Lung cancer Flashcards

1
Q

What is SACT?

A

Systemic anti-cancer therapy

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2
Q

What are the types of lung cancer?

A

Non-small cell lung carcinoma (75-85%)
- Adenocarcinoma (with subgroups eg EGFR
mutation)
- Squamous cell
- Large cell, adenosquamous, carcinomas,
carcinoid

Small cell lung carcinoma (15-20%)

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3
Q

How is lung cancer managed based on the stage of disease?

A

Stage I: Surgery/Stereotactic
radiotherapy (SABR)

Stage II: Surgery (+/- SACT) or radical
radiotherapy (RT)

Stage III: Multimodality treatment

Stage IV: Palliative SACT (+/- RT)

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4
Q

What is the response to chemotherapy of a lung cancer if it’s <4cm?

A

50%

Compared to 20% in>4cm

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5
Q

What is the ECOG PS scale (0-5)?

A

Eastern Cooperative Oncology Group Performance status scale

0 - indicating fully active
1 - restricted in strenuous activity
2 - restricted in work activity but ambulatory and capable of self-care
3 - capable of limited self-care
4 - completely disabled
5 - dead

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6
Q

How does tumour hypoxia affect treatment?

A

There are no blood vessels to deliver drug treatments and no oxygen to create free-radical with radiotherapy

A problem in larger tumours

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7
Q

How does weight loss contribute to prognosis?

A

Worse prognosis because it’s a form of compensation and suggests there is microscopic disease

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8
Q

What is stereostatic radiosurgery?

A

Uses many precisely focused radiation beams to treat tumours and other problems in the brain, neck, lungs, and liver

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9
Q

What are some mutations seen in Non-small cell lung cancer?

A

EGFR, ALK,ROS-1, KRAS

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10
Q

What is the class of drugs developed to treat EGFR mutations positive or ALK rearrangement positive lung cancer?

A

Tyrosine kinase inhibitors (TKI)

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11
Q

What are the chemotherapy drugs used to block PD-1?

A

Pembrolizumab and Nivolumab

Programmed Cell Death Protein 1 (PD-1) plays a vital role in inhibiting immune responses and promoting self-tolerance through modulating the activity of T-cells, activating apoptosis of antigen-specific T cells and inhibiting apoptosis of regulatory T cell

So blocking it kills the cancer

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12
Q

What are some drugs that block PDL-1?

A
  • Atezolizumab (use with chemotherapy in extensive stage small cell lung cancer and in second-line non small cell lung cancer)
  • Durvalumab (adjuvantly for 1 year duration after chemo-RT for stage 3 lung cancer)

PD-L1 acts as a pro-tumorigenic factor in cancer cells via binding to its receptors and activating proliferative and survival signalling pathways

So blocking it kills the cancer

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13
Q

Which lifestyle choice causes often cancer mutations ?

A

Non smokers or light smokers

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