Thoracic Flashcards
indications for lung cancer screening (3)
1) 55-77
2) current or former smoker within last 15 year
3) 30 pack year history
IHC marker for lung cancer (2)
CK7+, CD20-
IHC marker for adenocarcinoma (2)
TTF-1, Hapsin A
IHC marker for squamous cell (2)
p63+, p40+
Prognosis of KRAS mutation (2)
Poor OS, does not respond to EGFR-TKIs
What to do if resection is positive
R1 (microscopic) - resect or RT
R2 (macroscopic) - concurrent chemoRT
Indication for adjuvant therapy in lung cancer
Stage2A+ after complete resection, often with cisplatin or carboplatin
Treatment of Stage 3A (N2+)
Concurrent chemoRT
Treatment of Stage 3A (N1)
Surgery + adjuvant chemotherapy
Treatment of ROS1 mutated metastatic NSCLC
ALK inhibitor (crizotinib)
Analysis method for ALK
FISH for rearrangements
Evaluation of mediastinal lymph nodes
EBUS
Pemetrexed contraindication
Squamous
IOs approved for second line regardless of PDL1 expression
Nivolumab and atezolizumab
SCLC limited vs extensive stage
Ipsilateral hemithroax or not
Treatment of SCLC
Cis/carbo + Etop + radiation if limited stage
When to offer PCI in extensive stage SCLC
After complete response
Staging in SCLC
MRI brain with CT C/A/P
Most common cytogenetics in SCLC
3p deletion
Treatment of SCLC after relapse
If >90 days with response, reinitiation chemotherapy
If <90 days, other chemo or clinical trial
SCLC Encephalomyelitis Ab
Anti-Hu
Good prognosis mesothelioma
Epitheloid
First line treatment for mesothelioma
Carbo/Cis plus pemetrexed
Relationship between tobacco smoke and mesothiloma
No relationship
Treatment of sarcomatoid mesothelioma
chemo or radiation, no surgery
Supplementation with pemetrexes
VitB12 and folate
Treatment of stage I-II operable mesothelioma
induction chemotherapy
Prognostic impact of MG in thymoma presentation
Good prognosis (presents earlier)
Test before thymoma resection
Anti-AcH receptor antibody levels
Post operative treatment of thymoma or thymic carcinoma
R1: radiation
R2: chemoradiation (thymic carcinoma only)
Chemotherapy for thymoma
Platinum based (e.g. cyclophosphamide, doxorubicin, cisplatin)
Management of suspected resectable thymoma
Resect - don’t biopsy
Management of MG in thymoma
Control MG first, then resect
Management of oligometastatic thymoma
Chemotherapy with surgical re-evaluation
Indications for cranial radiation in SCLC
limited stage after CR
First line treatment for ALK mutated lung cancer
Alectinib or brigatinib