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BPT Oncology > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

Why does lung cancer have such high mortality?

A

mostly diagnosed at late stage

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2
Q

What are the risk factors for lung cancer?

A

smoking, occupational exposure, passive smoking, domestic pollution

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3
Q

Why is there currently no role for screening with low dose CT for lung cancer?

A

because the false positive rate is 96%

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4
Q

What is the role of PET scanning in lung cancer?

A

sensitive and specific for mediastinal lymph nodes to avoid futile thoracotomy, and to exclude distant metastasis
not indicated in metastatic lung cancer

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5
Q

What is the role of CT in lung cancer?

A

standard of care for lung cancer staging

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6
Q

What are the positive prognostic factors for lung cancer?

A

stage of disease, good performance status, lack of substantial weight loss, female sex

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7
Q

What is the treatment for stage 1 lung cancer?

A

surgery or stereotactic surgery if patient not fit

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8
Q

What is the treatment for stage 2 lung cancer?

A

surgery or radiotherapy if not a surgical candidate

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9
Q

What surgery is recommended?

A

lobectomy and resection of draining lymph nodes

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10
Q

What patients can stereotactic radiotherapy be used for?

A

patients with node negative non bulky tumours

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11
Q

What is the chemotherapy for lung cancer?

A

cisplatin based combination treatment

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12
Q

What is the treatment for stage III NSCLC?

A

concurrent radiotherapy and chemotherapy followed by immunotherapy (durvalumab)

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13
Q

What factors need to be considered in treating stage IV NSCLC?

A

presence of driver mutation
presence of PDL-1
squamous vs non squamous
performance status

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14
Q

What is the most common mutation in NSCLC?

A

KRAS

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15
Q

What percentage of patients have small cell lung cancer?

A

15%

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16
Q

What are the two types of NSCLC?

A

squamous, non squamous

17
Q

What are the two types of non squamous lung cancer?

A

large cell neuroendocrine carcinoma and adenocarcinoma

18
Q

What are the actionable mutations in NSCLC?

A

ALK rearrangement, EGFR, ROS-1

19
Q

Which patients commonly have EGFR mutations?

A

asian females, younger, non smoker

20
Q

What is the treatment for acneiform rash?

A

topical or oral antibiotics (tetracyclines), topical steroids, skin care and sun protection

21
Q

What percentage of NSCLC have ALK rearrangement mutations?

A

2-7%

22
Q

What population typically get ALK rearrangement mutations?

A

asian, non smoking males with adenocarcinoma

23
Q

What drugs are used to target ALK rearrangement?

A

crizotinib, alectenib

24
Q

What are the side effects of crizotinib?

A

visual changes, neutropaenia, altered bowel habit, pulmonary toxicity, fluid retention, hepatotoxicity, bradycardia, prolonged QT, fatigue, cytochrome p450 interactions

25
Q

What percentage of patients have ROS-1 rearrangement?

A

1% of NSCLC

26
Q

What drug is used to target ROS-1 rearrangement?

A

crizotinib

27
Q

What patients can immunotherapy be used in?

A

patients with high PDL1 status (>50%)

28
Q

Which patients should you check PDL1 status in?

A

those without an actionable mutation or those with squamous cell lung cancer

29
Q

What agent is used to treat PDL-1?

A

pembrolizumab

30
Q

Can patients with low PDL-1 get treated with pembrolizumab?

A

yes but only as second line

31
Q

Which lung cancer is strongly associated with smoking?

A

small cell lung cancer

32
Q

What metastases are frequent with small cell lung cancer?

A

CNS

33
Q

What is the recommended treatment for small cell lung cancer?

A

chemotherapy (platinum with etoposide) and radiotherapy if limited stage

34
Q

What is mesothelioma?

A

a pleural malignancy related to asbestos exposure

35
Q

What is the treatment for mesothelioma?

A

palliative intent chemotherapy (cisplatin and pemetrexed)

BPT Oncology (10 decks)

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