Medical Oncology Module 4

A 55 year old lady presents with orthopnea and paroxysmal nocturnal dyspnea. She has a history of breast cancer treated with chemoradiotherapy and surgery 10 years ago. She has no known cardiac risk factors.

On examination, her apex beat is displaced to the 6th intercostal space in the mid axillary line.She has bibasal crackles on auscultation. She receives treatment with frusemide with good effect.

Which chemotherapeutic agent is responsible for her condition?

Doxorubicin

Correct Incorrect Correct answer

Capecitabine

Correct Incorrect Correct answer

Carboplatin

Correct Incorrect Correct answer

Docetaxin

Correct Incorrect Correct answer

Tamoxifen

Correct Incorrect Correct answer

A 45-year-old woman presents with a new breast lump. Which imaging modality is recommended as the initial step in her diagnostic workup according to current guidelines?

Both mammography and ultrasound

Correct Incorrect Correct answer

Ultrasound only

Correct Incorrect Correct answer

Mammogram only

Correct Incorrect Correct answer

MRI

Correct Incorrect Correct answer

PET CT

Correct Incorrect Correct answer

A 55-year-old woman presents to your clinic with a palpable lump in her left breast that she noticed 2 weeks ago. She denies any nipple discharge or skin changes over the lump. On examination, the lump is firm and located in the upper outer quadrant of the left breast. You perform a core biopsy, and the pathology report describes atypical ductal hyperplasia.

Which of the following is the most appropriate next step in management?

Surgical referral for further evaluation and management

Correct Incorrect Correct answer

Provide reassurance and arrange a routine follow-up in 6 months

Correct Incorrect Correct answer

Initiate antibiotic therapy and reassess in 2 weeks

Correct Incorrect Correct answer

Order a full blood count and inflammatory markers

Correct Incorrect Correct answer

Start topical treatment and review in 1-2 weeks

Correct Incorrect Correct answer

A 42-year-old woman has recently had a mastectomy after being diagnosed with breast carcinoma. Her paternal grandmother had ovarian carcinoma in her early fifties. She has a 32-year-old well sister. Apart from advising her on appropriate adjuvant therapy, the next most important issue you should also discuss with her is:

screening her for a genetic mutation

Correct Incorrect Correct answer

prophylactic oophorectomy.

Correct Incorrect Correct answer

radiation ovarian ablation

Correct Incorrect Correct answer

prophylactic contralateral mastectomy

Correct Incorrect Correct answer

screening her sister for a genetic mutation

Correct Incorrect Correct answer

A 48-year-old woman presents to your clinic with a 3-month history of spontaneous, unilateral bloody discharge from her right nipple. She denies any palpable lump or recent trauma to the breast.

On examination, the nipple appears slightly inverted but can be easily everted with manipulation, and no skin changes are observed. Mammography and ultrasound of the right breast have been performed, showing no definitive mass.

Nipple discharge cytology was performed, and no malignant cells were identified.

Which of the following statements is most accurate regarding this clinical scenario?

The presence of spontaneous, unilateral bloody discharge from a single duct warrants further evaluation despite negative imaging and cytology.

Correct Incorrect Correct answer

Given the slit-like retraction of the nipple that can be easily everted, no further investigation is necessary.

Correct Incorrect Correct answer

Ulceration and eczematous-like changes of the nipple are required to suspect malignancy in the presence of bloody nipple discharge.

Correct Incorrect Correct answer

Mammography alone is sufficient for the evaluation of nipple discharge.

Correct Incorrect Correct answer

The absence of malignant cells on nipple discharge cytology effectively rules out cancer.

Correct Incorrect Correct answer

According to a study using the Cancer Intervention and Surveillance Modeling Network (CISNET) models to simulate US breast cancer mortality rates from 1975 to 2019, which factor contributed the most to the observed reduction in breast cancer mortality?

