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Lung Cancer Flashcards

1
Q

Lung cancer is the _____ most diagnosed cancer

A

Second

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2
Q

What is the average age of diagnosis for lung cancer?

A

70

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3
Q

What are 5 risk factors of lung cancer?

A
  1. Smoking
  2. Radon
  3. Asbestos
  4. Occupational exposure
  5. Genetic predisposition
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4
Q

What is the primary risk factor for lung cancer?

A

Smoking

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5
Q

What would you recommend for the prevention of lung cancer?

A

Smoking reduction

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6
Q

What patient population are low dose CT scans recommended for?

A

High risk individuals

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7
Q

What are the 3 criteria that would make someone a high risk individual?

A
  1. Age 55-80
  2. > or = 30 pack yr smoking history
  3. Currently smoking or quit < 15 years ago
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8
Q

What is the most common symptom of lung cancer?

A

Cough

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9
Q

What are 8 signs and symptoms of lung cancer?

A
  1. Cough
  2. Hemoptysis
  3. Dyspnea
  4. Chest pain
  5. Wheezing/ stridor
  6. Hoarseness
  7. Pleural or pericardial effusion
  8. Weight loss
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10
Q

What are the 5 sites of metastases?

A
  1. Liver
  2. Lymph nodes
  3. Brain
  4. Bone
  5. Adrenal glands
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11
Q

What are the 3 criteria for diagnosing lung cancer?

A
  1. Location
  2. Evaluation of the tumor
  3. Obtaining tissue
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12
Q

What type of lung cancer is the most common?

A

Non small cell lung cancer

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13
Q

True or False: non small cell lung cancer is generally slow growing

A

True

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14
Q

How sensitive is non small cell lung cancer to radiation?

A

Moderately sensitive

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15
Q

How sensitive is non small cell lung cancer to chemotherapy?

A

Low sensitivity

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16
Q

What are the 3 subtypes of non small cell lung cancer?

A
  1. Adenocarcinoma
  2. Squamous cell carcinoma
  3. Large cell carcinoma
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17
Q

What is the most common subtype of lung cancer?

A

Adenocarcinoma

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18
Q

What subtype of non small cell lung cancer is slow growing and related to smoking?

A

Squamous cell carcinoma

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19
Q

What is the standard for stage I lung cancer?

A

Surgery

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20
Q

What is the least invasive type of surgery for lung cancer?

A

Wedge resection

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21
Q

What is the standard treatment for stage II lung cancer?

A

Surgical resection

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22
Q

What type of chemotherapy is standard for stage II?

A

Adjuvant chemotherapy

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23
Q

What is the the standard chemotherapy regimen for stage II?

A

Cisplatin + something

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24
Q

What is the standard of care for lung cancer?

A

Patient based chemotherapy

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25
Treatment for stage IIIB lung cancer is _______
Unresectable
26
What is the treatment regimen for stage IIIB lung cancer?
Platinum based + XRT
27
What is the goal of therapy with stage IV lung cancer?
Improve quality of life
28
What does the choice of chemotherapy depend on?
1. Performance status 2. Driver mutations
29
How would you treat stage IV lung cancer with 0 or 1 performance status and no driver mutations?
Platinum doublet regimen
30
How many cycles of the platinum doublet is recommended?
4-6 cycles
31
How would you treat stage IV lung cancer in a pt with performance status of 2 or 3 with no driver mutations?
Single NON platinum agent
32
Why can’t you use platinum doublet regimen in patients with a performance status of 2 or 3?
Platinum doublet is too toxic
33
What do you use for the programmed death receptor ligands in NSCLC?
Immune checkpoint inhibitors
34
Pembrolizumab
KEYTRUDA
35
What is the pembrolizumab considered as?
An immune checkpoint inhibitor antibody
36
When can keytruda be used in a first line setting?
If tumor proportion score (TPS) is > or equal to 5%
37
What are the ADEs associated with pembrolizumab?
1. Colitis 2. Pneumonitis 3. Thyroiditis
38
What is the frequency that shows if there is an EGFR mutation?
20%
39
What EGFR inhibitor is used in NSCLC?
Erlotinib
40
Erlotinib
TARCEVA
41
What are the 2 select toxicities of the EGFR inhibitors?
1. Acne form rash 2. Diarrhea
42
EGFR inhibitors are _____ of CYP3A4
Substrates
43
When can you used nivolumab?
In a second line setting
44
What is second line treatment for stage IV NSCLC? 3
1. Reassess performance status and patient goals 2. Alternative platinum doublet 3. Single agents
45
Nivolumab
OPDIVO
46
What is opdivo considered as?
Immune checkpoint antibody
47
What platinum agent should you give in stage IV NSCLC?
Carboplatin
48
Which type of lung cancer has rapid proliferation?
Small cell lung cancer
49
What has no role in small cell lung cancer?
Surgery
50
How sensitive is small cell lung cancer to radiation and chemotherapy?
Highly sensitive
51
Small cell lung cancer has a clear relationship to_____
Smoking
52
What are the 2 stages of SCLC?
1. Limited stage 2. Extensive stage
53
How long can a patient survive without treatment in limited stage SCLC?
11 weeks
54
What is first line treatment for limited stage SCLC?
Radiation + combination chemotherapy
55
Prophylactic ___________ should be considered in patients with complete response
Cranial irradiation
56
What regimens are the standard first line therapy in limited stage SCLC?
Platinum based regimens
57
What is the most emetic agent?
Cisplatin
58
How long can patients survive extensive stage SCLC without treatment?
5 weeks
59
How long can treatment prolong survival in extensive stage SCLC?
7-11 months
60
What can radiation be used for in extensive stage NSCLC.
For palliation

PY3 (24 decks)

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