oncology Flashcards
krukenberg tumor
A tumor in the ovary caused by the spread of stomach cancer.
Tissue of origin of leiomyosarcoma
A malignant (cancer) tumor of smooth muscle cells that can arise almost anywhere in the body
tumor thrombus
intravascular tumor extension
long term survivors of ALL are at increased risk of…
metabolic syndrome, including high BMI, truncal obesity, dyslipidemia, insulin resistance, and hypertension.
subtypes of hodgkin lymphoma
classic = nodular sclerosing, mixed cellularity, lymphocyte predominant, and lymphocyte depleted)
nonclassic subtype = (nodular lymphocyte-predominant subtype expressing the CD20 cell surface antigen)
fertility preservation options for women getting chemo
An established fertility preservation option for a woman with a partner is in vitro fertilization with embryo freezing. Newer options include freezing of unfertilized eggs and ovarian cryopreservation with future reimplantation.
first step in NSCLC workup
test for EGFR, ALK, c-ROS oncogene 1 [ROS1], BRAF) + assess PDL1 expression
How people can become deficient in mismatch repair genes
Tumors may be mismatch repair deficient either because of a germline mutation (Lynch syndrome) or a somatic mutation or epigenetic silencing that is limited to the tumor.
significance of deficiency in mismatch repair protein in CRC
Indicated for an immune checkpoint inhibitor, such as pembrolizumab
what wild type refers to
(nonmutated) genes
Use of PARP inhibitors in ovarian cancer
germline BRCA-mutated advanced ovarian cancer previously treated with three or more lines of chemotherapy
FOLFIRI and FOLFIRINOX components
5-FU, leucovorin, and irinotecan (); or 5-FU, leucovorin, irinotecan, and oxaliplatin ()
cancers requiring TLS prophylaxis
leukemia and Burkitt lymphoma and after treatment of bulky large B-cell lymphoma or advanced chronic lymphocytic leukemia.
TLS treatment
ICU transfer Telemetry q6h BMP (monitor calcium, creatinine), phosphate, serum uric acid rasburicase 0.2 mg/kg daily
typical chemo regimen for DLBCL
R-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone)
advanced ovarian cancer management
surgery with debulking then intravenous (IV) and intraperitoneal (IP) cisplatin and paclitaxel chemotherapy.
origin of neuroendocrine tumors
Usually GI (intestinal or pancreas) but can also be from lungs or elswhere.
endocrine therapy for hormone receptor positive breast cancer
IF premenopausal → Tamoxifen for 10 years
Monitor for signs of endometrial cancer
IF postmenopausal → Anastrozole
observation vs active surveillance in prostate cancer management
Observation consists of periodic follow-up to assess symptoms related to cancer progression that require palliation. Active surveillance, however, is a plan to defer definitive prostate cancer therapy until there is evidence of cancer progression based on evidence from systematic monitoring, including changes in prostate-specific antigen level and findings on digital rectal examination, biopsy results, or both.
Idelalisib MOA + clinical use
a PI3K kinase inhibitor, is an oral agent that has shown significant activity for the treatment of relapsed follicular lymphoma.
most common adult leukemia
CLL
what are the b cell antigens
CD19, CD20, and CD23
most common TLS conditions
Leukemia and Burkitt lymphoma and after treatment of bulky large B-cell lymphoma or advanced chronic lymphocytic leukemia
concept of conversion chemotherapy
tumor is not believed to be currently resectable but could possibly become resectable if adequate tumor regression can be accomplished with chemotherapy
general management of non muscle invasive bladder cancer
For patients with non−muscle invasive cancer, transurethral resection of the bladder tumor (TURBT) is the standard initial management. For those with high-grade or recurrent low-grade cancer, standard care is to follow TURBT with six rounds of intravesical chemotherapy, most commonly BCG or mitomycin given directly into the bladder. he risk of either recurrent cancer or a new bladder cancer arising elsewhere is significant. Therefore, after BCG or mitomycin treatment, it is essential to perform cystoscopy 3 months after treatment and subsequently at 3- to 6-month intervals to look for new cancers.
use of palbociclib
Combination of antiestrogen therapy with palbociclib for hormone receptor–positive, HER2-negative advanced breast cancer, with an increased response rate and an approximate doubling of progression-free survival compared to hormonal therapy alone.
why you give leucovorin with FOLFOX regimen
drug 5-FU is usually given with the reduced folate leucovorin, which is inactive alone but causes 5-FU to bind more tightly to its target enzyme.
Medication for NSCLC that expresses PDL1
pembrolizumab
how pembrolizumab works
monoclonal antibody directed against PD-L1, and it blocks binding of this ligand to the programmed death receptor 1 receptor, preventing the cancer from silencing cellular immunity.
management of non seminamotous germ cell tumor
BEP regimen – bleomycin, etoposide, cisplatinum
what adeno means
glandular (secretory cells)
Glandular cells are found in tissue that lines certain internal organs and makes and releases substances in the body.
what carcinoma means
Cancer derived from epithelial cell
what sarcoma means
cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.
what squamous means
barrier function
contiguous spread
predictive marker meaning
help identify specific aspects of the tumor that can guide clinicians in determining which therapies are or are not appropriate for particular patients.
BRAF targeted treatment
tyrosine kinase inhibitors targeting BRAF (vemurafenib and dabrafenib)
two types of germ cell tumors
pure seminomas or nonseminomas.
tumor markers in germ cell tumors
The serum α-fetoprotein level is never elevated in patients with pure seminomas, and β-human chorionic gonadotropin is elevated in only approximately 20% of patients with pure seminomas
Non seminamotous cancer types
yolk sac tumor, choriocarcinoma, and embryonal carcinoma
driver mutations to test for in NSCLC
(EGFR, ALK, c-ROS oncogene 1 [ROS1], BRAF) + assess PDL1 expression
management of Stage III NSCLC
- chemoradiotherapy (patients with bulky lymphadenopathy or mediastinal invasion aren’t candidates for surgery)
first step with stage IV NSCLC
assess for PDL-1 expression
first step with gastroesophageal cancer
test for HER2
management of castrate sensitive prostate cancer
leuprolide plus docetaxel
ADT mechanisms
Inhibiting androgen synthesis by using a gonadotropin-releasing hormone (GnRH) agonist (such as leuprolide) or blocking the androgen receptor with an antiandrogen agent (such as flutamide or bicalutamide). Bilateral orchiectomy is a reasonable alternative to GnRH agonist therapy, particularly in the very elderly.
most common SE of docetaxel
myelosuppression
meaning of term median survival
amount of time after which 50% of the patients have died and 50% have survived.
macrocytic anemia section
Chronic alcoholism → B12/Folate deficiency → hemolysis → COPD (rapid RBC turnover) → myelodysplastic syndrome → medication side effect -->
definition of tumor marker
biomarker found in blood, urine, or body tissues that can be elevated by the presence of one or more types of cancer.
