Lung Cancer

Question 1

how common is lung cancer

Answer 1

2nd most common cancer

Question 2

how common is lung cancer death

Answer 2

number 1 most cancer deaths

Question 3

5 year survival rate lung cancer

Answer 3

15-62%

Question 4

what percent of lung cancers are from tobacco

Answer 4

85-90%

Question 5

patho of lung cancer

Answer 5

epithelial cells are exposed to carcinogens and theres chronic inflammation

Question 6

EGFR mutations predict resistance to what therapies

Answer 6

tyrosine kinase inhibitors

Question 7

KRAS mutations predict resistance to what therapies

Answer 7

tyrosine kinase inhibitors

Question 8

are EGFR mutations found in non smokers or smokers

Answer 8

non smokers

Question 9

are KRAS mutations found in non-smokers or smokers

Answer 9

smokers

Question 10

are ALK mutations found in smokers or nonsmokers

Answer 10

non-smokers

Question 11

what are ALK mutations sensitive to

Answer 11

EGFR inhibs/chemo

Question 12

is ROS-1 mutations in smoker or non smoker

Answer 12

non smoker

Question 13

is BRAFV600 in smoker or non smoker

Answer 13

smoker

Question 14

what mutations should we test for first line

Answer 14

BRAF
PD-L1 in metastatic

Question 15

when is PD-L1 testing not reccomended

Answer 15

SCLC

Question 16

percentages of histology lung cancer

Answer 16

adenocarcinoma 50%
squamous 30%
large cell 5%
small cell 15%

Question 17

which type of carcinoma seen in non smokers

Answer 17

adenocarcinoma

Question 18

which lung cancer has clear relationship to smoking

Answer 18

small cell lung cancer

Question 19

which type of lung cancer has paraneoplastic syndrom

Answer 19

small cell

Question 20

which lung cancer grows faster

Answer 20

small cell

Question 21

SIADH seen with which cancer

Answer 21

small cell

Question 22

what is SCLC sensitive to

Answer 22

chemo and radiation
NOT surgery

Question 23

limited SCLC treatment

Answer 23

radiation + cisplatin(or carbo) +etoposide

Question 24

what kind of radiation is reccommended in SCLC for prophylaxis

Answer 24

cranial radiation

Question 25

treatment of SCLC extensive chemo

Answer 25

cisplatin/carboplatin etoposide/ironotecan + atezolizumab or durvalumab

Question 26

should SCLC extensive get radiation

Answer 26

no

Question 27

when to do cranial radiation if symptomatic in brain (extensive)

Answer 27

before chemo

Question 28

atezolizumab moa

Answer 28

PDL1 inhibitor

Question 29

durvalumab moa

Answer 29

PD-L1 inhibitor

Question 30

when to stop atezolizumab and durvalumab after chemo

Answer 30

keep it going, indefinite

Question 31

cisplatin toxicities

Answer 31

N/V nephrotoxicity (renal failure) ototoxicity neuropathy

Question 32

pembrolizumab MOA

Answer 32

PD-1 inhibitor

Question 33

if pt progresses or cant tolerate chemo whats an option for single agent therapy in SCLC metastatic

Answer 33

pembrolizumab

Question 34

once we do radiation once can we do it again?

Answer 34

no, only once on brain

Question 35

is NSCLC sensitive to chemo / radiation

Answer 35

moderate to radiation low to chemo

Question 36

what is the best option in NSCLC

Answer 36

surgery

Question 37

neoadjuvant therapy for resectable NSCLC consists of what

Answer 37

nevolumab + platinum doublet

Question 38

adjuvant chemo for non squamous NSCLC

Answer 38

cisplatin + pemetrexed

Question 39

adjuvant chemo for NSCLC squamous

Answer 39

cisplatin + gemcitibine cisplatin + docetaxel

Question 40

adjuvant chemo for NSCLC squamous if no cisplatin

Answer 40

carboplatin + paclitaxel carboplatin + gemcitibine

Question 41

alectinib indication after chemo and length

Answer 41

ALK + 2 years

Question 42

osimertinib indication after chemo and length

Answer 42

exon 19 deletion 3 years

Question 43

atezolizumab indication and length

Answer 43

PD-L1 > 1%, no mutations q2-4 weeks x 1 year

Question 44

pembrolizumab indicatin and length

Answer 44

no mutations q3-6 weeks x 1 year

Question 45

unresectable NSCLC non squamous

Answer 45

platinum + pemetrexed

Question 46

unresectable NSCLC squamous

Answer 46

platinum + taxane

Question 47

immuno agents to give after chemo in unresectable NSCLC

Answer 47

duvalamab osimertinib

Question 48

single agent if cant tolerate chemo in NSCLC

Answer 48

pembrolizumab

Question 49

NSCLC metastatic tx if T790M

Answer 49

osimertinib

Question 50

NSCLC metastatic if BRAF mutation

Answer 50

dabrafinib + trametinib

Question 51

side effects dabrafinib

Answer 51

skin cancer fever

Question 52

side effects trametinib

Answer 52

fevers, rash visual changes

Question 53

NSCLC metastatic KRAS G12C mutation

Answer 53

sotorasib

Question 54

NSCLC metastatic non-squamous no mutation

Answer 54

carboplatin + pemetrexed + pembrolizumab

Question 55

contraindications to immunotherapy

Answer 55

autoimmune diseases

Question 56

NSCLC metastatic squamous if contraindication to immunotherapy

Answer 56

platinum doublet carboplatin + taxane / gemcitibine

Question 57

NSCLC metastatic squamous if no contraindication to immunotherapy

Answer 57

pembrolizumab carboplatin paclitaxel / Nab-paclitaxel

Question 58

what can happen from immune mediated toxicity

Answer 58

pneumonitits colitis hepatitis nephritis endocrine

Question 59

what labs should we get for pts on immunotherapy? (6)

Answer 59

CBC CMC TSH free T4 amylase lipase

Question 60

who should be screened in lung cancer?

Answer 60

high risk age 55-74 30 pack year history still smoking or quit within past 15 years good health and willing to have surgery if detected

Question 61

what supplement can cause lung cancer

Answer 61

beta carotene