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PHRM 864 > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

how common is lung cancer

A

2nd most common cancer

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2
Q

how common is lung cancer death

A

number 1 most cancer deaths

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3
Q

5 year survival rate lung cancer

A

15-62%

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4
Q

what percent of lung cancers are from tobacco

A

85-90%

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5
Q

patho of lung cancer

A

epithelial cells are exposed to carcinogens and theres chronic inflammation

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6
Q

EGFR mutations predict resistance to what therapies

A

tyrosine kinase inhibitors

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7
Q

KRAS mutations predict resistance to what therapies

A

tyrosine kinase inhibitors

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8
Q

are EGFR mutations found in non smokers or smokers

A

non smokers

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9
Q

are KRAS mutations found in non-smokers or smokers

A

smokers

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10
Q

are ALK mutations found in smokers or nonsmokers

A

non-smokers

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11
Q

what are ALK mutations sensitive to

A

EGFR inhibs/chemo

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12
Q

is ROS-1 mutations in smoker or non smoker

A

non smoker

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13
Q

is BRAFV600 in smoker or non smoker

A

smoker

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14
Q

what mutations should we test for first line

A

BRAF
PD-L1 in metastatic

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15
Q

when is PD-L1 testing not reccomended

A

SCLC

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16
Q

percentages of histology lung cancer

A

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

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17
Q

which type of carcinoma seen in non smokers

A

adenocarcinoma

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18
Q

which lung cancer has clear relationship to smoking

A

small cell lung cancer

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19
Q

which type of lung cancer has paraneoplastic syndrom

A

small cell

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20
Q

which lung cancer grows faster

A

small cell

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21
Q

SIADH seen with which cancer

A

small cell

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22
Q

what is SCLC sensitive to

A

chemo and radiation
NOT surgery

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23
Q

limited SCLC treatment

A

radiation + cisplatin(or carbo) +etoposide

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24
Q

what kind of radiation is reccommended in SCLC for prophylaxis

A

cranial radiation

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25
Q

treatment of SCLC extensive chemo

A

cisplatin/carboplatin
etoposide/ironotecan
+ atezolizumab or durvalumab

26
Q

should SCLC extensive get radiation

A

no

27
Q

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

A

before chemo

28
Q

atezolizumab moa

A

PDL1 inhibitor

29
Q

durvalumab moa

A

PD-L1 inhibitor

30
Q

when to stop atezolizumab and durvalumab after chemo

A

keep it going, indefinite

31
Q

cisplatin toxicities

A

N/V
nephrotoxicity (renal failure)
ototoxicity
neuropathy

32
Q

pembrolizumab MOA

A

PD-1 inhibitor

33
Q

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

A

pembrolizumab

34
Q

once we do radiation once can we do it again?

A

no, only once on brain

35
Q

is NSCLC sensitive to chemo / radiation

A

moderate to radiation
low to chemo

36
Q

what is the best option in NSCLC

A

surgery

37
Q

neoadjuvant therapy for resectable NSCLC consists of what

A

nevolumab + platinum doublet

38
Q

adjuvant chemo for non squamous NSCLC

A

cisplatin + pemetrexed

39
Q

adjuvant chemo for NSCLC squamous

A

cisplatin + gemcitibine
cisplatin + docetaxel

40
Q

adjuvant chemo for NSCLC squamous if no cisplatin

A

carboplatin + paclitaxel
carboplatin + gemcitibine

41
Q

alectinib indication after chemo and length

A

ALK +
2 years

42
Q

osimertinib indication after chemo and length

A

exon 19 deletion
3 years

43
Q

atezolizumab indication and length

A

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

44
Q

pembrolizumab indicatin and length

A

no mutations
q3-6 weeks x 1 year

45
Q

unresectable NSCLC non squamous

A

platinum + pemetrexed

46
Q

unresectable NSCLC squamous

A

platinum + taxane

47
Q

immuno agents to give after chemo in unresectable NSCLC

A

duvalamab
osimertinib

48
Q

single agent if cant tolerate chemo in NSCLC

A

pembrolizumab

49
Q

NSCLC metastatic tx if T790M

A

osimertinib

50
Q

NSCLC metastatic if BRAF mutation

A

dabrafinib + trametinib

51
Q

side effects dabrafinib

A

skin cancer
fever

52
Q

side effects trametinib

A

fevers, rash
visual changes

53
Q

NSCLC metastatic KRAS G12C mutation

A

sotorasib

54
Q

NSCLC metastatic non-squamous no mutation

A

carboplatin + pemetrexed + pembrolizumab

55
Q

contraindications to immunotherapy

A

autoimmune diseases

56
Q

NSCLC metastatic squamous if contraindication to immunotherapy

A

platinum doublet
carboplatin + taxane / gemcitibine

57
Q

NSCLC metastatic squamous if no contraindication to immunotherapy

A

pembrolizumab
carboplatin
paclitaxel / Nab-paclitaxel

58
Q

what can happen from immune mediated toxicity

A

pneumonitits
colitis
hepatitis
nephritis
endocrine

59
Q

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

A

CBC
CMC
TSH
free T4
amylase
lipase

60
Q

who should be screened in lung cancer?

A

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

61
Q

what supplement can cause lung cancer

A

beta carotene

62
Q
A

PHRM 864 (23 decks)

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