Malignant Hematology
Breast Cancer
Thorax
GU/GI
Fun Facts
100
Name the BiTes approved for r/r DLBCL
Epcoritamab and Glofitamab
Epcoritamab - based on EPCORE NHL-1 (DLBCL)
Glofitamab - based on phase 1/2 NP30179, but we usually use the regimen from Starglo trial
100
52 year old female underwent prophylactic complete mastectomy for BRCA1 mutation and pathology of both breast revealed DCIS in left breast 7 mm, <2 mm from the closest margin, ER 80%, PR 70%, grade 2. How long should the adjuvant endocrine treatment be given?
Not required
Adjuvant endocrine therapy is not recommended for ER-positive DCIS after bilateral mastectomy, as there is no residual breast tissue and no demonstrated benefit in recurrence or survival. The primary rationale for adjuvant endocrine therapy in DCIS is to reduce the risk of ipsilateral and contralateral breast events, particularly in patients treated with breast-conserving surgery who retain breast tissue.
100
This the target for Telistotuzumab vedotin
c-MET directed ADC >= 25%
100
choice of regimen in esophageal adenocarcinoma in perioperative setting
FLOT - based on ESOPEC trial
4 2 weeks cycle pre and post surgery
100
Madame Curie discovered this radioactive material and subsequently died from it
Radium, Polonium
200
lymphoma most commonly having t(11;14)
Mantle Cell Lymphoma
t(8;14)(q24;q32): Burkitt's lymphoma
t(14;18)(q32;q21): Mantle zone lymphoma
t(11;14)(q13;q32): follicular lymphoma
t(11;18)(q21;q21): extranodal MALToma
t(2;5)(p23;q35): ALK-positive anaplastic large cell T-cell lymphoma
200
These PARPis are approved in Breast cancer
Olaparib - Metastatic - Olympiad
Olaparib - Adjuvant - Olympia
Talazoparib - Metastatic - Embraca
200
Neoadjuvant treatment modality in resectable superior sulcus tumor - T3/T4 N0/N1 disease
ChemoRT
SWOG 9416/Intergroup 0160 trial, which demonstrated that induction chemoradiation (cisplatin/etoposide with concurrent 45 Gy radiation) followed by surgery achieved a 5-year overall survival of 44%, with complete resection rates of 92% and pathologic complete response in approximately one-third of patients.
200
This regimen is standard of care for cis eligible muscle invasive bladder cancer
Cis Gem Durva - Niagara trial
200
Frank Baum, born in Chittenango, NY close proximity to Syracuse, wrote this famous book
The Wizard of Oz
300
before starting this drug, need to send RBC genotyping
Daratumumab
300
First line for de novo metastatic TNBC with NGS showing tp53 mutation, PDL1 8%, TMB 7 muts/mb
Single agent chemo - taxane, anthracyclines or platinum
if PDL1 > 10% - pembro can be added or can also use Saci with Pembro
300
In which cancer Masaoka staging used
Thymoma
300
This TKI is used in patients with unresectable/metastatic GIST with PDGFRA exon 18 mutation (D842V)
Avapritinib
300
This famous furniture company, with major outlets now across US, was started in Syracuse
Raymour and Flanigan
Founded in 1947 in Syracuse, New York, by brothers Bernard and Arnold Goldberg, originating from a family-owned jewelry and furniture business. Originally named Raymour’s Furniture, it grew from a single store into the Northeast's largest furniture retailer, expanding through acquisitions like Flanigan’s Furniture in 1990
400
AML mutation confers a favorable prognosis only in the absence of FLT3-ITD
Fav:
t(8;21)(q22;q22.1) → RUNX1–RUNX1T1
inv(16)(p13.1q22) or t(16;16) → CBFB–MYH11
NPM1 mutation without FLT3-ITD
bZIP in-frame mutated CEBPA
Intermediate:
NPM1 mutation with FLT3-ITD
Wild-type NPM1 with FLT3-ITD
t(9;11)(p21.3;q23.3) → KMT2A–MLLT3
Cytogenetic abnormalities not classified as favorable or adverse
Adverse
Cytogenetics
Complex karyotype (≥3 abnormalities)
Monosomal karyotype
inv(3)(q21q26.2) or t(3;3) → GATA2–MECOM
t(6;9)(p23;q34.1) → DEK–NUP214
t(v;11q23.3) other than t(9;11)
t(9;22) (BCR-ABL1)
−5 or del(5q)
−7
−17 / abn(17p)
Mutations
TP53
RUNX1
ASXL1
BCOR
EZH2
- SF3B1
- SRSF2
- STAG2
- U2AF1
- ZRSR2
400
58 year old female with BRCA 2 mutation developed early stage HER2 positive breast cancer s/p neoadjuvant systemic treatment, lumpectomy with sentinel node dissection and found to have some residual disease. Plan to start T-DM1. Which PARPi would be recommended for her BRCA mutation for adjuvant treatment?
None
Only approved in HER2 negative breast cancer
400
These are the mutation we look for if a patient is undergoing resection of stage II NSCLC
ALK - Alina Trial - Alectinib
EGFR 21 L858R and 19 del - Adaura Trial - Osimertinib
400
65 year old male with recently diagnosed prostate cancer, which is invading seminal vesicle and has node enlargement on scan, majority cores showing 4+5, PSA 37 ng/ml. He is not a candidate for surgery. RT is preferred modality of treatment. This additional systemic treatment is necessary?
Abiraterone (2 years) plus ADT (3 years)
400
Place in the world where traffic lights are upside down, instead of red yellow green, here they have green yellow red
Intersection of Milton Avenue and Tompkins Street on Tipperary Hill in Syracuse, NY
500
This mutation predicts response to venetoclax in AML due to mitochondrial dependence.
IDH1/2
mutations lead to increased conversion of alpha-ketoglutarate to 2-hydroxyglutarate, which causes inhibition of Cytochrome c oxidase in mitochondria. This inhibition causes mitochondrial dysfunction that mimics a state of oxygen deprivation (hypoxia) and this stress signal normally activates pro-apoptotic proteins BAX and BAK, which lead to mitochondrial outer membrane permeabilization (MOMP) and cell death.
To survive this elevated apoptotic pressure, IDH1/2-mutant cells upregulate or become heavily dependent on the anti-apoptotic protein BCL2 to neutralize the activated BAX/BAK.
Because the cells rely on BCL2 to prevent death, inhibiting BCL2 like venetoclax removes this survival signal, allowing BAX/BAK to trigger massive apoptosis.
VIALe trial - Aza Ven vs Aza alone in naive AML
All comers: composite complete response: 66.4% vs 28.3%
IDH1/2 mutated: 75.4% vs 10.7%
FLT3 mutation: 72.4% vs 36.4%
NPM1 mutation: 66.7% vs 23.5%
Tp53 mutation: 55.3% vs 0%
500
60 year old female with pT1a grade 1 ER+ HER2- IDC s/p lumpectomy with no sentinel lymph node biopsy. Should the patient receive partial breast RT/Whole breast RT?
Whole breast
500
duration of durvalumab maintenance for SCLC after getting concurrent chemoRT
24 months
500
Perioperative Durva FLOT did not show benefit in this subgroup of gastric and GEJ adenocarcinoma based on histology
Diffuse
500
This HemOnc Attending have birthday next week
Dr. Benjamin - 2/12
Happy birthday to Alanna and Sujan