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Oncology > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

What are risk factors for lung cancer?

A
  1. smoking
  2. radon/ionizing radiation
  3. asbestos
  4. occupational exposure
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2
Q

What is the primary risk factor for lung cancer?

A

smoking

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3
Q

What point does smoking drastically increase risk of cancer?

A

30 pack years

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4
Q

How is pack years measured?

A

cigarrettes/day and # of years smoking

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5
Q

How long does it take for risk to decrease after smoking cessation?

A

5 years

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6
Q

How is lung cancer prevented?

A

no effective prevention; smoking cessation if a smoker

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7
Q

What criteria must be met for annual screening?

A

55-80 y/o
AND
>/= 30 year smoking history
AND
currently smoking or quit <15 years ago

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8
Q

What type of screening should high risk individuals have?

A

low dose CT scans

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9
Q

What are the signs and symptoms of lung CA?

A
  1. cough
  2. hemoptysis
  3. dyspnea
  4. chest pain
  5. wheezing/ stridor
  6. hoarseness
  7. pleural/pericardial effusion
  8. weight loss
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10
Q

What are common sites of metastasis for lung cancer?

A

Lymph nodes
Liver
Brain
Bone

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11
Q

What is the most common type of NSCLC?

A

adenocarcinoma

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12
Q

What NSCLC is directly related to smoking?

A

squamous cell carcinoma

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13
Q

Which type of NSCLC is easier to do surgery on?

A

adenocarcinoma

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14
Q

What is treatment for stage 2 lung CA?

A

surgical resection
+ adjuvant chemotherapy

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15
Q

What agents are used for chemo in stage 2 lung cancer?

A

Cisplatin + Paclitaxel

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16
Q

What is treatment for stage 3A lung cancer?

A

chemo + surgery +/- XRT

17
Q

What is the standard of chemotherapy care?

A

patient-based chemotherapy

18
Q

What are options for chemo in stage 3A?

A
  1. cisplatin + vinorelbine
  2. cisplatin + gemcitabine
  3. cisplatin + docetaxel
19
Q

What is treatment for stage 3B?

A

XRT + platin agent

20
Q

What are options for chemo in stage 3B?

A
  1. cisplatin + etoposide
  2. vinblastine + Paclitaxrl
21
Q

What 2 drug combination agents improve overall survival?

A

cisplatin or carboplatin + paclitaxel, docetaxel, gemcitabine, vinorelbine, irinotecan, etoposide, vinblastine, pemetrexed

22
Q

What is the choice of chemotherapy dependent on in stage 4 lung?

A
  1. performance status
  2. presence/absence of driver mutations
23
Q

What is considered first line when the tumor proportion score is >/= 5%?

A

Checkpoint inhibitors:
Pembrolizumab (KEYTRUDA)

24
Q

What are side effects with Pembrolizumab (checkpoint inhibitors)?

A

“itis” due to enhanced T cell activity

25
Q

What side effects are seen with Erlotinib (TARCEVA)

A

Rash (acne)
Diarrhea

26
Q

What drug interactions are seen with EGFR inhibitors?

A

substrate CYP3A4

27
Q

What are second line treatments for stage 4 NSCLC?

A

Nivolumab
Docetaxel
Erlotinib

28
Q

What is the MOA of Nivolumab?

A

checkpoint inhibitor; inhibits PD-1 receptors

29
Q

When is Pembrolizumab alone used in stage 4 NSCLC?

A

If PDL-1 >/= 5%

30
Q

What role does surgery have in SCLC?

A

NO surgery

31
Q

What is the treatment for limited stage SCLC?

A

XRT +. platinum doublet

32
Q

When should a patient get Prophylactic Cranial Irradication?

A

If they had a complete response

33
Q

What agents are used for SCLC chemo?

A

Cisplatin
Carboplatin

34
Q

What side effect has an increased risk in carboplatin vs. cisplatin?

A

myelosuppression

35
Q

What is treatment of extensive stage SCLC?

A

palliative chemo + platin based agent

36
Q

What are the second line agents used in SSSCLC?

A

Topotecan
Irinotecan
taxane
Ifosfamide

37
Q

What platin based combination is favored in extensive SCLC?

A

carboplatin + etoposide

Oncology (22 decks)

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