Treatment of stage I to III breast cancer

Correct Incorrect Correct answer

Treatment of metastatic breast cancer

Correct Incorrect Correct answer

Mammography screening

Correct Incorrect Correct answer

Lifestyle and dietary modifications

Correct Incorrect Correct answer

Genetic screening and counseling

Correct Incorrect Correct answer

A 62-year-old woman is diagnosed with breast cancer. Histopathological examination reveals that the tumor expresses estrogen receptors (ER) but not progesterone receptors (PR).

Based on the hormone receptor status, which of the following characteristics is most likely associated with this patient’s breast cancer subtype?

Indolent disease course with a higher rate of late recurrence and death (>5 years after diagnosis)

Correct Incorrect Correct answer

Aggressive disease with a high likelihood of early recurrence

Correct Incorrect Correct answer

Predominantly brain metastases

Correct Incorrect Correct answer

Very low risk of metastasis

Correct Incorrect Correct answer

High likelihood of responding well to chemotherapy alone

Correct Incorrect Correct answer

In a study analyzing gene expression patterns in breast cancer patients using cDNA microarrays, which of the following findings was NOT observed?

Hierarchical cluster analysis segregated tumors into groups correlating with menopausal status.

Correct Incorrect Correct answer

Gene expression patterns were strongly associated with estrogen receptor (ER) status.

Correct Incorrect Correct answer

Genes involved in cell cycle, DNA replication, and chromosomal stability were elevated in poor prognostic groups.

Correct Incorrect Correct answer

Glutathione S-transferase M3 was identified as an important marker for survival.

Correct Incorrect Correct answer

A set of 16 genes was significantly associated with relapse-free survival at a stringent significance level.

Correct Incorrect Correct answer

A 32-year-old woman presents to your oncology clinic for a follow-up visit after recently undergoing breast-conserving surgery for early-stage breast cancer. She is otherwise healthy, with no significant past medical history or family history of breast or ovarian cancer. She does not smoke, consumes alcohol socially, and leads an active lifestyle. The surgery was uncomplicated, and she has recovered well, with no residual pain or significant side effects.

The final pathology report from her surgery provides the following details about the tumor:

• Size: 2cm
• Hormone status: Estrogen Receptor (ER) negative, Progesterone Receptor (PR) negative
• HER-2 status: Positive
• Histology: Well-differentiated ductal carcinoma
• Nodal status: No lymph node involvement (Node negative)

Given her young age, the tumor’s characteristics, and her current post-operative status, you are considering the best adjuvant treatment options to improve her overall survival.

The goal is to address the aggressive nature of HER-2 positive tumors while considering the patient’s quality of life and potential treatment-related side effects.

What is the best adjuvant treatment to improve her overall survival?

Chemotherapy and Trastuzumab

Correct Incorrect Correct answer

Chemotherapy and Tamoxifen

Correct Incorrect Correct answer

Chemotherapy alone

Correct Incorrect Correct answer

Chemotherapy and letrozole

Correct Incorrect Correct answer

Lapatinib

Correct Incorrect Correct answer

A 48-year-old postmenopausal woman presents to your clinic with a recent diagnosis of breast cancer. She has been participating in annual breast cancer screening programs due to her dense breast tissue, which is known to increase the risk of breast cancer and can make mammograms less effective at detecting tumors.

During her most recent screening, a new 1.5-cm area of microcalcifications was detected in her left breast, without any associated palpable mass. Subsequent biopsy of this area revealed a Grade 2, ER/PR negative, and HER2-negative infiltrating ductal carcinoma.

The patient has a family history of breast cancer, with a maternal aunt diagnosed at the age of 50. Aside from her current diagnosis, she reports being in good health, with no significant past medical history. Her medications include a daily multivitamin and occasional ibuprofen for headaches. She denies any history of hormone replacement therapy.

On physical examination, she appears well, with normal vital signs and no lymphadenopathy. The only abnormal finding is ecchymosis at the site of the recent breast biopsy.

Given her postmenopausal status, tumor characteristics, and family history, you are considering the most appropriate next step in her management, focusing on local control of the disease while minimizing the risk of recurrence and considering the patient’s quality of life.

Which of the following is the most appropriate next step in management?

Left lumpectomy with sentinel lymph node biopsy followed by breast irradiation

Correct Incorrect Correct answer

Left lumpectomy with axillary node dissection followed by breast irradiation

Correct Incorrect Correct answer

Left lumpectomy with sentinel lymph node biopsy without breast irradiation

Correct Incorrect Correct answer

Left modified radical mastectomy

Correct Incorrect Correct answer

Left modified radical mastectomy and right simple mastectomy

Correct Incorrect Correct answer

A 42-year-old premenopausal woman presents to your clinic with a recent diagnosis of early-stage hormone receptor-positive breast cancer. She has no significant past medical history and her family history is notable for breast cancer in her mother at the age of 50.

On examination, there is a palpable 2 cm mass in the upper outer quadrant of the left breast, with no palpable axillary lymph nodes. Mammography and biopsy have confirmed the diagnosis, and the tumor is found to be estrogen and progesterone receptor positive, HER2 negative, with no lymphovascular invasion.

As part of the multidisciplinary team meeting to discuss her management, you are considering adjuvant systemic therapy options to reduce the risk of recurrence.

Given her premenopausal status and tumor characteristics, which of the following medications should generally be avoided in her treatment plan?

Aromatase inhibitor and Trastuzumab

Correct Incorrect Correct answer

Trastuzumab only

Correct Incorrect Correct answer

Goserelin

Correct Incorrect Correct answer

Tamoxifen

Correct Incorrect Correct answer

Anthracyclines

Correct Incorrect Correct answer

In the APHINITY trial, which patient group demonstrated a statistically significant improvement in 3-year invasive-disease–free survival (IDFS) rates when treated with pertuzumab added to adjuvant trastuzumab and chemotherapy for operable early stage breast cancer?

Patients with HER2 +ve, node-positive disease

Correct Incorrect Correct answer

Patients with HER 2 +ve, node-negative disease

Correct Incorrect Correct answer

Patients with hormone-receptor–negative disease

Correct Incorrect Correct answer

All patients regardless of node or hormone-receptor status

Correct Incorrect Correct answer

Patients with HER2 -ve, node positive disease

Correct Incorrect Correct answer

A 45-year-old woman with HER2-positive early breast cancer underwent neoadjuvant chemotherapy consisting of a taxane and trastuzumab. Post-treatment surgical assessment revealed residual invasive disease in the axilla. Considering the patient’s prognosis and the potential benefits of further adjuvant therapy, you are contemplating the next step in her treatment plan.

Which adjuvant therapy should be considered to significantly reduce the risk of recurrence of invasive breast cancer or death in this patient?

Switch to adjuvant T-DM1 (Trastuzumab Emtansine) for 14 cycles

Correct Incorrect Correct answer

Continue with trastuzumab for 14 cycles

Correct Incorrect Correct answer

Initiate adjuvant anthracycline-based chemotherapy

Correct Incorrect Correct answer

Administer adjuvant hormone therapy regardless of hormone receptor status

Correct Incorrect Correct answer

No further adjuvant therapy is indicated

Correct Incorrect Correct answer

In a post-menopausal patient, which one of the following is the best initial hormonal therapy for hormone receptor-positive metastatic breast cancer?

Aromatase inhibitor

Correct Incorrect Correct answer

Androgen

Correct Incorrect Correct answer

Anti-oestrogen

Correct Incorrect Correct answer

Oestrogen.

Correct Incorrect Correct answer

Progesterone

Correct Incorrect Correct answer

A 60-year-old postmenopausal woman has recently undergone surgery for early-stage breast cancer. She is estrogen receptor-positive and is starting adjuvant endocrine therapy. You are considering additional treatments to reduce her risk of recurrence, particularly given her postmenopausal status.

Which of the following is the most appropriate addition to this patient’s treatment plan to reduce the rate of breast cancer recurrence in the bone and improve breast cancer survival?

Start adjuvant bisphosphonate treatment for 2-5 years

Correct Incorrect Correct answer

Initiate adjuvant chemotherapy with a taxane-based regimen

Correct Incorrect Correct answer

Prescribe a monthly dose of oral cholecalciferol

Correct Incorrect Correct answer

Short course adjuvant bisphosphonate treatment for 6 months

Correct Incorrect Correct answer

No additional treatment is needed beyond endocrine therapy.

Correct Incorrect Correct answer

With regards to cancer screening, which of the following cancer is routinely recommended in Australia?

Bowel cancer

Correct Incorrect Correct answer

Prostate cancer

Correct Incorrect Correct answer

Lung cancer

Correct Incorrect Correct answer

Melanoma

Correct Incorrect Correct answer

Ovarian cancer

Correct Incorrect Correct answer

How do CDK4/6 inhibitors, such as palbociclib, ribociclib, and abemaciclib, exert their therapeutic effect in HR+, HER2− breast cancer?

By inducing complete dephosphorylation of the retinoblastoma (Rb) tumor suppressor protein, resulting in cell cycle arrest at the G1 phase.

Correct Incorrect Correct answer

By enhancing the expression of estrogen and progesterone receptors, thereby increasing the sensitivity of breast cancer cells to endocrine therapy.

Correct Incorrect Correct answer

By activating the protein p53, leading to apoptosis of breast cancer cells

Correct Incorrect Correct answer

By inhibiting the HER2 receptor, leading to a decrease in cell proliferation and growth in HER2-positive breast cancer cells.

Correct Incorrect Correct answer

By inhibiting the mTOR pathway, which is involved in cell growth and proliferation.

Correct Incorrect Correct answer

A 52-year-old woman with advanced HR+, HER2− breast cancer is being considered for treatment following progression on first-line endocrine therapy.

Given the proven efficacy of CDK4/6 inhibitors in combination with endocrine therapy in this setting, you are evaluating which CDK4/6 inhibitor to include in her treatment regimen.

Which of the following factors is most critical in selecting the optimal CDK4/6 inhibitor for this patient?

The specific toxicity profile and cost of each CDK4/6 inhibitor

Correct Incorrect Correct answer

The patient's previous response to endocrine therapy alone

Correct Incorrect Correct answer

Individual physician's experience and hospital preference policy

Correct Incorrect Correct answer

The presence of specific biomarkers indicating resistance to CDK4/6 inhibitors

Correct Incorrect Correct answer

The need for combination therapy with chemotherapy instead of endocrine therapy

Correct Incorrect Correct answer

A 48-year-old woman with previously untreated, locally recurrent inoperable metastatic triple-negative breast cancer (TNBC) is under consideration for first-line treatment.

Her tumor has a PD-L1 combined positive score (CPS) of 12.

Which treatment option would most likely provide a significant and clinically meaningful improvement in progression-free survival (PFS) for this patient?

Pembrolizumab in combination with chemotherapy

Correct Incorrect Correct answer

Chemotherapy alone

Correct Incorrect Correct answer

Pembrolizumab monotherapy

Correct Incorrect Correct answer

Endocrine therapy in combination with a CDK4/6 inhibitor

Correct Incorrect Correct answer

PARP inhibitor monotherapy

Correct Incorrect Correct answer

A 55-year-old woman with relapsed metastatic triple negative breast cancer (TNBC), after receiving a taxane-based regimen, is evaluating treatment options with her oncologist.

She has no history of brain metastases and is looking for a treatment that could potentially offer her a longer progression-free survival (PFS) and overall survival (OS).

Which treatment option is most likely to offer this patient a significant improvement in PFS and OS?

Initiating treatment with sacituzumab govitecan

Correct Incorrect Correct answer

Continuing with another line of standard single-agent chemotherapy (eribulin, vinorelbine, capecitabine, or gemcitabine)

Correct Incorrect Correct answer

Starting treatment with a PD-1 or PD-L1 inhibitor monotherapy

Correct Incorrect Correct answer

Combining chemotherapy with a PD-1 or PD-L1 inhibitor

Correct Incorrect Correct answer

Utilizing an HER2-targeted antibody–drug conjugate

Correct Incorrect Correct answer

A 47-year-old woman with HER2-positive metastatic breast cancer, previously treated with trastuzumab and a taxane, is discussing second-line treatment options with her oncologist.

She has an Eastern Cooperative Oncology Group (ECOG) performance status of 1 and at least one measurable lesion.

Which treatment is most likely to offer this patient the longest median progression-free survival (PFS) in the second-line setting for HER2-positive metastatic breast cancer?

Initiating treatment with trastuzumab deruxtecan

Correct Incorrect Correct answer

Initiating treatment with trastuzumab emtansine

Correct Incorrect Correct answer

Continuing treatment with trastuzumab alone

Correct Incorrect Correct answer

Combining trastuzumab with a chemotherapy agent of the physician's choice

Correct Incorrect Correct answer

Starting treatment with a PD-1 or PD-L1 inhibitor in combination with trastuzumab

Correct Incorrect Correct answer

A 55-year-old woman with a history of hormone receptor (HR)–positive, human epidermal growth factor receptor 2 (HER2)–negative advanced breast cancer presents to the oncology clinic. She has previously received endocrine therapy. On further investigation, her tumor is found to have a PIK3CA mutation. Based on her cancer profile and previous treatments, she is considered for a new treatment regimen.

Given the patient’s HR-positive, HER2-negative advanced breast cancer with confirmed PIK3CA mutation, which of the following treatment options is most likely to prolong her progression-free survival?

Alpelisib 300 mg per day plus fulvestrant 500 mg every 28 days and once on day 15

Correct Incorrect Correct answer

Fulvestrant 500 mg every 28 days and once on day 15 alone

Correct Incorrect Correct answer

High-dose estrogen therapy

Correct Incorrect Correct answer

Lapatinib plus capecitabine

Correct Incorrect Correct answer

Pembrolizumab plus chemotherapy.

Correct Incorrect Correct answer

A 62-year-old woman presents to your oncology clinic for evaluation and management after being newly diagnosed with metastatic breast cancer. Her medical history is notable for hypertension and type 2 diabetes, both well-controlled with medication. She has no known drug allergies and her family history is unremarkable for cancer.

On presentation, she reports recent unintended weight loss and a palpable mass in her right breast.

Diagnostic workup, including a mammogram and subsequent biopsy, reveals a 4 cm tumor in the right breast. Imaging studies, including a CT scan, identify liver metastases, indicating metastatic disease. Histopathological examination of the biopsy specimen reveals a Grade 2, moderately differentiated lobular carcinoma with involvement of two lymph nodes. Hormone receptor testing shows the tumor to be estrogen receptor (ER) positive, progesterone receptor (PR) negative, and HER-2 positive.

Given the patient’s hormone receptor status and the presence of metastatic disease, you are considering the best initial hormone therapy to incorporate into her treatment plan, alongside HER-2 targeted therapy and other systemic treatments as appropriate.

What is the best initial hormone therapy for this patient?

Aromatase inhibitor

Correct Incorrect Correct answer

Androgen

Correct Incorrect Correct answer

Anti-estrogen

Correct Incorrect Correct answer

Estrogen

Correct Incorrect Correct answer

Progesterone

Correct Incorrect Correct answer

A 58-year-old postmenopausal woman with a strong family history of breast cancer, including her mother diagnosed at age 45 and a sister diagnosed at age 52, presents to your clinic for a discussion on breast cancer risk reduction strategies. She has a history of osteopenia but no history of cardiovascular disease.

Her Gail model 5-year risk score for breast cancer is calculated to be 3.2%, categorizing her as high risk.

After discussing various options, the conversation turns to the use of selective estrogen receptor modulators (SERMs) for risk reduction.

Given her risk profile and medical history, you consider prescribing a SERM. You weigh the benefits and risks of Raloxifene and Tamoxifen, two SERMs effective in reducing the risk of invasive breast cancer in high-risk postmenopausal women.

