Elly FRACP > Oncology > Flashcards

Oncology Flashcards

(113 cards)

Study These Flashcards
1
Q

Breast Ca - generic management

A

Stage I-III disease is resectable and typically treated with curavtive intent
(+/- adjuvant neoadjuvant )

Stage IV disease - incurable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Tamoxifen and letrozole side effects

A

Tamoxifen - Endometrial Cancer , VTE (inhibits anti-thrombin III)
Letrozole - accelerated bone loss,

Vasomotor = both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Baretts Oesophagus follow-up

A

For patients with no dysplasia, the current guidelines recommend surveillance endoscopy every 3 to 5 years. However, if there is a history of high-grade dysplasia or esophageal cancer, more frequent surveillance is typically recommended, often every 6 to 12 months.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Seminoma vs non-seminoma

A

AFP elevated in non-seminoma only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Tumour markers
Epithelial

A

CK7 Lung breast Ovary Endometrium

CK20 (cytokeratin) - Colon bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Tumour markers Muscles

A

Desmin, Actin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Tumour markers Neural

A

Neuron-Specific Enolase and S100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which one has increased risk of breast cancer - BRCA 1 vs BRCA 2

Which one is ER positive BRCA 1 vs BRCA 2

A

BRCA 1 has incrased risk of breast cancer compared to BRCA 2

BRCA 2, is more ER +ve compared to BRCA 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ribociclin and Abemaciclin in Breast Ca

A

CD4/6i (cyclin dependent kinase inhibitors) can be used in adjuvant setting for high risk breast Ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Fertility preservation in those receiving chemotherapy in Breast Ca

A

GnRHagonist therapy - keeps ovarian follicles in a quiescent state, making them less vulnerable to chemotherapy-induced damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Herceptin mechanism

what is Pertuzumab

A

Herceptin - stops dimerisation with other HER2 receptors

Pertuzumab inhibits HER2 dimerization by preventing HER2 pairing with other HER receptors, including HER3.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Olaparib

A

PARP inhibitor
Breast Ca
used in HER 2 -ve, BRCA 1/2 mutation +ve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Apelisib

A

Breast Ca
PI3K inhibitor

Used with HR+ HER-ve metastatic breast ca after failure of CKD4/6 with activating PIK3CA mutation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Breast Ca major histological subtypes

A

Ductal (75-80%) - tends to respond to both endocrine therapy and chemotherapy

Lobular (10-15%) - tend to be lower grade, ER +ve
Responds much more to endocrine therapy than chemotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Trastazumab side -effects

A

Cardiotoxicity - LVEF decline (mostly reversible)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Chemotherapy related toxicity - 5FU (side effects, which gene)

A

Coronary artery disease
DPYD gene deficiency can cause diarrhoea, mucositis, myelosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Irinotecan
1) side-effects
2) which gene mutation should avoid this

A

Irinotecan (topoisomerase inhibitor)
Diarrhoea, neurtopenia, myelosupression
UGT1A enzyme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Oxaliplatin toxicity

A

Acute neurotoxicity - aggravated by exposure to cold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

EGFRi (cetuximuab/panintumumab) - side effects

A

Acneiform rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which genetic mutation is most commonly associated with pancreatic ductal adenoCa

A

KRAS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Gastric Ca gene involved in inheritance

A

CDH1 autosomal dominant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Histological subtypes of gastric Ca

A

Diffuse - undifferentiated, associated with linitis plastica and carries worse prognosis

Intestinal - well differentiated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Zolbetuximab in gastric Ca

A

Benefits in advanced Cancer
Claudin 18.2 - tight junction protein expressed in malignant gastric mucosa cells - targeted by Zolbetuximab and induces cell death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

