Lung Cancer Flashcards
Non-small-cell lung cancer
includes all primary lung carcinomas other than small cell carcinoma, but the two most common types are adenocarcinoma and squamous cell carcinoma
Lung adenocarcinoma
Lung Squamous Cell Carcinoma
Small Cell Lung Cancer
Small-cell lung cancer
Arises from neuroendocrine cells of the lung.
(It can arise in any organ where neuroendocrine cells are present, although the lung is most common). Small cell carcinoma tends to metastasize early in its course, so it is not treated surgically (it is presumed metastatic at presentation).
It frequently causes paraneoplastic phenomena, and has a dismal prognosis
Use of the term “non-small-cell lung cancer” is . . .
Use of the term “non-small-cell lung cancer” is no longer considered standard of care
While all forms of lung cancer are more common in smokers, ____ is relatively more common in nonsmokers
While all forms of lung cancer are more common in smokers, adenocarcinoma is relatively more common in nonsmokers
While anti-angiogenic agents are effective against adenocarcinoma, they are associated with _____ in squamous cell carcinoma.
While anti-angiogenic agents are effective against adenocarcinoma, they are associated with a risk of fatal pulmonary hemorrhage in squamous cell carcinoma.
Most adenocarcinomas have a ____. Most squamous cell carcinomas do not.
Most adenocarcinomas have a defined oncogenic driver. Most squamous cell carcinomas do not.
____ is almost exclusively seen in heavy smokers.
Small-cell lung cancer is almost exclusively seen in heavy smokers.
____ mutations are the most common clinically targetable mutations found in lung cancer
EGFR mutations are the most common clinically targetable mutations found in lung cancer
While patients with EGFR mutations _____, those without mutations in EGFR ____.
While patients with EGFR mutations do show clinically significant responses to EGFR inhibitors, those without mutations in EGFR actually do worse than patients receiving conventional chemotherapy
In general, EGFR mutations are only found in ____
In general, EGFR mutations are only found in adenocarcinomas
ALK
Anaplastic lymphoma kinase
The second majorly prevalent mutation in lung cancer and therapeutic target (second to EGFR). Tyrosine kinase usually activated by translocation in lung cancer.
ALK-positive lung cancers usually respond to targeted ALK inhibitors.
Crizotinib and ceritinib
FDA-approved ALK inhibitors
Non-small cell lung cancer makes up ___% of lung cancers today.
Non-small cell lung cancer makes up 85% of lung cancers today.
___ is seen early on in 50% of small cell lung cancers, but rarely in non-small cell lung cancers.
Methylation of the p16INK4a locus is seen early on in 50% of small cell lung cancers, but rarely in non-small cell lung cancers.
The three factors that predict how well someone will respond to tyrosine kinase inhibitor therapy for EGFR+ lung cancer
- Nonsmoker
- Female
- Asian
Amplification of ___ is a major mechanism of EGFR inhibitor-resistance in lung cancer
Amplification of c-Met is a major mechanism of EGFR inhibitor-resistance in lung cancer
TITF1
TITF1 encodes a lineage-specific transcription factor that is essential for the formation of cells lining lung alveoli (type II pneumocytes). It is found to be upregulated in many squamous cell carcinomas of the lung, but not small cell carcinomas or adenocarcinomas.
LKB1
Frequently mutated in non–small-cell lung tumors and is thought to act as a tumor-suppressor gene through interactions with p53 and CDC42
____ may predict the clinical benefit of VEGF inhibitors in patients with lung cancer.
Circulating VEGF levels may predict the clinical benefit of VEGF inhibitors in patients with lung cancer.
Anthrocotic pigment
Black sooty pigment in lungs/lymphatics from smoking or air pollution. Accumulates in macrophages.
