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

Therapeutics of Lung Cancer (Weddle) Flashcards

(51 cards)

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1
Q

What is the most effective screening tool for lung cancer?

A

low-dose CT scan

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2
Q

What frequency of lung cancer screening is recommended for asymptomatic adults age 50-80 with a 20 pack year history or who have quit within the last 15 years?

A

annually

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3
Q

EGFR mutations can predict sensitivity to ________.

A

TKIs

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4
Q

______ mutations can predict resistance to TKIs.

A

KRAS

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5
Q

True or false: BRAFV600E should be tested for in NSCLC and SCLC.

A

false; just NSCLC

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6
Q

Patients with EGFR mutations, ALK, or ROS-1 rearrangements typically don’t have _____ expression.

A

PD-1

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7
Q

Which has a clear relationship to smoking: SCLC or NSCLC?

A

SCLC

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8
Q

In which type of lung cancer are paraneoplastic syndromes common: SCLC or NSCLC?

A

SCLC

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9
Q

Which is more sensitive to radiation: SCLC or NSCLC?

A

SCLC

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10
Q

Which has a slower growth fraction: SCLC or NSCLC?

A

NSCLC

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11
Q

What is the ideal treatment regimen for limited-stage SCLC?

A

cisplatin + etoposide (EP) AND radiation

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12
Q

What would be an appropriate drug regimen for extensive-stage SCLC?

A

carboplatin + etoposide + atezolizumab/durvalumab

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13
Q

What drug regimen as studied in the IMpower133 Trial?

A

atezolizumab + carboplatin + etoposide

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14
Q

What drug regimen was studied in the CASPIAN Trial?

A

durvalumab + carboplatin + etoposide

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15
Q

What are some common toxicities associated with radiation therapy?

A
  • fatigue
  • esophagitis
  • pneumonitis
  • cardiac toxicity
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16
Q

Is radiation preferred in extensive-stage SCLC?

A

nope

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17
Q

What are the preferred treatment options for a SCLC relapse in 6 months or less?

A
  • topotecan PO or IV
  • lurbinectidin
  • clinical trial
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18
Q

What are the preferred treatment options for a SCLC relapse that occurs later than 6 months after treatment?

A

restart the original regimen

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19
Q

When would you consider using pembrolizumab for SCLC?

A

metastatic disease that has progressed on or after platinum-based therapy and at least 1 prior line of therapy

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20
Q

How is NSCLC staged?

A

TNM system

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21
Q

What is the standard of treatment for resectable NSCLC?

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A

surgery + adjuvant chemotherapy

22
Q

What is the preferred adjuvant chemotherapy for non-squamous NSCLC?

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A

cisplatin + pemetrexed

23
Q

Give a preferred adjuvant chemotherapy regimen for squamous NSCLC.

Study These Flashcards
A
  • cisplatin + gemcitabine
  • cisplatin + docetaxel

(there are other recommended regimens but let’s pretend there aren’t)

24
Q

What is the standard of therapy for unresectable NSCLC?

Study These Flashcards
A

chemotherapy + radiation

25
Which immunotherapy would you use for unresectable, stage III NSCLC with disease that has not progressed following concurrent chemotherapy and radiation therapy (as maintenance)?
durvalumab
26
What regimen might be used for stage IIIB/IV unresectable NSCLC?
* carboplatin/paclitaxel (fewer toxicities) * cisplatin/paclitaxel * cisplatin/docetaxel * cisplatin/gemcitabine
27
What drug may be an option for stage III unresectable NSCLC patients who aren't candidates for surgery or definitive chemotherapy with radiation?
pembrolizumab
28
What is the 1st line EGFR-targeting therapy for metastatic NSCLC?
osimertinib
29
What drug can be used against T790M mutations?
osimertinib
30
What are some common toxicities of osimertinib?
* rash * diarrhea * cardiomyopathy * QTc prolongation * nail changes
31
What ALK inhibitor is 1st line for metastatic NSCLC?
alectinib
32
What toxicities are associated with alectinib?
* muscle pain * increased LFTs * edema * electrolyte abnormalities * cough * bradycardia * N/V * constipation * diarrhea
33
What ROS-1 therapy is 1st line for metastatic NSCLC?
crizotinib
34
What toxicities are associated with crizotinib?
* edema * fatigue * neuropathy * skin rash * N/V * diarrhea * constipation * increased LFTs * visual disturbances * QTc prolongation
35
What BRAF therapy is 1st line against metastatic NSCLC?
_dabrafenib_ + trametinib
36
What toxicities are associated with dabrafenib?
* fevers * rash * secondary skin cancers * hyperglycemia * visual changes
37
What toxicities are associated with trametinib?
* fevers * rash * hand foot syndrome * hypertension * visual changes * diarrhea
38
What NTRK gene fusion therapy is 1st line for metastatic NSCLC?
larotrectinib
39
What toxicities are associated with larotrectinib?
* neurotoxicity * fatigue * N/V * constipation * diarrhea * anemia * increased LFTs
40
What RET rearrangement therapy is 1st line for metastatic NSCLC?
selpercatinib
41
What drug class should be avoided with selpercatinib?
PPIs (or give 2 hours before PPI)
42
What toxicities are associated with selpercatinib?
* edema * HTN * rash * electrolyte abnormalities * constipation * diarrhea * N/V * fatigue * increased LFTs * increased creatinine * thrombocytopenia
43
What MET Exon 14 skipping therapy is 1st line for metastatic NSCLC?
capmatinib OR tepotinib
44
What toxicities are associated with MET Exon 14 therapies?
* edema * electrolyte changes * N/V * lymphocytopenia * increased LFTs * fatigue * increased SCr
45
What KRAS G12C therapy is 1st line for metastatic NSCLC?
sotorasib
46
What toxicities are associated with sotorasib?
* N/V * diarrhea * increased LFTs * rash * edema * decreased hemoglobin * pneumonitis
47
What should be checked if a metastatic NSCLC patient has no mutations, or if targeted oral chemotherapy options have been exhausted for a positive mutation?
PD-L1 (then, could use pembrolizumab)
48
What oral chemotherapy is recommended for metastatic non-squamous NSCLC patients with 50%+ PD-L1?
cemiplimab-rwlc
49
What is the preferred drug regimen for metastatic non-squamous NSCLC with no mutations?
carboplatin + pemetrexed + pembrolizumab
50
What treatment would you recommend for metastatic squamous NSCLC (PD-L1 + PS) with no contraindication for immunotherapy?
pembrolizumab + carboplatin + paclitaxel/nab-paclitaxel
51
What treatment would you recommend for metastatic squamous NSCLC (PD-L1 + PS) with contraindication to immunotherapy?
platinum doublet regardless of PD-L1 status

Fall 2021: Therapeutics III (25 decks)

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