MKSAP Oncology Flashcards
(115 cards)
1
Q
What is the treatment for metastatic cholangiocarcinoma?
A
Gemcitabine-Cisplatin
2
Q
What are two chemo agents that can cause HTN and AKI due to thrombotic microangiopathy?
A
Bevacizumab, Gemcitabine
3
Q
What is the initial chemotherapy for leptomeningeal metastases from leukemia and lymphoma?
A
Methotrexate and cytarabine
4
Q
What are two main side effects of tyrosine kinase inhibitors?
A
Fluid retention, QTc prolongation
5
Q
What is the treatment for AML in younger adults vs. older adults (4 options)?
A
- Anthracycline + Cytarabine
2. Hydroxyurea, low dose cytarabine, decitabine, or azacitidine
6
Q
Between NPM1-mutated AML and FLT3-ITD AML, which has a favorable outcome and which has a poor outcome?
A
NPM1 has favorable outcome
FLT3 has poor outcome; consider midostaurin with 7+3, and transplant in first remission
7
Q
What is the chemo regimen for ALL? Is CNS prophylaxis and/or maintenance treatment needed?
A
DVAP - Daunorubicin, vincristine, asparaginase, prednisone
CNS ppx is required, and maintenance with daily PO mercaptopurine and weekly methotrexate
8
Q
What are the differences between SPEP, UPEP, free serum light chains, and serum/urine immunofixation?
A
Monoclonal protein can be a complete immunoglobulin with a heavy chain (IgG, IgA, IgD, or IgM) complexed with a light chain (kappa or lambda), or free light chains without a heavy chain component
SPEP & UPEP can quantify the presence of a monoclonal protein but cannot identify the subtype of immunoglobuiln, and may miss small M proteins
Serum FLC testing detects light chains that are not bound to heavy chains, and can quantify them
Serum/urine immunofixation can subtype the immunoglobulin and differentiate monoclonal vs. polyclonal spike
9
Q
What are the 3 criteria for MGUS?
A
Monoclonal protein (M protein) <3 g/dL or urinary monoclonal FLCs <500 mg/24 hours
Clonal plasma cells comprising <10% of bone marrow cellularity
Absence of end-organ damage signs/sx
10
Q
What are the 3 criteria for patients w/ smoldering multiple myeloma at imminent risk of progression in next 2 years, meaning they require immediate treatment?
A
> 60% plasma cells in bone marrow, more than one focal lesion on bone MRI, or serum FLC ratio <0.01 or >100
11
Q
What is the criteria for smoldering multiple myleoma? What should be used to assess for bony lesions?
A
Monoclonal protein >3 g/dL, urine free light chains >500 mg/24 hours, 10-59% plasma cells in bone marrow, and no CRAB criteria (end organ damage)
Need whole body MRI (bone scan does not detect lytic lesions)
12
Q
What are some induction chemotherapy regimens for multiple myeloma?
A
RVD (revlimid or lenalidomide), Velcade (Bortezomib), Dexamethasone
VCD - Velcade, Cyclophosphamide, Dexamethasone
VTD - Velcade, Thalidomide, Dexamethasone
Alkylating agent Melphalan or cyclophosphamide are alternatives for non transplant candidates
13
Q
What is the main side effect of lenalidomide and pomalidomide? Bortezomib (name 2)? Thalidomide?
A
- VTE
- Peripheral neuropathy, herpes zoster reactivation, LV dysfunction
- Peripheral neuropathy, VTE
14
Q
What are aprepitant and netupitant used for?
A
Neurokinin 1 receptor blockers used for chemotherapy related nausea/vomiting
15
Q
What are some side effects of 5-fluorouracil and capecitabine? Name 3.
A
Hand-foot syndrome
Coronary spasm and ischemia during administration
Neutropenia
16
Q
What are some chemotherapy agents that are associated w/ pulmonary toxicity? Name 3.
A
Bleomycin, Nitrosureas (carmustine, lamustine, sumstine), Gemcitabine - these have the strongest association
Rituximab, Trastuzumab, Cetuximab, Erlotinib
17
Q
What are 2 chemo agents that can cause significant tubular toxicity? What are 2 chemo agents that can cause hemorrhagic cystitis? What are 2 chemo agents that can cause HUS?
A
- Cisplatin, Ifosfamide
- Cyclophosphamide, Ifosfamide
- Mitomycin, Gemcitabine
18
Q
What chemo agent causes a transient hypersensitivity to the cold forcing patients to avoid drinking, eating, or touching cold items for several days after infusions?
A
Oxaliplatin
19
Q
What are 2 chemo agents that are associated w/ cerebellar toxicity?
A
5-fluorouracil
High dose cytosine arabinoside
20
Q
What are 2 chemo agents associated with reversible encephalopathy syndrome - presents w/ HA, visual changes, delirium, and seizures?
A
Bevacizumab, Sunitinib
21
Q
What cardiac side effects are the following associated with? Nilotinib, Ponatinib, Dasatinib?
A
Nilotinib & Ponatinib - coronary insufficiency
Dasatinib - pulmonary HTN
22
Q
When should screening breast MRI start in women who have received radiation to the mediastinum?
A
25 y.o. or 8 years after completion of radiation therapy, whichever occurs last
23
Q
Which cytogenetic patterns in AML are high risk vs. favorable risk in the following: t(8;21), inv(16), t(15;17), -5, -7, -5q, 3q?
A
Favorable: t(8;21), inv(16), t(15;17)
High risk: -5, -7, -5q, 3q
24
Q
What is differentiation syndrome (name 3 findings) and how is it treated?
A
Fever, pulmonary infiltrates, hypoxemia, and occasionally hyperleukocytosis; can have pericardial or pleural effusion
Seen with ATRA for APML treatment
Tx: dexamethasone
25
What are some chemotherapy agents that increase risk for VTE? Name 4.
Thalidomide, Lenalidomide, Bevacizumab, Sunitinib, Sorafenib, Cisplatin, Erlotinib
26
What 3 genes should be tested in colorectal cancer? If this mutation is present what 2 chemo agents cannot be used, and what is their major side effect?
KRAS, NRAS, BRAF genes
Cetuximab, Panitumumab (EGFR inhibitors)
Major side effect is acneiform rash (painful, pruritic)
27
What is the MOA of ipilimumab? What is the MOA of nivolumab and pembrolizumab?
1. Anti-CTLA-4
| 2. Anti-PD-1
28
What imaging/test/procedure should be performed for isolated inguinal lymphadenopathy?
Anoscopy
29
What are the 3 mutations found in melanoma?
BRAF (50%)
| MEK or NRAS (20%)
30
What are the treatment regimens in melanoma?
Surgery
BRAF inhibitors - Vemurafenib, Dabrafenib
MEK inhibitors - Trametinib, Cobimetinib
Combine above for patients w/ BRAF mutations
Ipilimumab (anti-CTLA-4) + Nivolumab or Pembrolizumab (anti-PD-1) despite BRAF status
31
What is the MOA for tamoxifen and raloxifene? What are some side effects? Name 4. Which one has lower vascular risk?
1. Selective estrogen receptor modulator (SERM)
2. Vasomotor symptoms, cataracts, vascular events (stroke, TIA, DVT/PE), endometrial cancer, uterine sarcoma; reduction in osteoporotic fractures
3. Raloxifene has 25% lower risk of vascular events
32
What is the MOA for anastrozole and exemestane? What are some side effects? Name 5.
Aromatase inhibitor
Vasomotor symptoms, arthralgia, joint stiffness, bone pain, headache, insomnia, osteoporosis
Anastrozole has above + carpal tunnel syndrome, dry eyes, HTN
33
When should breast cancer screening start for women w/ BRCA mutations? When should a prophylactic BSO be performed?
1. Age 25 with breast MRI, age 30 with mammography
2. BSO should be performed between ages 35-40 for BRCA1 carriers, age 40-45 for BRCA2 carriers (since they develop ovarian cancer 8-10 years later)
34
At what stages of breast cancer should you perform imaging studies for staging?
Stage III and beyond
35
When can breast conservation therapy (wide excision followed by radiation) be used? When is axillary dissection required?
1. Cancers <5 cm, without skin involvement, and with clear margins after excision
2. Clinically involved axillary nodes, 3 or more positive sentinel nodes, and/or if patient will be receiving chemotherapy or anti-estrogen therapy in addition to whole breast radiation
36
Who should receive adjuvant endocrine therapy for breast cancer and for how long?
Hormone receptor positive patients
Tamoxifen is preferred in pre-menopausal women for at least 5 years, but 10 years is recommended; ovarian suppression w/ surgical oophorectomy or pelvic irradiation for premenopausal women also receiving chemotherapy (high risk)
Aromatase inhibitors are preferred in post menopausal women for a total of 10 years
37
What is the 21 gene recurrence score and when is it used?
Multigene assay that predicts recurrence of hormone receptor positive, HER2 negative invasive breast cancers with anti-estrogen therapy alone - determines need for adjuvant chemotherapy
38
When should triple negative breast cancers get adjuvant chemotherapy? What are the most common chemotherapies used?
1. >5 mm in size or with positive lymph nodes
| 2. Anthracyclines, cyclophosphamide, and taxanes (paclitaxel, docetaxel)
39
When should HER2 positive cancers receive adjuvant chemotherapy? What HER2 targeted treatment should be used?
1. >5 mm in size and/or lymph node positive
2. Trastuzumab and Pertuzumab (combined if >2 cm in size and/or node positive); if <3 cm in size and node negative, can treat w/ trastuzumab + paclitaxel for less toxicity
40
What medications should be avoided w/ tamoxifen?
Medications with strong CYP2D6 inhibition such as bupropion or fluoxetine, as they may decrease tamoxifen activation
41
In metastatic breast cancer, what can be combined with anti-estrogens to improve response rate to hormonal therapy?
Palbociclib (CDK4/6 inhibitor) or Everolimus (mTOR inhibitor)
Those who develop metastatic breast cancer during adjuvant therapy w/ aromatase inhibitor, first line is palbociclib + fulvestrant (inhibits estrogen receptor function)
Those who develop metastatic breast cancer after having completed adjuvant therapy w/ aromatase inhibitor, palbociclib + aromatase inhibitor is first line
42
What is the treatment regimen for HER2 positive metastatic breast cancer?
Trastuzumab and Pertuzumab + Docetaxel
43
What are single agent chemotherapy options used in metastatic breast cancer? Name 4.
Taxanes, Capecitabine, Gemcitabine, Liposomal doxorubicin, Eribulin, Ixabepilone
44
What are treatment options for BRCA carriers with metastatic breast cancer?
Olaparib, Talazoparib (Poly (ADP-ribose) polymerase (PARP) inhibitors)
45
What is used in multiple myeloma to prevent skeletal events?
Zoledronic acid or Pamidronate
46
What is the maintenance treatment for patients with BRCA mutations and advanced ovarian cancer previously treated w/ 3 lines of chemotherapy?
Olaparib
47
What are the treatment options for ovarian cancer?
Carboplatin + Paclitaxel
Surgery
Intraperitoneal chemotherapy if stage III and above (spread to abdomen)
48
What is the treatment for stage III cervical cancer (extend to pelvic wall and/or involves lower third of vagina and/or causes hydronephrosis)? Those w/ distant metastases?
1. Radiation with concurrent platinum-based chemotherapy (cisplatin)
2. Same as above + bevacizumab
49
Stage I rectal cancer is managed with surgery. What is the management for stage II (full thickness tumors) and above rectal cancer?
Radiation, chemotherapy, and surgery
5-FU or oral capecitabine is given with radiation
FOLFOX (FOLinic acid or leucovorin, 5-FU, OXaliplatin) is given for the chemo-only portion of treatment
50
What is the management for stage II colon cancer? Stage III and above?
```
Stage II w/o high risk features -> surgery
Stage II w/ high risk features (poorly differentiated, T4 primary tumor [invasion into adjacent structures or through peritoneum], lymphovascular invasion, elevated post-op CEA, perforation/obstruction) -> adjuvant 5-FU or capecitabine
Stage III (lymph node metastasis)-> FOLFOX or CAPOX (CAPecitabine and OXaliplatin)
```
51
What are some 3 chemotherapy regimens used for metastatic colon cancer? What agent can be used to increase the efficacy of the regimen, and what are some side effects of this?
FOLFOX, CAPOX, FOLFIRI (Folinic acid, 5-FU, irinotecan)
Bevacizumab to potentiate other chemotherapies; side effects include HTN, interference with wound healing (needs to be discontinued 6-8 weeks before surgery and withheld for at least a month after surgery), VTE (including MI and cerebrovascular accidents), GI perforations, reversible encephalopathy syndrome
52
What must be present in metastatic colon cancer in order to use pembrolizumab or nivolumab?
dMMR mutation (mismatch repair) or MSI (microsatellite instability); some of these patients have Lynch syndrome
53
What are treatment options for anal cancer?
Mitomycin + 5-FU or capecitabine
Radiation
Avoid surgery
54
What is the treatment for non-metastatic pancreatic cancer? Metastatic pancreatic cancer?
1. Gemcitabine + Capecitabine
| 2. Oxaliplatin, Irinotecan, 5-FU, Leucovorin (FOLFIRINOX), or Nab-Paclitaxel + Gemcitabine
55
Which type of gastrointestinal tumor warrants PET-CT for pre-operative staging?
Gastroesophageal cancer
56
What protein receptor should all gastroesophageal cancers be tested for?
HER2 overexpression - can use Trastuzumab
57
What mutation is found in GIST tumors? What is the treatment for this cancer?
1. c-kit
2. Surgery for localized, low risk tumors; adjuvant Imatinib for higher risk tumors (occur outside of stomach, large size, and higher mitotic index), or patients w/ unresectable or metastatic disease
58
Neuroendocrine tumors are typically indolent. What is the treatment for pancreatic NETs when tx is needed?
Temozolamide + Capecitabine, or Sunitinib, or Everolimus
59
What is the main chemotherapy agent used in NSCLC? What are the 4 most commonly used chemo partners?
1. Cisplatin
| 2. Pemetrexed, Gemcitabine, Docetaxel, Vinorelbine
60
What mutations should be screened for in metastatic NSCLC? What are the treatment options if these are present?
EGFR, ALK, ROS1, PD-L1
EGFR -> Erlotinib
ALK or ROS1 -> Crizotinib
PD-L1 -> Pembrolizumab
61
In addition to cisplatin which chemo agent is preferred in metastatic adenocarcinoma? What is an agent that can be given in combination? Should there be maintenance chemotherapy?
1. Pemetrexed in adenocarcinoma
2. Bevacizumab - improves survival
3. Yes - continue pemetrexed; alternatively can use docetaxel
62
What is the management for small cell lung cancer?
Cisplatin based chemo, typically + etoposide; can also use gemcitabine
Radiation
Prophylactic cranial irradiation
*No need for molecular profiling
63
Which type of lung cancer presents in the peripheral lung parenchyma as a solitary nodule or mass? In the central airways, and may have post-obstructive PNA or lobar collapse? Peripheral mass w/ prominent necrosis? In the central airways with extensive lymphadenopathy and distant metastasis?
1. Adenocarcinoma
2. Squamous cell carcinoma
3. Large cell carcinoma
4. Small cell carcinoma
64
What tumor stain is used in evaluation of head/neck cancer? Which imaging studies?
1. p16 for HPV
| 2. MRI > CT; PET-CT
65
What is the main chemo agent is used in advanced head and neck cancer? What is it combined w/ in distant metastasis? What can be used if it continues to progress?
Cisplatin; use Cetuximab if CKD
If distant metastasis or unresectable persistent local disease can use with 5-FU and Cetuximab
Pembrozliumab and Nivolumab can be used if progression after platinum based chemotherapy
66
What is the management for intermediate or higher risk localized prostate cancer? High risk or very high risk?
Radiation + GnRH agonist (Leuprolide) vs. Surgery
| Above + Docetaxel
67
What is the mainstay of therapy for metastatic prostate cancer?
1. Androgen deprivation therapy - orchiectomy, GnRH agonist therapy (+/- anti-androgen), GnRH antagonist therapy
* First use anti-androgen like Bicalutamide or Flutamide, b/c GnRH agonist therapy temporarily increases testosterone levels and can worsen metastasis
68
What are treatment options for patients w/ metastatic prostate cancer that respond to ADT? Do not respond?
1. ADT responders = castrate sensitive cancer; Docetaxel x 6 cycles
2. Castrate resistant -> Docetaxel + Prednisone, Abiraterone (antiandrogen) + Prednisone, Enzalutamide (antiandrogen), Radium-223 (for symptomatic bone metastases), secondary hormone therapy; bisphosphonates if bone metastasis
69
How do you diagnose testicular cancer? What is the preferred chemotherapy agent for treatment?
1. Inguinal orchiectomy (after tumor markers are checked)
| 2. Cisplatin
70
What are some paraneoplastic syndromes seen in RCC? Name 5.
Thrombocytosis, Erythrocytosis, Hypercalcemia, AA amyloidosis, Polymyalgia rheumatica, Stauffer syndrome (hepatic dysfunction in absence of liver metastasis), anemia
71
What are some chemotherapy agents that can be used in RCC? Name 5.
Anti-PD1: Pembrolizumab, Nivolumab
VEGF inhibitors: Bevacizumab
VEGF tyrosine kinase inhibitors: Sunitinib, Sorafenib, Pazopanib, Axitinib
mTOR inhbitors: Everolimus, Temsirolimus
72
What is the management for non-muscle invasive bladder cancer? Muscle invasive cancer? Metastatic disease?
1. TURBT + intravesical chemotherapy w/ BCG or mitomycin
2. Cystectomy +/- cisplatin
3. Cisplatin; after further progression can use Atezolizumab (PD-L1 antagonist)
73
What type of lymphoma is hepatitis C associated with? Human herpesvirus 8?
1. Splenic marginal zone lymphoma
| 2. Kaposi sarcoma, primary effusion lymphoma, multicentric castleman disease
74
What is the most common indolent B-cell lymphoma? What gene translocation is present? What is the treatment?
1. Follicular lymphoma - accounts for 30% of NHL
2. t(14;18), overexpression of bcl2
3. Radiation for localized disease; R-CHOP, R-CVP, or Rituximab + Bendamustine for stage III or IV
75
Which heme malignancy presents w/ increased lymphocytes, and expression of CD19, 20, 23, and CD5?
CLL
76
What are the 2 first line therapies for hairy cell leukemia? What can be used in relapse?
1. Cladribine, Pentostatin
| 2. Rituximab, Vemurafenib (BRAF inhibitor)
77
What genes are overexpressed in double hit lymphoma? What is the treatment?
myc, bcl2, or bcl6
| R-EPOCH
78
Which type of lymphoma arises from thymic B cells, presents in younger patients (typically female), and w/ bulky disease?
Primary mediastinal large cell lymphoma
79
What lymphoma is associated with t(11;14) translocation and overexpression of cyclin D1? What are the treatment options?
1. Mantle cell lymphoma
| 2. Rituximab + Lenalidomide or Bendamustine (least aggressive) -> R-CHOP (most aggressive)
80
What CD is found in anaplastic large cell lymphoma? What gene translocations/protein expression are important for prognostic reasons?
1. CD30
2. t(2;5) or variant ALK; ALK positive patients are typically younger and have more favorable prognosis, can be treated w/ crizotinib
81
What are the 4 types of classical Hodgkin lymphoma? What is the treatment for Hodgkin lymphoma? What are tx options for relapsed or refractory disease?
1. Nodular sclerosis, lymphocyte rich, mixed cellularity, lymphocyte depleted
2. ABVD - doxorubicin, bleomycin, vinblastine, dacarbazine
3. Brentuximab (anti-CD30), Pembrolizumab, Nivolumab
82
What is the treatment for nodular lymphocyte predominant hodgkin lymphoma, which is associated w/ high rate of late relapse?
Radiation for early stage disease
| Rituximab +/- chemotherapy for advanced or relapsed disease
83
What is the management for a young man w/ poorly differentiated carcinoma characterized by centrally located bulky RP or mediastinal LAD?
Chemotherapy for germ cell tumor - cisplatin and etoposide
84
What are some paraneoplastic syndromes associated with small cell lung cancer? Name 4.
SIADH, hypercortisolism (via ACTH), Lambert-Eaton syndrome, cortical cerebellar degeneration, limbic encephalitis, peripheral neuropathy
85
Which type of lung cancer is associated w/ hypercalcemia?
Squamous cell carcinoma
86
In patients with extensive disease and poor performance status, which should be offered chemotherapy? SCLC vs. NSCLC?
Those w/ SCLC should be offered chemo b/c it can improve sx and increase survival
87
What tumor markers should be checked in testicular cancer? Which one is never elevated in a pure seminoma?
AFP, b-hCG, LDH
| AFP is never elevated in a pure seminoma
88
What mutation is associated w/ papillary thyroid carcinoma? Medullary thyroid carcinoma?
1. BRAF gene mutation
| 2. RET proto-oncogene
89
What are the 4 type of thyroid cancers, starting with most common to least common? Which thyroid cancer can not be treated w/ radioiodine after surgery?
Papillary -> follicular -> medullary -> anaplastic
| Medullary b/c C cells do not take up radioiodine
90
What are are the first line therapies for CLL?
Ibrutinib (BTK inhibitor) +/- Rituximab
Venetoclax (anti bcl2) +/- Obinutuzumab (anti-CD20)
Alternatives include cyclophosphamide, chlorambucil, bendamustine, fludarabine, cladribine, pentostatin, lenalidomide
91
What is the management for a woman with axillary lymphadenopathy and normal breast mammogram/MRI?
Treat as stage II breast cancer
92
What type of heme malignancy typically presents w/ cytopenia and splenomegaly, without LAD, and has the following surface markers: CD20, CD11c, CD25, CD103?
Hairy cell leukemia
93
What is the management for men w/ early stage prostate cancer w/ limited life expectancy or significant co-morbidities?
Observation
94
How do you diagnose suspected primary CNS lymphoma that is biopsy-inaccessible? If radiation is part of the treatment regimen, what type of radiation is used?
1. Slit lamp exam and vitreous fluid collection w/ cytologic analysis
2. Whole brain irradiation
95
What is the management for women w/ high risk hormone receptor positive breast cancer that remain pre-menopausal after chemotherapy?
```
Ovarian suppression (leuprolide) + aromatase inhibitor
Next option is ovarian suppression + tamoxifen
```
96
Which malignancies is right supraclavicular lymphadenopathy associated with? Left supraclavicular LAD?
Right -> cancer in thorax (lungs, mediastinum, esophagus)
| Left -> abdominal, lymphoma
97
What are the 3 criteria for high risk prostate cancer?
PSA >20 ng/mL, gleason score 8-10, or evidence of extraprostatic extension of the cancer
98
What is the management for SVC syndrome?
Mediastinoscopy to obtain tissue
| Can place intravascular stent for patients in respiratory distress
99
What is the management for a residual mass after treatment of bulky DLBCL?
Observation with serial CT scanning if diagnostic testing shows low likelihood of active disease (PET CT w/ no metabolic activity of mass)
100
What is the preferred management for early stage laryngeal cancer? Early stage oral cancer?
1. Radiation
2. Surgery
However either can be considered
101
What is the management for melanoma with single metastasis to the brain? What is the management for lung cancer w/ brain metastases?
Surgical resection for both
102
What are some chemo agents that lead to HTN? Name 3.
Bevacizumab, Sorafenib, Sunitinib
103
What are some chemo agents that can lead to LV dysfunction? Name 5.
Cyclophosphamide, anthracyclines, taxanes, doxorubicin, trastuzumab, sunitinib, bortezomib, ifosfamide
104
What are some chemo agents that can lead to bradycardia? Name 2.
Thalidomide, paclitaxel
105
What are the contraindications to surgical resection of metastatic liver lesions? Name 4.
Involvement of the common artery or portal vein or common bile duct, >70% liver involvement, more than 6 involved segments, involvement of all 3 hepatic veins, predicted inadequate hepatic reserve after resection
106
Who needs MRI for breast cancer screening? Name 5 groups.
BRCA mutation, first degree relative of BRCA carrier but are untested, strong fam hx of breast cancer w/ lifetime breast cancer risk >20-25%, radiation to chest between ages 10-30, hx of other rare familial breast cancer syndromes
107
What are the indications for G-CSF?
Persistent neutropenic fever despite abx treatment, severe neutropenia (ANC <100) expected to last >7 days
Prophylaxis in patients w/ previous episode of neutropenic fever, or with chemotherapy regimens w/ high risk of neutropenia
108
Which type of cancer has brain metastases that have higher risk of ICH and patients cannot get anti-coagulation? Name 4
Melanoma, thyroid cancer, renal cell carcinoma, and choriocarcinoma
109
How do you prevent skeletal related events in bone metastases?
Denosumab (preferred)
| IV bisphosphonates - Zoledronic acid (cannot use in GFR <35), Pamidronate
110
Which patients w/ NSCLC benefit from post-op radiation?
Those w/ positive surgical margins
111
What are some side effects of asparaginase? Name 3.
Hypersensitivity, pancreatitis, thrombosis, hemorrhage
112
For how long should tamoxifen be held prior to surgery that his moderate or high risk of VTE?
2-4 weeks
113
What effect does smoking and early menopause have on endometrial cancer?
Both reduce the risk
114
What are some cardiac effects of cisplatin? Name 2.
SVT, myocardial ischemia, cardiomyopathy
115
What is the management for locoregional gastroesophageal cancer?
Neoadjuvant chemotherapy +/- radiation therapy, and surgery
