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100
In 1968, the staging system frequently used today was developed by this group
What is the Veterans Administration Lung Cancer Study Group?
100
This is the best time to begin radiation therapy for limited stage SCLC
What is early, concurrent therapy (within cycle 1 or 2 of chemotherapy)?
100
This is the most commonly used regimen to treat small cell lung cancer
What is etoposide/platinum?
100
The mechanism of action of etoposide
What is a topoisomerase II inhibitor?
100
This is the primary risk factor for small cell lung cancer
What is tobacco?
200
Historical name used to describe small cell carcinoma, primarily used by Europeans
What is oat cell carcinoma?
200
In limited stage patients with a good response to initial therapy, the addition of PCI improves these outcomes
What is decreases brain metastases and increases overall survival?
200
Topotecan is FDA approved for use in SCLC with platinum-sensitive disease who progressed at least this many days after initiation of first-line chemotherapy.
What is 60 days?
200
This drug has a NCCN category 1 recommendation to not be used in patients receiving concurrent chemoradiation for SCLC
What is G-CSF and GM-CSF? SWOG trial with 215 pts: more grade 3/4 thrombocytopenia and more treatment-related deaths NCCN: CSFs can ameliorate chemotherapy-induced myelosuppression and reduce incidence of febrile neutropenia, but cumulative thrombocytopenia remains dose limiting. Does not prolong disease free or overall survival.
200
The incidence of SCLC is doing this and accounts for this percentage of total lung cancer cases annually.
What is its incidence is decreasing and currently represents about 13% of total lung cancer? Proportion of SCLC declined from 17% in 1986 to 13% in 2002. This was accompanied by an increase cases in women (28% in 1973, up to 50%)
300
The year in which it was determined that smoking was a cause of lung cancer (noted to be "a cause, and an important cause" as published by Doll and Hill in the British Medical Journal)
What is 1950?
300
Prophylactic cranial irradiation (PCI) is not recommended for this group of SCLC patients
What is patients with a poor performance status or impaired neurocognitive functioning?
300
This regimen has similar efficacy to standard first line therapy of etoposide/platinum
What is CAV (cyclophosphamide/adriamycin/vincristine) or IP (irinotecan/etoposide)?
300
Etoposide can cause rearrangements in this gene on this chromosome which is associated with secondary leukemia
What is the MLL (mixed lineage leukemia gene) on chromosome 11q23?
300
This is the median overall survival (range) for patient with extensive stage SCLC
What is 8-13 months? 5 yo OS 1-2%. In limited stage: median OS 5-20 months, 5 yo OS rate 10-13%)
400
In 1973, a pathology study of autopsies done on patients who died within 1 month of 'curative' resection revealed this important feature of small cell lung cancer
What is the systemic/disseminated nature of SCLC? The presence of microscopic widely metastatic disease in most patients despite pre-op evaluation lact thereof. This led to chemotherapy as the cornerstone of management.
400
This is the preferred dose for prophylactic cranial irradiation
What is 25 Gy in 10 daily fractions?
400
For ES SCLC, this treatment strategy has failed to show any improvement in overall survival when compared to currently standard first line therapy.
What is dose intensification, dose escalation, triplet therapy, maintenance or consolidation therapy?
400
This is the Calvert formula, used to calculate the dose of carboplatin
What is total dose (mg) = (target AUC) x (GFR + 25) AUC is most relevant measure of drug exposure.
400
This is one of the most common molecular genetic changes associated with small cell lung cancer (list one)
p53 mutation (75-90%); Loss of retinoblastoma gene (RB1) function (almost 100%); Upregulation of c-Kit (80-90%); Others: myc amplification (20%), chromosomal abnormalities especially at chromosome 3
500
The year/decade that small cell carcinoma was distinguished as a separate tumor entity from other lung cancers
What is 1959-1962?
500
In LS SCLC patients receiving concurrent chemoradiation therapy, accelerated hyperfractionated radiation therapy with 45 Gy delivered in three weeks (1.5 Gy BID) was found to be superior to this radiation scheme
What is 45 Gy in five weeks (1.8 Gy daily)? Study is not answer question of efficacy of 45 Gy BID vs daily treatment with a higher dose (60 to 70 Gy), which would have provided a more comparable biologically equivalent dose. The optimal dose and schedule have not been established
500
This is the dose of topotecan used to treat relapsed small cell lung cancer (either the po or IV formulations)
What is 2.3 mg/m2 PO daily x 5 days OR 1.5 mg/m2 IV daily x 5 days, given q3 weeks? - Oral formulation similar activity to IV formulation (RR 18 vs 22%, median OS 33 vs 35 weeks, 1 yr OS 33 vs 29%) - q3 weeks never directly compared to weekly, indirectly weekly felt less effective
500
How is etoposide metabolized/excreted?
What is by the liver P450 system? Also, ~45% excreted as unchanged drug.
500
This is the definition of 'resistant relapse' in small cell lung cancer
What is tumor progression occurring within 90 days after the last day of initial treatment?