Oncology

Question 1

why is there no screening for lung Ca by CT?

Answer 1

Very poor spec and sensitivity - 95% false positive rate

Question 2

Which test is more sensitive in identifying lung Ca? CT or PET or x-ray

Answer 2

PET (91% sens, 86% spec)
CT (75% sens 66% spec)
X-ray shit

Question 3

Is lung cancer increasing or reducing in males and females?

Answer 3

Reducing in males,

Increasing in females - assoc with smoking rates

Question 4

How many fold does smoking and asbestos increase your risk of lung Ca?
What fold increase in lung Ca does someone have if they smoke and have asbestos exposure?

Answer 4

Smoking - 10-30x
Asbestos - 5x
Combined - 50x

Question 5

Which common occupational exposure does NOT result in lung Ca

Answer 5

Coal dust

Question 6

Adjuvant chemotherapy for lung cancer is based on which agent?

Answer 6

Cisplatin / paltinum drugs.

Always in combo with another chemo agent +/- immunotherapy

Question 7

At what stage is surgery NOT recommended for the Mx of lung Ca?

Answer 7

Stage 3A with Bulky tumour or 3B. Not for surg. For RTx + chemo (platinum-based)

Question 8

What is now important to investigate in almost all cancers that will assist in their therapy?

Answer 8

Driver mutations in KRAS, EGFR, ALK, ROS, BRAF, HER-2, MEK, PDL-1…
Enable alternate and targeted therapy

Question 9

If tumour contains >50% PDL expression, what treatment can you use? SE of this therapy?

Answer 9

Pembrolizumab, Durvalimumab

SE -

Question 10

What cell expresses PD-1 to bind PDL-1 on tumour cells?

Answer 10

T-cells

Question 11

Which type of Non-SCLC has the worst prognosis?

Answer 11

Large-cell neuroendocrine cancer

Question 12

A young Asian female presents wit acneform rash, diarrhoea. What class of chemo agent are they experiencing SE from?

Answer 12

EGFR inhibs - Erlotinib, Gefetinib, Osematinib

EGFR-expressing Ca more common in adenocarcinomas of Asian Females