LUNG CANCER 2 Flashcards
Small cell lung cancer
Limited disease define vs. extensive disease
Limited = limited to ipsilateral hemithorax (incl contralateral mediastinal nodes) = 25-30%
Extensive = tumor extends beyond hemithorax (incl pleural effusions)
How to treat SCL
Treat with chemo (cisplatin and etoposide) and radiation
Rarely surgery
High incidence of micrometastases
How to treat NSCLC
Stage 1
define
Primary in lung, no node involved
Surgery
How to treat NSCLC
Stage II
define
Primary in lung and lymph nodes of same lung or hilum or chest wall
NO NODAL
Chemo + surgery
How to treat NSCLC
Stage III
define
Locally advanced
Mediastinal node and invasion
NO SURGERY
Chemo + radiation
How to treat NSCLC
Stage IV
Define
Cancer spread to other lung or outside chest
Pleural effusion
NO SURGERY
Chemo + radiation
Common mutations with NSCLC
1) EGFR (ERB1 or EGFR)
2) Her2/neu (ERB2)
3) Kras
4) VEGF, EML-4-Alk
5) Braf
How to treat EGFR NSCLC
Block EGF Receptor extracellular
1) erlotinib
2) gefitinib
Block EGF receptor intracellularly
1) cetuximab
How to treat Her2/neu NSCLC
Herceptin = binds extracellular Her2 and arrest in G1
How to treat VEGF NSCLC
Avastin that inhibits angiogenesis
How to treat Ras NSCLC
Resistant to TKI and EGFR blocker
1) mTor inhibitor
How to treat EML4-Alk NSCLC
Crizotinib
