Skin

Question 1

Adjuvant therapy for merkel cell

Answer 1

after surgery, should give RT (unless small <1cm and no other risk factors)

Question 2

systemic therapy of merkel cell

Answer 2

Immunotherapy preferred: pembro or avelumab

Historically treated like small cell

Question 3

BRAF therapy in melanoma

Answer 3

For BRAFV600E or BRAFV600K

RAF+MEK inhibitor (vemurafenib+cobimetinib, dabrafenib+trametinib, encorafenib/binimetinib)

Question 4

Molecular subtypes in melanoma

Answer 4

BRAFV600E (50-60%)

NRAS (15-20%)

GNAQ/GNA11 (uveal)

C-KIT (mucosal, solar elastosis, acral lentiginous)

Question 5

Adjuvant therapy in melanoma

Answer 5

Stage III –> node +, in transit mets, micro satellite mits

Question 6

Staging in melanoma

Answer 6

1A/B: <1mm or 1.01-2mm w/o ulceration

IIA-C: 1.01-2mm w/ulceration or any 2.01mm or greater

IIIA-C: Regional LN or in transit mets, microsatellite metastasis

IV: Disant mets