Show:
Rise & Shine -- Its Early
Stuck in the Middle
Go to Bed -- It's Late
Take Action
Lagniappe
100
For patients receiving adjuvant therapy for resected early stage NSCLC, this is the standard of care treatment.
What is adjuvant cisplatin-based chemotherapy x four cycles
100
This is the standard of care management for patients with unresectable stage III NSCLC.
What is concurrent chemoradiation therapy? The only non-controversial area in Stage III disease.
100
This is the standard of care first-line therapy for patients with Stage IV NSCLC.
What is platinum-based doublet x 4-6 cycles?. In non-squamous NSCLC, can add bevacizumab.
100
These characteristics are commonly found in patients with actionable mutations (EGFR/ALK) in NSCLC (list four).
What is young age, Asian, adenocarcinoma, never smokers, women?
100
This IHC test can be utilized to differentiate lung adenocarcinoma from metastatic adenocarcinoma to the lung.
What is TTF-1?
200
FREE SPACE!
What is BINGO? #freestuff
200
_ a _ _ i _ a _ e _
What is paclitaxel? #hangman
200
In patients with Stage IV non-squamous NSCLC who have responded to initial chemotherapy, this should be considered.
What is maintenance therapy?
200
This EGFR mutation has intrinsic resistance to EGFR TKI therapy.
What is EGFR exon 20 insertion mutations?
200
These are the patient characteristics defining high risk patients who are recommended to undergo screening with annual low-dose CT for two years.
What is age 55-74, ≥30 pack-year smoking history and current smoker or smoked within the last 15 years?)
300
This is your recommendation for management of a long-term smoker with a 1.9 cm RUL adenocarcinoma s/p RUL lobectomy with a RO resection and pT1aN0M0 disease
What is observation? What is stop smoking!?! This is Stage IA disease. No role for adjuvant chemotherapy. Surgery alone results in 60-70% OS.
300
In Stage III NSCLC, these tumor characteristics would be considered unresectable. (list one)
What is T4 disease, 'bulky' N2, or N3 disease?
300
These two agents have a NCCN category 1 recommendation for continuation maintenance in patients with Stage IV non-squamous NSCLC.
What is pemetrexed and bevacizumab?
300
This is your recommendation for a Stage IV EGFR mutated patient on erlotinib who has now progressed with a new liver metastasis.
What is biopsy the liver metastasis?
300
This is the TNM stage of a patient with a 2.1 cm peripheral LLL mass, a 2 cm subcarinal LN, a 1.5 cm left paratracheal LN, and no metastatic disease
What is T1bN2M0, Stage IIIA?
400
In the LACE meta-analysis evaluating adjuvant chemotherapy, this group of patients [ie, disease Stage(s)] was found to have an OS benefit from adjuvant chemotherapy. *NCCN category 1 recommendation
What is Stage II and III?
400
This is the standard radiation regimen administered with concurrent chemoradiation therapy in patients with Stage III lung cancer.
What is 60 Gy in 30 fractions?
400
A patient with Stage IV NSCLC (wild type EGFR/ALK) who has progressed following treatment with carboplatin/pemetrexed followed by pemetrexed maintenance should receive this in the second line setting.
What is an immune checkpoint inhibitor (or docetaxel)?
400
This mutation occurs in 20-25% of NSCLC cases, is usually mutually exclusive of EGFR/ALK mutations, and is prognostic of poorer survival in Stage IV patients.
What is a KRAS mutation?
400
While imperfect, this may serve as a potential biomarker for selection of patients who may benefit from immune checkpoint inhibitor therapy.
What is PD-L1 IHC?
500
While controversial, trials (subgroup analysis of CALGB 9633 and JBR.10) indicate that Stage IB patients with this feature may benefit from adjuvant chemotherapy.
What is tumor size >4cm? Remember, Stage IB is pT2aN0 (size 3-5 cm). Other high risk features: poorly differentiated tumors, vascular invasion, visceral pleural involvement, wedge resection
500
While controversial, this can be considered in patients with resected lung NSCLC who are upstaged pathologically due to N2 disease (ie, ‘surprise’ N2).
What is PORT (post-op radiation therapy)?
500
In patients with Stage IV NSCLC, this regimen was found to have inferior efficacy in squamous cell patients when compared to cisplatin/gemcitabine.
What is cisplatin/pemetrexed? Histology matters!
500
This drug was recently approved for the treatment of patients with progressive Stage IV EGFR mutated lung cancer who has progressed on afatinib with a T790M EGFR mutation.
What is osimertinib (Tagrisso)?
500
List three counseling points to tell your patient when prescribing erlotinib. (At least one AE and one pharmacokinetic parameter)
What is take on empty stomach, avoid antacids, don't smoke, rash, diarrhea, etc?