Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Fall 2021: Therapeutics III > Therapeutics of Colorectal Cancer (Weddle) > Flashcards

Therapeutics of Colorectal Cancer (Weddle) Flashcards

1
Q

Patients of what disease state(s) are at 5-10x higher risk of developing colorectal cancer?

A

UC and Crohn’s

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

People with which syndrome have nearly a 100% lifetime risk of developing colon cancer?

A

familial adenomatous polyposis (FAP)

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

What tests can be used for the primary detection of colorectal cancer?

A

FOBT and FIT

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

What tests can be used for the detection of colorectal cancer and advanced lesions (NOT primary detection)?

A

endoscopic and radiologic exams

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

What’s the definite drawback of using FOBT to detect colorectal cancer?

A

high false negative rate

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

How can you avoid a false negative with FOBT?

A
  • < 250 mg in vitamin C supplements, citrus juices and fruits for 3 days prior
  • avoid aspirin/NSAIDs for up to 7 days prior
  • delay test until 3 days after end of period
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How can you avoid a false positive FOBT?

A
  • avoid red meat/vegetables with peroxidase for 3 days prior
  • avoid enemas, rectal medications, and digital rectal exams for 3 days prior
  • avoid testing if blood from hemorrhoids is present
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The fecal immunochemical test (FIT) detects __________.

A

hemoglobin

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

Which primary detection test would be preferred for colorectal cancer screening: FOBT or FIT?

A

FIT

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

What is the difference between a flexible sigmoidoscopy and a colonoscopy?

A

flexible sigmoidoscopy only examines the lower 60% of the bowel, colonoscopy examines the entire bowel

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

Which organization recommends screening for colorectal cancer starting at age 45?

A

American Cancer Society

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

What screening practices are recommended if you have HPNCC?

A

colonoscopy at 20-25 or 10 years younger than the youngest age at first familial diagnosis (whichever comes first)

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

What diet considerations can be made to prevent colorectal cancer?

A
  • high fiber
  • low fat
  • high calcium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What medications have been shown to help with colorectal cancer prevention?

A
  • COX inhibitors
  • NSAIDs/aspirin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

>95% of colorectal cancers are ______________.

A

adenocarcinomas

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

What are the eight warning signs of colon cancer?

A
  1. constipation
  2. diarrhea
  3. blood in stools
  4. narrow stools
  5. unexplained anemia
  6. tender abdomen/abdominal pain
  7. unexplained weight loss
  8. weakness/fatigue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where may a colorectal tumor be located if they find occult blood in the stool?

A

transverse colon

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

Where may a colorectal tumor be located if a patient is complaining of dull abdominal pain?

A

ascending colon

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

Where may a colorectal tumor be located if a patient states they have noticed increased cramps and flatulence?

A

descending colon

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

Where may a colorectal tumor be located if a patient is producing low-caliber stools?

A

descending colon

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

Where may a colorectal tumor be located if a patient is experiencing weight loss?

A

ascending colon

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

Where may a colorectal tumor be located if the patient complains of tenesmus (feeling of rectal fullness)?

A

sigmoid colon/rectum

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

How is colorectal cancer staged?

A

TNM

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

In most cancers’ staging, the “T” in TNM is for tumor size. What does the “T” stand for in colorectal cancer?

A

the level of invasion into the colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

dMMR or MSI-H tumors predict a ________ benefit from adjuvant 5-FU for stage ___ disease.

A

decreased; II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Stage ____ patients with dMMR or MSI-H ________ from adjuvant 5-FU.

A

III; benefit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Is stage IV colorectal cancer curable?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the definitive therapy for stage I and II colorectal cancer?

29
Q

Should you consider initiating chemotherapy in stage II colon cancer?

A

current guidelines recommend against it…might be acceptable in *high-risk* stage II patients

30
Q

True or false: MSI-H colon cancer patients will not benefit from chemotherapy.

31
Q

What characteristics would make a colorectal cancer patient high-risk?

A
  • poorly-differentiated tumors
  • lymphatic/vascular invasion
  • bowel obstruction
  • <12 lymph nodes removed
  • perineural invasion
  • localized perforation
  • close/indeterminate/positive margins
32
Q

What are the two chemotherapy options for high-risk stage II colon cancer?

A

FOLFOX and CapeOx

33
Q

What is the general treatment guidance for stage III colon cancer?