What is the main benefit of choosing Raloxifene over Tamoxifen for this patient?

lower risk of thromboembolic events

Correct Incorrect Correct answer

lower risk of fractures

Correct Incorrect Correct answer

lower risk of stroke

Correct Incorrect Correct answer

lower risk of ischaemic heart disease

Correct Incorrect Correct answer

lower risk of non invasive breast cancer

Correct Incorrect Correct answer

Which of the following is considered a risk factor for the development of bowel cancer?

Ulcerative colitis with a disease duration of 10-20 years, especially in patients with primary sclerosing cholangitis

Correct Incorrect Correct answer

Routine consumption of fresh vegetables

Correct Incorrect Correct answer

Engagement in regular physical activity

Correct Incorrect Correct answer

High intake of unprocessed red meats

Correct Incorrect Correct answer

History of lower limb radiation therapy

Correct Incorrect Correct answer

Which gene mutation is most frequently observed in colorectal cancer?

APC

Correct Incorrect Correct answer

KRAS

Correct Incorrect Correct answer

BRAF

Correct Incorrect Correct answer

TP53

Correct Incorrect Correct answer

PIK3CA

Correct Incorrect Correct answer

A 62-year-old male with metastatic colorectal cancer, confirmed to have microsatellite-instability-high (MSI-H) and mismatch-repair-deficient (dMMR) markers, is evaluating first-line treatment options with his oncologist.

Given his condition, which of the following treatment strategy is more likely to result in better progression free survival?

Initiate pembrolizumab at a dose of 200 mg every 3 weeks.

Correct Incorrect Correct answer

Start with 5-fluorouracil–based chemotherapy combined with bevacizumab

Correct Incorrect Correct answer

Begin treatment with cetuximab monotherapy.

Correct Incorrect Correct answer

Initiate combination therapy consisting of pembrolizumab and bevacizumab.

Correct Incorrect Correct answer

Use of high-dose intermittent pembrolizumab as the initial treatment to intensify the immune response.

Correct Incorrect Correct answer

A 55-year-old female presents with metastatic colorectal cancer and is confirmed to have the BRAF V600E mutation. She has undergone one previous chemotherapy regimen but has shown disease progression. Her oncologist is considering the next line of treatment based on recent clinical trial findings.

Considering the patient’s BRAF V600E mutation status and previous treatment failure, which of the following treatment options is most likely to improve her overall survival?

Encorafenib, binimetinib, and cetuximab triplet therapy

Correct Incorrect Correct answer

Encorafenib monotherapy

Correct Incorrect Correct answer

Encorafenib and cetuximab combination therapy

Correct Incorrect Correct answer

Cetuximab and irinotecan combination therapy

Correct Incorrect Correct answer

Palliative care focusing on symptom management

Correct Incorrect Correct answer

Based on the background and findings of the Rectal cancer And Preoperative Induction therapy followed by Dedicated Operation (RAPIDO) trial, what was the primary endpoint of the study trial in evaluating treatment efficacy for high-risk locally advanced rectal cancer?

Cumulative probability of disease-related treatment failure at 3 years post-randomization

Correct Incorrect Correct answer

Overall survival at 5 years post-treatment

Correct Incorrect Correct answer

Disease-free survival at 2 years post-randomization

Correct Incorrect Correct answer

Rate of complete pathological response post-surgery

Correct Incorrect Correct answer

Incidence of grade 3 or higher adverse events during treatment

Correct Incorrect Correct answer

What is the primary rationale for administering adjuvant chemotherapy in patients with resected colon cancer?

To eliminate microscopic disease and reduce the risk of recurrence

Correct Incorrect Correct answer

To enhance the radiographic appearance of the colon post-surgery

Correct Incorrect Correct answer

To provide symptomatic relief from post-operative pain

Correct Incorrect Correct answer

To prepare the patient for a second surgical intervention

Correct Incorrect Correct answer

To increase the absorption of oral medications post-surgery

Correct Incorrect Correct answer

In which type of cancer is the combination of sotorasib and panitumumab primarily investigated for its therapeutic role?

Metastatic colorectal cancer with KRAS G12C mutation

Correct Incorrect Correct answer

Metastatic colorectal cancer with TP53 mutation

Correct Incorrect Correct answer

Breast cancer with HER2 amplification

Correct Incorrect Correct answer

Melanoma with BRAF V600E mutation

Correct Incorrect Correct answer

Non-small cell lung cancer with ALK rearrangement

Correct Incorrect Correct answer

Which of the following statements is correct regarding the differences between left-sided and right-sided colorectal cancer?

Right-sided colorectal cancer tends to exhibit a more immunological phenotype and has a poorer prognosis compared to left-sided colorectal cancer.

Correct Incorrect Correct answer

Right-sided colorectal cancer is embryologically derived from the hindgut, whereas left-sided colorectal cancer is derived from the midgut.

Correct Incorrect Correct answer

Left-sided colorectal cancer generally has a poorer prognosis compared to right-sided colorectal cancer due to more aggressive histological features.

Correct Incorrect Correct answer

BRAF mutations are predominantly found in left-sided colorectal cancer, while RAS mutations are more common in right-sided cancers.

Correct Incorrect Correct answer

The gender distribution and epidemiology of left-sided colorectal cancer are significantly different from other gastrointestinal cancers, with a higher prevalence in females.

Correct Incorrect Correct answer

A 55-year-old male patient with unresectable, RAS wild-type, left-sided, metastatic colorectal cancer is under your care.

Which treatment option would most likely improve his overall survival when added to standard first-line chemotherapy?

Bevacizumab, an anti-VEGF antibody, added to mFOLFOX6.

Correct Incorrect Correct answer

Panitumumab, an anti-EGFR antibody, added to mFOLFOX6.

Correct Incorrect Correct answer

Cetuximab, an anti-EGFR antibody, added to mFOLFOX6.

Correct Incorrect Correct answer

A combination of both panitumumab and bevacizumab with mFOLFOX6.

Correct Incorrect Correct answer

A combination of both cetuximab and bevacizumab with mFOLFOX6.

Correct Incorrect Correct answer

A 58-year-old female patient undergoing treatment for colorectal cancer presents with severe mucositis and early onset of myelosuppression after her first cycle of chemotherapy. Her treatment regimen includes a fluoropyrimidine-based chemotherapy.

Considering her clinical presentation, which underlying condition is most likely contributing to her exaggerated response to the chemotherapy?

Dihydropyrimidine dehydrogenase (DPD) deficiency, leading to increased toxicity from fluoropyrimidines

Correct Incorrect Correct answer

Gilbert's syndrome, leading to increased toxicity from irinotecan metabolites

Correct Incorrect Correct answer

G6PD deficiency, leading to hemolytic anemia

Correct Incorrect Correct answer

UGT1A1 enzyme deficiency, leading to increased toxicity from irinotecan metabolites

Correct Incorrect Correct answer

Deficiency of thymidine synthetase, leading to resistance to fluoropyrimidines

Correct Incorrect Correct answer

A 62-year-old patient with gastrointestinal cancer is being treated with FOLFIRINOX.

Which of the following toxicities is most specifically associated with the oxaliplatin component of this regimen?

Peripheral neuropathy and cold dysaesthesia

Correct Incorrect Correct answer

Mucositis and severe diarrhea

Correct Incorrect Correct answer

Coronary artery vasospasm

Correct Incorrect Correct answer

Diarrhea exacerbated by deficiency of UGT1A1 enzyme

Correct Incorrect Correct answer

Myelosuppression due to dihydropyrimidine dehydrogenase deficiency

Correct Incorrect Correct answer

Average score
Your score

Medical Oncology Module 4

Quiz Summary

Information

Results

Results

Categories

1. Question

2. Question

3. Question

4. Question

5. Question

6. Question

7. Question

8. Question

9. Question

10. Question

11. Question

12. Question

13. Question

14. Question

15. Question

16. Question

17. Question

18. Question

19. Question

20. Question

21. Question

22. Question

23. Question

24. Question

25. Question

26. Question

27. Question

28. Question

29. Question

30. Question

31. Question

32. Question

33. Question

34. Question

35. Question