Lung Cancer

Question 1

In what patient population should you consider lung cancer screenings?

Answer 1

high risk

Question 2

What are some factors that would put a patient at high risk for lung cancer?

Answer 2

age 55-74; 30 pack per year history; still smoking or quit in the last 15 years

Question 3

What is the benefit of smoking cessation in relation to lung cancer?

Answer 3

decreases risk of secondary cancers developing

Question 4

EFGR mutations predict sensitivity to ____.

Answer 4

tyrosine kinase inhibitors

Question 5

KRAS mutations predict resistance to ____.

Answer 5

tyrosine kinase inhibitors

Question 6

KRAS mutations are exclusive to what patient population?

Answer 6

heavy smokers

Question 7

ROS-1 mutations are present in what patient population?

Answer 7

never smoked/light smokers

Question 8

Do you test for PD-L1 in NSCLC or SCLC?

Answer 8

NSCLC

Question 9

What are the two most common types of NSCLC?

Answer 9

adenocarcinoma; squamous

Question 10

NSCLC adenocarcinoma is most common in ____.

Answer 10

non-smokers

Question 11

Squamous NSCLC is clearly related to ____.

Answer 11

smoking

Question 12

Which is more rapidly progressive? NSCLC or SCLC?

Answer 12

SCLC

Question 13

What are the mainstays of treatment for SCLC?

Answer 13

chemotherapy & radiation

Question 14

What is the mainstay of treatment for NSCLC?

Answer 14

surgery

Question 15

What stage of lung cancer do most patients present with?

Answer 15

metastatic

Question 16

Definition: tumor is confined to the hemithorax and contained in one radiation port

Answer 16

limited stage SCLC

Question 17

Definition: tumor not confined to the hemithroax, not contained in one radiation port, distant metastasis

Answer 17

extensive stage SCLC

Question 18

What is the goal of therapy in limited stage SCLC?

Answer 18

cure

Question 19

What chemotherapy regimen is used in limited stage SCLC?

Answer 19

cisplatin + etoposide

Question 20

What should be given along with chemotherapy in limited stage SCLC?

Answer 20

radiation

Question 21

Does surgery play a role in limited stage SCLC?

Answer 21

no

Question 22

What is used to prevent brain metastases in SCLC?

Answer 22

prophylactic cranial radiation

Question 23

Is radiation used as curative therapy in extensive stage SCLC?

Answer 23

no, just chemotherapy

Question 24

What are the two first line therapies for extensive stage SCLC?

Answer 24

atezolizumab + carboplatin + etoposide OR durvalumab + carboplatin + etoposide

Question 25

Is maintenance therapy recommended after chemotherapy cycles are completed in extensive stage SCLC?

Answer 25

yes

Question 26

What drugs are used as maintenance therapy for extensive stage SCLC?

Answer 26

atezolizumab & durvalumab

Question 27

Which is preferred in SCLC? Cisplatin or carboplatin?

Answer 27

cisplatin

Question 28

Why would you choose carboplatin over cisplatin?

Answer 28

the patient requires a less toxic therapy

Question 29

What is the preferred regimen in non-squamous NSCLC?

Answer 29

cisplatin + pemetrexed

Question 30

What is the preferred regimen in squamous NSCLC?

Answer 30

cisplatin + docetaxel OR cisplatin + paclitaxel

Question 31

What maintenance therapy is given to patients with unresectable NSCLC?

Answer 31

durvalumab

Question 32

Is treatment considered palliative or curative in unresectable NSCLC?

Answer 32

palliative

Question 33

What therapy is available for PD-L1+ patients with unresectable NSCLC?

Answer 33

pembrolizumab

Question 34

What is the first line EGFR targeted therapy?

Answer 34

osimeritinib

Question 35

What is the first line ALK targeted therapy?

Answer 35

alectinib

Question 36

What is the first line ROS-1 targeted therapy?

Answer 36

crizotinib

Question 37

What is the first line BRAF targeted therapy? Hint: includes a MEK inhibitor

Answer 37

dabrafenib + trametinib

Question 38

What is the first line NTRK gene fusion therapy?

Answer 38

larotrectinib

Question 39

What is the first line RET rearrangement therapy?

Answer 39

selpercatinib

Question 40

What is the first line MET targeted therapy? (2)

Answer 40

capmatinib OR tepotinib

Question 41

What is the first line KRAS targeted therapy?

Answer 41

sotorasib

Question 42

What regimen is recommended for patients with mutation negative non-squamous NSCLC?

Answer 42

carboplatin + pemetrexed + pembrolizumab

Question 43

What regimen is recommended for patients with mutation negative squamous NSCLC? (immunotherapy is not contraindicated)

Answer 43

pembrolizumab + carboplatin + paclitaxel

Question 44

What regimen is recommended for patients with mutation negative squamous NSCLC if immunotherapy is contraindicated?

Answer 44

carboplatin + etoposide

Question 45

When would you give a patient albumin-bound paclitaxel instead of regular paclitaxel?

Answer 45

if they have a contraidication to steroids