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
Q

Treatment for stage IIIB lung cancer is _______

A

Unresectable

26
Q

What is the treatment regimen for stage IIIB lung cancer?

A

Platinum based + XRT

27
Q

What is the goal of therapy with stage IV lung cancer?

A

Improve quality of life

28
Q

What does the choice of chemotherapy depend on?

A
  1. Performance status
  2. Driver mutations
29
Q

How would you treat stage IV lung cancer with 0 or 1 performance status and no driver mutations?

A

Platinum doublet regimen

30
Q

How many cycles of the platinum doublet is recommended?

A

4-6 cycles

31
Q

How would you treat stage IV lung cancer in a pt with performance status of 2 or 3 with no driver mutations?

A

Single NON platinum agent

32
Q

Why can’t you use platinum doublet regimen in patients with a performance status of 2 or 3?

A

Platinum doublet is too toxic

33
Q

What do you use for the programmed death receptor ligands in NSCLC?

A

Immune checkpoint inhibitors

34
Q

Pembrolizumab

A

KEYTRUDA

35
Q

What is the pembrolizumab considered as?

A

An immune checkpoint inhibitor antibody

36
Q

When can keytruda be used in a first line setting?

A

If tumor proportion score (TPS) is > or equal to 5%

37
Q

What are the ADEs associated with pembrolizumab?

A
  1. Colitis
  2. Pneumonitis
  3. Thyroiditis
38
Q

What is the frequency that shows if there is an EGFR mutation?

A

20%

39
Q

What EGFR inhibitor is used in NSCLC?

A

Erlotinib

40
Q

Erlotinib

A

TARCEVA

41
Q

What are the 2 select toxicities of the EGFR inhibitors?

A
  1. Acne form rash
  2. Diarrhea
42
Q

EGFR inhibitors are _____ of CYP3A4

A

Substrates

43
Q

When can you used nivolumab?

A

In a second line setting

44
Q

What is second line treatment for stage IV NSCLC? 3

A
  1. Reassess performance status and patient goals
  2. Alternative platinum doublet
  3. Single agents
45
Q

Nivolumab

A

OPDIVO

46
Q

What is opdivo considered as?

A

Immune checkpoint antibody

47
Q

What platinum agent should you give in stage IV NSCLC?

A

Carboplatin

48
Q

Which type of lung cancer has rapid proliferation?

A

Small cell lung cancer

49
Q

What has no role in small cell lung cancer?

A

Surgery

50
Q

How sensitive is small cell lung cancer to radiation and chemotherapy?

A

Highly sensitive

51
Q

Small cell lung cancer has a clear relationship to_____

A

Smoking

52
Q

What are the 2 stages of SCLC?

A
  1. Limited stage
  2. Extensive stage
53
Q

How long can a patient survive without treatment in limited stage SCLC?

A

11 weeks

54
Q

What is first line treatment for limited stage SCLC?

A

Radiation + combination chemotherapy

55
Q

Prophylactic ___________ should be considered in patients with complete response

A

Cranial irradiation

56
Q

What regimens are the standard first line therapy in limited stage SCLC?

A

Platinum based regimens

57
Q

What is the most emetic agent?

A

Cisplatin

58
Q

How long can patients survive extensive stage SCLC without treatment?

A

5 weeks

59
Q

How long can treatment prolong survival in extensive stage SCLC?

A

7-11 months

60
Q

What can radiation be used for in extensive stage NSCLC.

A

For palliation