Lung Cancer

Question 1

Non-small-cell lung cancer

Answer 1

includes all primary lung carcinomas other than small cell carcinoma, but the two most common types are adenocarcinoma and squamous cell carcinoma

Question 2

Answer 2

Lung adenocarcinoma

Question 3

Answer 3

Lung Squamous Cell Carcinoma

Question 4

Answer 4

Small Cell Lung Cancer

Question 5

Small-cell lung cancer

Answer 5

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

Question 6

Use of the term “non-small-cell lung cancer” is . . .

Answer 6

Use of the term “non-small-cell lung cancer” is no longer considered standard of care

Question 7

While all forms of lung cancer are more common in smokers, ____ is relatively more common in nonsmokers

Answer 7

While all forms of lung cancer are more common in smokers, adenocarcinoma is relatively more common in nonsmokers

Question 8

While anti-angiogenic agents are effective against adenocarcinoma, they are associated with _____ in squamous cell carcinoma.

Answer 8

While anti-angiogenic agents are effective against adenocarcinoma, they are associated with a risk of fatal pulmonary hemorrhage in squamous cell carcinoma.

Question 9

Most adenocarcinomas have a ____. Most squamous cell carcinomas do not.

Answer 9

Most adenocarcinomas have a defined oncogenic driver. Most squamous cell carcinomas do not.

Question 10

____ is almost exclusively seen in heavy smokers.

Answer 10

Small-cell lung cancer is almost exclusively seen in heavy smokers.

Question 11

____ mutations are the most common clinically targetable mutations found in lung cancer

Answer 11

EGFR mutations are the most common clinically targetable mutations found in lung cancer

Question 12

While patients with EGFR mutations _____, those without mutations in EGFR ____.

Answer 12

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

Question 13

In general, EGFR mutations are only found in ____

Answer 13

In general, EGFR mutations are only found in adenocarcinomas

Question 14

ALK

Answer 14

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.

Question 15

Crizotinib and ceritinib

Answer 15

FDA-approved ALK inhibitors

Question 16

Non-small cell lung cancer makes up ___% of lung cancers today.

Answer 16

Non-small cell lung cancer makes up 85% of lung cancers today.

Question 17

___ is seen early on in 50% of small cell lung cancers, but rarely in non-small cell lung cancers.

Answer 17

Methylation of the p16^INK4a locus is seen early on in 50% of small cell lung cancers, but rarely in non-small cell lung cancers.

Question 18

The three factors that predict how well someone will respond to tyrosine kinase inhibitor therapy for EGFR⁺ lung cancer

Answer 18

• Nonsmoker
• Female
• Asian

Question 19

Amplification of ___ is a major mechanism of EGFR inhibitor-resistance in lung cancer

Answer 19

Amplification of c-Met is a major mechanism of EGFR inhibitor-resistance in lung cancer

Question 20

TITF1

Answer 20

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.

Question 21

LKB1

Answer 21

Frequently mutated in non–small-cell lung tumors and is thought to act as a tumor-suppressor gene through interactions with p53 and CDC42

Question 22

____ may predict the clinical benefit of VEGF inhibitors in patients with lung cancer.

Answer 22

Circulating VEGF levels may predict the clinical benefit of VEGF inhibitors in patients with lung cancer.

Question 23

Anthrocotic pigment

Answer 23

Black sooty pigment in lungs/lymphatics from smoking or air pollution. Accumulates in macrophages.