GIST
- Most common location
- Histology

A

Stomach
- Histology: spindle shaped, cells,, expresses KIT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Lung Ca screening eligibility
Age 50-60 years old Asymptomatic Smoking history of 30 pack year history
26
Lung Ca Staging
Stage 1: No nodal involvement Stage 2: Hilar nodes Stage 3: Mediastinal/Supraclavicular Fossa nodes Stage 4: Metastatic disease including effusion
27
Lung Ca Staging Imaging
PET Scan + separate MRI Brain
28
NSCLC Treatment Principles
29
Chemotherapy for NSCLC - Squamous vs non squamous histology
- Squamous: Paclitaxel - Non sqamous: Pemetrexed
30
Which lung cancer mutation found in non-smokers
EGFR/ALK/ROS1/RET
31
Which lung cancer mutation typically found in nonsquamous pathology
KRAS/BRAF
32
Lung Cancer: Which mAb for EGFR Exon 20 insertion (resistance to most 3rd generation TKI)
EGFR Exon 20 insertion Amivantamab Bispecific EGFR MET
33
ALK fusion gene - which drug targets this?
Lorlatinib, Crizotinib, alectinib
34
ROS 1 - which drug targets this?
Entrectinib - metastatic NSCLC
35
MET Exon 14 Skipping Mutation (NSCLC) - which drug target this?
Tepotinib *MET Is a different marker compared to EGFR
36
RET fusion in NSCLC and thyroid Ca- which drug targets this?
Selpercatinib
37
7What is Tartalamab
Bi-Specific T Cell Engager (BITE) targeting DLL3 Used in second line - SCLC whose disease has progressed on or after platinum-based chemotherapy
38
Which HPV causes SCC
16 and 18
39
Risk factors associated with melanoma
Xeroderma pigmentosum Previous melanoma High naevus count
40
A
41
Prognosis of Skin Ca depends on
Depth and ulceration of lesion Thickness
42
Which mutation is most commonly found in superficial spreading melanomas
BRAFV600
43
Why use BRAF with MEKi
No increased incidence of squamous cell carcinoma, as inhibits downtstream MEK BRAF never use alone paradoxical MAPK activation
44
Poor prognosis in melanoma
High LDH Intracranial mets high tumour burden
45
ER positive
46
GI toxicity checkpoint inhibitors - grading
47
Tamoxifen causes cells to accumulate in which cell cycle phase
G1
48
Abiraterone
CYP17A1 inhibitor Reduces testosterone for castrate resistant metastatic prostate Ca Give with prednisone due to secondary build up mineralocorticoid
49
Most emetogenic chemotherapy
Cisplatin
50
Paroxetine - CYP2D6 inhibitor Tamoxifen is a prodrug
51
Capecitabine side effects
Diarrhoea - just give loperamide Hand foot Syndrome
52
Chemotherapy induced diarrhoea management
Loperamide Codeine octreotide
53
Hedgehog
54
Leptomeningeal disease presentation
Headache, nausea and vomiting, altered mental status, cranial nerve deficits, cerebellar signs
55
Metastatic un-resectable HCC
Atezolizumab-Bevacizumab
56
Treatment of metastatic pancreatic Ca
- 5-FU, leucovorin, irinotecan, and oxaliplatin - Gemcitabine + nab-paclitaxel (Abraxane)
57
EGFR TKI resistance mechanisms
1st -2nd generation: EGFR T790M mutation 3rd generation: c-MET amplification
58
What cancer is associated with ALDH2 polymorphism
Oesophageal Ca
59
Trastuzumab deruxtecan toxicity
10-15% ILD/ pneumonitis ( withhold + steroids )
60
When to use Amivantamab over Omersitinib in EGFR +ve metastatic lung Ca
If exon 20 mutation - omersitinib cannot bind -> amivantamab bispecific EGFR + MET
61
BRCA2 specific associations
Male breast Pancreatic Prostate Melanoma (Ovarian + female breast BRCA1 higher risk)
62
Highest risk for BRCA (based on Manchester criteria)
Epithelial ovary <59 Male breast <59 (13points) Followed by female breast <30 (11 points) 15 points to test = 10% risk of mutation
63
Tissue that produce oestrogen post menopause:
Subcutaneous fat Hepatocyte Myocyte Brain
64
ESR1 activating mutation And treatment
Confers resistance to hormone therapy in metastatic breast cancer Treat with selective oestrogen receptor degraders: Fulveserant, inlunestrant ( all end in -strant) Combine if cdk4/6 Can look for mutation in ctDNA
65
When to pick amphotericin over caspofungin
Murcomycosis (diabetic/sinusitis/thrombosis) Cryptococcus Severe or CNS disease including histoplasma, coccidiodies
66
Ki-67
Proliferation marker= more aggressive Decisions for adjuvant therapy in breast cancer High Ki favours more aggressive lymphoma
67
Management of Stage 1 Testicular germ cell tumours, seminoma vs non-seminoma
Seminoma: Carboplatin Non seminoma - BEP x 1 cycle
68
Dagarelix MOA
GnRH antagonist Less CV risk compared to those on GnRH agonist
69
Abiraterone - MOA - What does it have to be given with
Androgen metabolism inhibitor, by blocking CYP17 - Has to be given with prednisolone, to reduce ACTH stimulation - upstream accumulation of precursors can otherwise cause hypokalaemia and HTN
70
Definition of castrate resistant disease
25% increase in serum PSA in the context of suppressed testosterone
71
Enzalutamide MOA
2nd generation androgen receptor pathway inhibitors
72
Which gene mutation is most frequently observed in colorectal cancer?
APC
73
BRCA 1 vs 2 - which one is more ER +ve
BRCA 1- 75% ER negative BRCA 2 - 77% ER positive
74
Alepelisib
PI3K inhibitor used in metastatic breast Ca
75
What kind of surgery in Stage 1-4 CRC
Stage 1-3 curative intent Stage 4 liver resection + liver transplant
76
Who gets adjuvant chemotherapy in CRC
High risk Stage 2 onwards
77
78
Cetuximab/Pantiumumab side effects EGFRi
Acneiform Rash Diarrhoea
79
Pancreatic cancer chemo
ECOG 0,1: MFOLFIRINOX Frail: gemcitabine +/- capecitabine
80
What targeted therapy is used in Gastrointestinal stromal tumour
IMATINIB
81
Who is eligible for liver transplant for HCC
Single tumour <5 cm <3 nodules <3 cm
82
Amivantamab
metastatic lung cancer Resistance to osimertinib (third generation TKI) due to EGFR Exon 20 insertion
83
ALK mutation NSCLC therapy
Crizotinib
84
Lung cancer therapy for MET EXON 14 skipping mutation
Tepotinib
85
Lung cancer therapy for RET mutation
Selpercatinib
86
Most emetogenic drug in chemotherapy
Cisplatin
87
EGFR inhibitors in colorectal cancer vs lung cancer
Colorectal = mAb binds to extracellular domain Lung cancer = mAb binds to intracellular domain
88
immune checkpoint mediated colitis - cut off for treatment with oral vs IV steroids
7 or more stools is Grade 3 diarrhoea requiring IV steroids
89
Milan criteria for tumour resection liver tumour
A single HCC lesion ≤ 5 cm, OR Up to 3 HCC lesions, each ≤ 3 cm
90
Sinusoidal obstruction syndrome/veno-occlusive syndrome
Following allogeniec stem cell transplant Endothelial cells are shet and obstruct the sinusoid which reduces hepatic outflow leading to hepatocellular damage
91
Metastatic adenocarcinoma, no targetable mutation PD-L1 =0%, treatment:
Chemo (platinum doublet e.g carboplatin + pemetrexed) + Pembrolizumab (STILL WORKS) Pembo mono therapy if >50% PD-L1 if cannot tolerate chemo
92
Clear cell RCC is naturally resistant to what treatment :
Chemotherapy ( platins taxanes anthracyclines) Mechanism : primarily efflux pumps , intrinsic resistance, hypoxia driven biology, low proliferative index Treat with immuno+ targeted multi TKI inhibitors ( sorafenib lenvatinib sunitinib)
93
Why do TKI work in RCC
Clear cell RCC driven by loss of VHL -> HIF upregulation -> VEGF production Therefore angiogenesis dependent
94
Levatinib mechanism
TKI targeting VEGF and potent Fibroblast Growth Factor Receptor inhibitor ( VEGF resistance mechanism) Used in thyroid, liver
95
Homologous recombination deficiency - definition and which genes
Occurs when cells cannot repair double stranded DNA Breaks (if both strands break no template to repair - high risk of error/mutation) BRCA1/2 PALB2 ( target by PARP inhibitor)
96
Cd4/6 inhibitor mechanism
In cancer CDK4/6 phosphorylates RB1 -> inactivated -> E2F released -> G1 a-> S First line with aromatase inhibitor
97
Prognostic markers in Gliomas
Good prognosis MGMT promoter hypermethylation - predicts response to Temozolomide (TMZ, chemotherapy) IDH1 mutant 1p/19q co deletion (oligodendroglioma marker - PCV chemo) Bad prognosis TERT Wildtype IDH1 High Ki-67
98
Metastatic GERM cell tumour prognosis
Good prognosis with cisplatin based therapy (BEP belomycin etoposide cisplatin) Die from CV / metabolic complications of cisplatin
99
Breast cancer which has highest risk of early versus late recurrence
Early - triple -VE Late - hormone receptor positive, HER2 -VE
100
Advanced but asymptomatic Follicular lymphoma (NEJM 2025 RCT) observation VS rituximab outcome
In low-tumour burden follicular lymphoma, early rituximab delays the need for further treatment and improves quality of life, but does not improve overall survival compared with watchful waiting.
101
Marginal zone lyphoma association
H. pylori (MALT) Chlamydia psittaci (conjunctival MALT) Sjogrens Hashimoto thyroiditis ie strong association with chronic inflammatory disease
102
Ipilimumab with tumour progression 6-12 weeks
Pseudoprogression Continue and re-image if clinically well
103
Cumulative UV exposure is associated with which melanoma
Lentigo maligna melanoma
104
When are patients given adjuvant immunotherapy in melanoma
Stage III onwards
105
BRCA2 associations
ER +VE Male breast & prostate Pancreatic
106
How do PARP inhibitors work
PARP repairs single stranded breaks with base excision repair Inhibiting this process > mutations accumulate > cell dies * BRCA involved in double strand repair
107
Pancreatic cancer resistance to which chemo agent?
Docetaxel resistance due to efflux pump and stromal barrier ( resistance) Use FOLFIRINOX or Nab-pacitaxel (albumin bound taxane) plus gencitabine
108
Which treatment for metastatic mismatch repair deficient with loss of MSH2
Pembrolizumab mono therapy
109
Pemigatinib
Used for cholangiocarcinoma FGF2 inhibitor in cancer
110
Sotorasib
KRAS inhibitor used in SCLC
111
PALB2 is involved in which process
Homologous recombination (repairing double stranded breaks)
112
Vismodegib
Hedgehog pathway inhibitor
113
Vinca alkaloid vs taxane
Taxane stabilises microtubules preventing their disassembly Vinca alkaloid inhibit microtubule polymerisation i
Elly FRACP
flashcards
Decks in class (17)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions