Cytogenetics Flashcards
CLL
Favorable:
-del(13q) as sole abnormality
Neutral:
-normal cytogenetics
-trisomy 12
Unfavorable:
-del(11q)
-del(17p)-reflects loss of TP53 tumor suppressor
Order of relevance: 17q > 11q >trisomy 12 > del13
ZAP-70 and CD38 overexpression: worse prognosis
Tumor suppressor and oncogenes
Tumor suppressor:
-TP53
-BRCA
-RB1
-ATM
-PTEN
Oncogenes:
-BRAF
-EGFR
-FGFR
-KRAS
-MET
-PIK3CA
CD10 positivity
Germinal center origin (FL, DLBCL, Burkitts)
ICI PD-L1 and other requirements
pembrolizumab
-persistent/recurrent/ metastatic cervical: CPS 1+
-recurrent endometrial/ovarian: MSI-H, dMMR, TMB-H
-m1CRPC: MSI-H, dMMR, TMB 10+
-metastatic breast: CPS10+
-early stage breast: none
-head/neck SCC: CPS 1+ (monotherapy)
-gastric/esophageal (adeno): cps 1+, monotherapy is MSI-H
-esophageal SCC: msi-h-monotherapy , second line- CPS 10+
-NSCLC: PD-L1 1%+
nivolumab
-NSCLC: PD-L1 1%+
-esophageal SCC: combo- no req, no monotherapy like pembro
-gastric/esophageal (adeno), combo only (no mono like pembro)- cps>5
atezoliumab
-bladder: IC 5%+ (cisplatin ineligible)
-NSCLC: TC 50%+, IC 10%+
dostarlimab
-ovarian- dMMR, MSI-H, TMB-H
-also for advance endometrial
Resource to help pick tx based on molecular test results
OncoKB
Wilms tumor poor prognosis cytogenetics
LOH at chromosomes 1p and 16q