shorter survival; SMOKERS]
  • ALK [4-8%; no/light smokers; young]
  • ROS-1 [1%; never smoked]
  • BRAF [1-2%; test in 1st line metastatic NSCLC]
  • PD-L1 [early stage & metastatic]
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the two histologic classifications for Lung Cancer?

A
  • NSCLC: adenocarcinoma [50% & non-smoker], Squamous [30%], Large Cell [5%]
  • SCLC: Small Cell [15% & Smokers]
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some of the main differences between NSCLC & SCLC in Lung Cancer?

A
  • SCLC: Smoking, Rapid Growth, HIGHLY sensitive to radiation & chemo
  • NSCLC: Slow growth MOD sensitive to radiation, Slight sensitive to chemo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the two stages in SCLC?

A
  • Limited & Extensive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Within SCLC, is surgery generally an option?

A
  • NO; Radation and Chemo is
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is important to know about Limited Stage SCLC?

A
  • CUREATIVE intent
  • Survival ~12w
  • Combined Modailty: Rads + Chemo
  • NEED prophylactic cranial Rads
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some of the regimens that are used for Limited Stage SCLC?

A
  • EP: Cisplatin + Etoposide
  • EC: Carboplatin + Etoposide
    [Cisplatin < Carboplatin]
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is important to know about Extensive Stage in SCLC?

A
  • RARELY CURABLE
  • Survival ~6w
  • Platinum Chemo WITHOUT Rads
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some of the chemos that are used in Extensive Stage SCLC?

A
  • Cisplatin or Carboplatin x4
    [Etoposide or Irinotecan]
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Should brain radiation by used in Extensive Stage SCLC?

A
  • Yes, if metastases
  • Symptomatic = Rads before Chemo
  • Asymptomatic = Rads after Chemo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some of the Immunotherapies that can be used in Extensive Stage SCLC?

A
  • Atezolizumab + Carboplatin + Etoposide [IMpower133 trail]
  • Durvalumab + Carboplatin + Etoposide [CASPIAN trial]
  • Durvalumab + Cisplatin + Etoposide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some of the complications of therapy for SCLC?

A
  • Platinum drugs = Nephrotoxicity & Neurotoxicity
  • Rads = Fatigue, Cardio issues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is important to know about PD-1 Inhibitors in SCLC?

A
  • Pembrolizumab: for patients that have progressed on or after platinum regardless of status
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In Limited or Extensive SCLC, should radiation be give concurrently with chemo?

A
  • Limited: yes; given with cisplatin
  • Extensive: ?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is important to know about Immunotherapy Extensive Stage SCLC?

A
  • BOTH of the immunotherapies will be used as maintenacne after the chemo cycles
20
Q

Within NSCLC, what are some of the important treatment stratedges to use?

A
  • Surgery = MOST EFFICACIOUS
  • Rads = when surgery not able
21
Q

What are the three types of NSCLC treatment options?

A
  • Resectable, Unresectable, Metastatic
22
Q

What is the flow for Resectable NSCLC?

A
  • Resectable [yes or no]
  • Neoadjuvant
  • Surgery
23
Q

What is the neoadjuvant therapy that is used in Resectable NSCLC?

A
  • Nivolumab + Platinum Doublet
24
Q

When should Chemotherapy be used in NSCLC?

A
  • Adjuvant [after surgery & Chemo] = standard of care
  • NEED to know if squamous or non-squamous
25
Q

For NON-SQUAMOUS, what is the preferred treatment for Adjuvant Resectable NSCLC?

A
  • Cisplatin + Pemetrexed
26
Q

For SQUAMOUS, what is the preferred treatment for Adjuvant Resectable NSCLC?

A
  • Cisplatin + Gemsitabine
  • Cisplatin + Docetaxel
27
Q

For both of the Adjuvant [squamous or non-squamous], if cisplatin is not tolerated what should be used?

A
  • Carboplatin [less toxicities]
28
Q

WHat are some of the other adjuvant NSCLC therapies that can be used?

A
  • Osimertinib [EGFR mutations]
  • Atezolizumab [PD-L1] & Pembromlizumab [PD-1]
29
Q

What is the flow for Unresectable NSCLC?

A
  • Chemo & Rads
30
Q

For NON-SQUAMOUS, what is the preferred treatment for Unresectable NSCLC?

A
  • Same as Resectable
  • Cisplatin [or Carboplatin] + Pemetrexed
31
Q

For SQUAMOUS, what is the preferred treatment for Unresectable NSCLC?

A
  • Paclitaxel + Carboplatin?
  • Cisplatin + Etoposide?
32
Q

What is the Immunotherapy that can be used for Maintenance in Unresectable NSCLC?

A
  • Durvalumab: APPROVED for unresectable, stage III that has NOT progressed [1y]
33
Q

When should Pembrolizumab be used in Unresectable NSCLC?

A
  • Stage III –> when there is a lot of comorbidities & are not cadidates for surgery or chemo
34
Q

For treatment of Metastatic NSCLC, what are some things that we want to look for?

A
  • if there is a target or no target [mutations in genes]
35
Q

What is the targeted therapy for EGFR mutations in Metastatic NSCLC?

A
  • Exon 19 deletion & Exon 21 substitution
  • Osimertinib [T790M]
36
Q

What is the targeted therapy for BRAF mutations in Metastatic NSCLC?

A
  • BRAF V600 mutation
  • Dabrafinib + Trametinib [BRAF + MEK]
37
Q

What is important to know about using Dabrafinib in general?

A
  • Could causes secondary cancers [skin]
38
Q

What is the targeted therapy mutation for K-RAS G12C mutations in Metastatic NSCLC?

A
  • More associated with smoking
  • Sotorasib
39
Q

When there is NO MUTATION in Metastatic Disease, what is the goal of treatment?

A
  • Check PD-L1 status [>1% = Pembrolizumab]
40
Q

For NON-SQUAMOUS, what is the treatment of Metastatic NSCLC?

A
  • Negative Mutation NSCLC
  • Carboplatin + Pemetrexed + Pembrolizumab
41
Q

For SQUAMOUS, what is the treatment of Metastatic NSCLC?

A
  • Pembrolizumab + Carboplatin + Paclitaxel [or Gemcitabine or Docetaxel]
42
Q

EXAMPLE: What would be the treatment regimen for someone that has LIMITED SCLC?

A
  • Cisplatin + Etoposide WITH Rads
43
Q

EXAMPLE: What would be the treatment regimen for someone that has EXTENSIVE SCLC?

A
  • Cisplatin + Etoposide + Atezoliumab
  • Add Immunotherapy WITHOUT Rads
44
Q

EXAMPLE: What is the preferred regimen for someone with STAGE II NSCLC without any mutations?

A
  • Neoadjuvant –> surgery
45
Q

EXAMPLE: What is the treatment regimen for someone that has been newly diagnosed with Metastatic NSCLC with NO mutations?

A
  • Squamous: Pembrolizumab + Carboplatin + Paclitaxel
  • Non-Squmous: Pembrolizumab + Carboplatin + Pemetrexed

PHRM 864: Therapeutics IV (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions