Personalised Treatment of Cancer Patients

Question 1

Which of these tests is most likely to give you the diagnosis in a patient with a cancer of UNKNOWN PRIMARY (CUP)?

a) CT scan
b) Blood tumour markers
c) Biopsy of the tumour with H&E stain
d) Immunohistochemistry on the biopsy
e) Molecular testing on the biopsy

Answer 1

No correct answer –> important to tie together all the information you have and then decide

Question 2

Which of these tests may be of most value in determining the treatment options in advanced lung cancer?

a) KRAS mutation
b) EGFR mutation
c) MLH1 promotor methylation
d) BRAF mutation

Answer 2

EGFR mutation testing

KRAS mutations are more common but there are no targeted treatments towards these, unlike EGFR mutations.

Question 3

What is the advantage of next generation sequencing over traditional sequencing technologies?

Answer 3

• Able to test multiple targets simultaneously
• Able to test multiple patient samples simultaneously
• Cheaper

Question 4

What type of molecular aberrations is FISH suited to?

Answer 4

Gene rearrangements (i.e. when bits of chromosomes break off and translocate to other areas)

Question 5

Which cancer patients should be routinely screened for Lynch syndrome at the point of diagnosis?

Answer 5

Endometrial and colorectal cancer

Question 6

Mismatch repair deficiency in colorectal cancer is associated with:

a) better prognosis stage for stage
b) poorer response to adjuvant/neoadjuvant chemo
c) Lynch syndrome
d) Right colon tumours
e) All of the above

Answer 6

E - all of the above