A

surgery (+ regional lymph removal) and chemotherapy

34
Q

What chemotherapy regimen would you recommend for stage III low-risk colon cancer?

A

3 months CapeOx or 3-6 months FOLFOX

35
Q

What chemotherapy regimen would you recommend for stage III high-risk colon cancer?

A

6 months FOLFOX or 3-6 months CapeOx

36
Q

What drugs make up FOLFOX?

A

leucovorin + 5-FU + oxaliplatin

37
Q

What drugs make up CapeOx?

A

capecitabine + oxaliplatin

38
Q

What did the MOSAIC Trial assess?

A

FOLFOX vs 5-FU/leucovorin

39
Q

What was the purpose of the IDEA Trial?

A

to evaluate if 3 months of oxaliplatin was non-interior to 6 months

40
Q

What did the IDEA Trial conclude?

A

3 months CapeOx = 6 months CapeOx

6 months FOLFOX > 3 months FOLFOX

41
Q

Which regimen requires a port: FOLFOX or CapeOx?

42
Q

Which regimen has fewer overall infusions: FOLFOX or CapeOx?

43
Q

Which regimen has increased incidence of hand foot syndrome: FOLFOX or CapeOx?

44
Q

Which regimen has more myelosuppression and mouth sores: FOLFOX or CapeOx?

45
Q

Which regimen is more prone to drug-drug interactions: FOLFOX or CapeOx?

A

CapeOx (capecitabine)

46
Q

What is the mainstay therapy of metastatic colon cancer?

A

chemotherapy

47
Q

What is the benefit of radiation therapy in metastatic colon cancer?

A

only for palliation of symptoms

48
Q

What is hepatic artery infusion (HAI)?

A

targeted chemotherapy to the liver

49
Q

What are the 1st line chemotherapy regimens for metastatic colon cancer with no targetable mutations?

A

FOLFOX/CapeOx/FOLFIRI +/- bevacizumab

50
Q

What would be an acceptable chemotherapy regimen for a metastatic colon cancer patient with no targetable mutations, who is NOT tolerative to intensive chemotherapy?

A

5-FU + leucovorin OR

capecitabine +/- bevacizumab

51
Q

What is the general dogma about 2nd line/salvage therapy for colon cancer?

A

If you’ve progressed on FOLFOX first, try FOLFIRI next (and vice versa)

52
Q

What treatment options are available for colon cancer patients with known BRAF V600E mutation?

A

encorafenib + cetuximab OR panitumumab

53
Q

What treatment options are available for colon cancer patients with known HER2 amplification?

A

trastuzumab + pertuzumab OR lapatinib OR fam-trastuzumab

54
Q

FdUMP binds ___________ and reduces rate of DNA synthesis, replication, and repair.

A

thymidylate synthase (TS)

55
Q

5-FU is extensively metabolized where?

A

in the liver

56
Q

What is a common 5-FU toxicity?

57
Q

What agent is a pro-drug of SN-38?

A

irinotecan

58
Q

What are the two dose-limiting toxicities of irinotecan?

A

diarrhea and neutropenia

59
Q

What agent could be used to help with early-onset diarrhea caused by irinotecan?

60
Q

_________ deficiency prevents SN-38 conversion of irinotecan and leads to increased toxicity.

61
Q

Describe some of the unique toxicities associated with oxaliplatin.

A
  • neuropathy
  • cold intolerance
  • sensation of breathlessness
62
Q

What agent is the oral pro-drug of 5-FU?

A

capecitabine

63
Q

What are the two dose-limiting toxicities of capecitabine?

A

hand foot syndrome and diarrhea

64
Q

What adverse events are associated with cetuximab?

A
  • acneiform rash
  • asthenia/malaise
  • fever
  • nausea
  • hypomagnesemia
65
Q

What can be used to help prevent infusion reactions with cetuximab?

A

premedicating with an H1 antagonist

66
Q

Bevacizumab is a _____ inhibitor.

67
Q

Why should you wait a period of time before surgery if taking bevacizumab?

A

the drug has a long half-life and can lead to decreased wound healing (significant toxicities of bleeding, GI perforations, decreased wound healing)

68
Q

True or false: regorafenib is pretty well-tolerated.

A

false; lots of toxicities (HTN, mucositis, fatigue, hand foot, hemorrhage, rash, metabolic disorders, diarrhea, myelosuppression, increased LFTs, proteinuria)

Fall 2021: Therapeutics III (25 decks)

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