Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Solid Tumor Oncology > Skin Cancer > Flashcards

Skin Cancer Flashcards

1
Q

What is the T staging for cutaneous melanoma?

A

T1 <1 mm Breslow thickness
T2 1-2 mm
T3 2-4 mm
T4 >4mm

Any b designation means ulceration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is N staging for cutaneous melanoma?

A

N1: 1 LN or any number of in-transit, satellite or microsatellite mets seen with no tumor involved nodes
N2: 2-3 LNs
N3: 4+ LNs

a=clinically occult (detected by SLNBx)
b=clinically detected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the local treatment for primary malignant melanoma in situ? if surgery, then what is the acceptable margin?

A

WLE, margin 0.5 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the local treatment for primary malignant melanoma in <2 mm? if surgery, then what is the acceptable margin?

A

WLE, margin 1 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the local treatment for primary malignant melanoma >2 mm depth? if surgery, then what is the acceptable margin?

A

WLE, margin 2 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When to perform SLNB in local cutaneous melanoma?

A

> 1 mm depth of invasion
Consider if <1 mm but high risk features like ulceration, signs of regression, BT >0.75 mm, elevated mitotic rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Who should get a completion lymph node dissection after WLE?

A

Those with clinically apparent LNs (N2+). Those with clinically occult disease (N1), do not benefit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Who should be considered for adjuvant radiation of nodal basin? (4)

A

Extranodal extension
>4 LNs
H&N region
Desmoplastic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Who should not be considered for adjuvant nodal basin irradiation?

A

Groin melanoma - wound healing is a major problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Adjuvant therapy for high-risk Stage IIB/IIC Melanoma?

A

Pembrolizumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Adjuvant therapy options for BRAFwt Stage III Melanoma?

A

Ipilimumab 10 mg/kg (super toxic)
Nivolumab
Pembro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Adjuvant therapy for BRAFmut Stage III melanoma?

A

Dabrafenib + Trametinib
Could also do Nivo, Pembro, or Ipi (technically)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the difference in likelihood of having BRAF and NRAS mutations in cutaneous vs acral vs uveal melanoma?

A

45% BRAF and 20% NRAS in cutaneous
None in uveal
20% BRAF in acral, 10% NRAS in acral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What mutation is more commonly seen in mucosal melanoma?

A

c-KIT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What mutation is more commonly seen in acral melanoma?

A

c-KIT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What mutation is commonly seen in uveal melanoma?

A

GNAQ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What side effect of Dabrafenib is MORE commonly seen when combined with Trametinib compared to monotherapy?

A

Pyrexia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What side effect of dabrafenib is LESS commonly seen when combined with Trametinib?

A

Cutaneous SCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are three BRAK+MEKi combinations approved for metastatic melanoma?

A

Dabrafenib + Trametinib
Vemurafenib + Cobimetinib
Encorafenib + Binimetinib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which BRAF+MEKi is least frequently used because of toxicity?

A

Vemurafenib + Cobimetinib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

You have a patient with metastatic cutaneous melanoma on vemurafenib monotherapy and is responding well. But they develop new cutaneous SCCs. How do you manage it?

A

Excise the SCC and keep going on the Vem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

6 Toxicities of Dabrafenib + Trametinib

A

Fever
Secondary cancer
Bleeding
Cardiomyopathy
Uveitis
Hyperglycemia
Rash
Fetal problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Toxicity of Vemurafenib + Cobimetinib

A

Bad photosensitivity
Secondary cancers
Bleeding
Cardiomyopathy
Retinopathy
Fetal abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Toxicity of Encorafenib + Binimetinib

A

Cardiomyopathy
VTE
Ocular
ILD
Hepatotoxic
Rhabdo
Bleeding
Fetal tox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What happens if you give a BRAFi+MEKi to a patient with metastatic melanoma who has a non-V600 BRAF mutation?
Paradoxically cause progression
26
Treatment of choice for KIT mutated metastatic melanoma?
Imatinib
27
In someone with a BRAFmutated metastatic cutaneous melanoma, do you do immunotherapy or BRAF+MEKi first?
Immunotherapy first
28
What are the two preferred first line therapies for metastatic cutaneous melanoma?
Ipi+Nivo Relatlamab + Nivo
29
What is TVEC and what is the use?
Intra-tumoral injection of oncolytic herpesvirus. Best used in patients with limited stage III disease. Not for metastatic disease
30
Second line treatment for Metastatic cutaneous melanoma
Ipilimumab High dose IL-2
31
Third line therapy for metastatic cutaneous melanoma?
Lifleucel (autologous TIL therapy) If progressed on ICI and BRAFi (if BRAF mut)
32
Systemic treatment options for CNS metastatic melanoma for BRAFwt?
Ipi+Nivo is beneficial for those with ASYMPTOMATIC untreated brain mets. No difference in symptomatic patients
33
Systemic treatment option for CNS metastatic melanoma with BRAF mutation?
Dabrafenib + Trametinib
34
Management of oligometastatic cutaneous melanoma?
Surgical resection then adjuvant immunotherapy (nivo or pembro or BRAFi/MEKi for BRAF mutations)
35
In mucosal melanoma, patients with what mutation are likely to have minimal to no sensitivity to TKIs?
KIT exon 17 mutations Also KIT amplifications
36
Preferred systemic therapy of metastatic uveal melanoma?
Tebentafusp for HLA 201*02 If not, then pembro, nivo, or Ipi+nivo.
37
Most common metastatic site of uveal melanoma
Liver
38
Treatment of Uveal melanoma metastatic only to the liver, progressed on Tebentafusp and immunotherapy.
Intra-hepatic melphalan
39
Treatment of choice for asymptomatic CNS mets from melanoma?
RadiationTreat
40
Treatment of choice for symptomatic CNS mets
Surgery if resectable
41
4 systemic treatment options for metastatic mucosal melanoma with KIT mutation
Imatinib Dasatinib Nilotinib Ripretinib
42
8 high risk features of cutaneous basal cell carcinoma?
Poorly defined borders >2 cm on trunk or extremities Any lesion on H&N, hands, feet, pretibil, anogenital Recurrent disease Immunosuppressed patient Site of prior RT Aggressive growth pattern +PNI
43
Treatment for high risk local BCC?
Mohs or other resection
44
When to given adjuvant radiation therapy for cutaneous BCC?
Positive margins
45
Only approved option for metastatic BCC in first line?
Vismodegib
46
2nd line metastatic treatment for BCC?
Cemiplimab
47
Indications for sonidegib in BCC?
Locally advanced BCC that recurred after surgery or RT Or for those who are not surgery or RT candidates **Not approved for metastatic disease
48
Main treatment for local Merkel Cell carcinoma
Surgery with SLNB
49
Indications for adjuvant RT in Merkel cell carcinoma
>1 cm tumor Chronic T cell suppression HIV CLL SOT H&N primary +LVI
50
What pathology marker is a sensitive finding for Merkel cell carcinoma?
CK20
51
4 treatment options for metastatic Merkel Cell Carcinoma
Avelumab Pembrolizumab Nivolumab Retifanlimab
52
Systemic therapy for recurrent or metastatic cutaneous SCC not curable by surgery or RT (2)
Pembrolizumab Cemiplimab
53
When to consider neoadjuvant treatment for cutaneous SCC?
Very rapid growth Intransit mets +LVI Borderline resectable
54
What systemic therapy can be given in neoadjuvant setting for cutaneous SCC?
Cemiplimab
55
What comprises Stage IIB melanoma?
T3b or T4a, N0 (2-4 mm thick with ulceration or >4 mm thick without ulceration)
56
What comprises Stage IIC melanoma?
T4b N0 >4mm thick with ulceration
57
desmoplastic melanoma is different from typical cutaneous melanoma in what way?
High risk for local recurrence Super responsive to immunotherapy Low likelihood of driver mutation
58
You have a patient with metastatic cutaneous melanoma in visceral crisis. NGS is pending. What to do to figure out if he is a candidate for BRAF/MEKi?
BRAF VE1 IHC testing
59
In cutaneous melanoma, who can be considered for neoadjuvant treatment?
Stage III (clinically N+) who have resectable disease, but surgery would be morbid or difficult
60
In cutaneous melanoma, what are two neoadjuvant treatment options for eligible patients?
Pembro Ipi Nivo

Solid Tumor Oncology (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions