20th Annual Mayo Clinic Hematology/Oncology Reviews

7 Questions | Total Attempts: 79

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Oncology Quizzes & Trivia

On July 29 - 31, 2010 we will be holding our 20th consecutive Mayo Clinic Hematology/Oncology Reviews with the main goal of providing each of you with a practical overview of the important clinically applicable new research findings that you should be aware of for the benefit of your patients. As a previous year's participant, we would like to personally invite you to participate in this pre-test course assessment.


Questions and Answers
  • 1. 
    A 60 year old female patient is diagnosed with metastatic pancreatic adenocarcinoma to the liver. She is not interested in clinical trail participation. Her performance score is 0 and liver and renal function studies are normal. Based on results of single randomized phase 3 trials, which one(s) of the following regimens have been shown to prolong overall survival compared wit gemcitabine:
    • A. 

      A. Gemcitabine and capecitabine

    • B. 

      B. Gemcitabine and erlotinib

    • C. 

      C. Gemcitabine and cetuximab

    • D. 

      D. A and B

    • E. 

      E. All of the above

  • 2. 
    What treatment is considered the standard first line treatment for the above patient according to NCCN guidelines:
    • A. 

      A. Gemcitabine

    • B. 

      B. Gemcitabine and capecitabine

    • C. 

      C. Gemcitabine and erlotinib

    • D. 

      D. Gemcitabine and cetuxima

    • E. 

      E. All of the above

  • 3. 
    A 78 year old African American female is diagnosed with stage 4 adenocarcinoma of the lung. She is willing to consider oral treatment that is not associated with alopecia. You have read about the high response rate to erlotinib associated with EGFR activating mutations and would like to know the chances of her having one of these mutations. Based on data from Leidner et al reported in JCO in November 2009, the chances of her tumor harboring one of these mutations is:
    • A. 

      A. Very high, 40-60%

    • B. 

      B. Very low, 2-4%

    • C. 

      C. Intermediate, 20-30%

    • D. 

      D. None of the above are correct.

  • 4. 
    A 58 year old female is diagnosed with a 0.2 cm grade 2 IDC, ER negative, PR negative and HER2 3+ status post lumpectomy. She is wondering if she should receive adjuvant treatment. Based on NCCN guidelines and recommendations of Burstein and Winer in an editorial in JCO December 1, 2009 page 5672, the recommendation should be:
    • A. 

      A. No adjuvant systemic treatment

    • B. 

      B. A shortened course of chemotherapy and trastuzumab following the FIN-HER regimen

    • C. 

      C. Adjuvant chemotherapy with concomitant trastuzumab

    • D. 

      D. Adjuvant chemotherapy with sequential trastuzumab

  • 5. 
    Your  65 yo male patient with metastatic colon cancer to the liver has responded to 6 cycles of FOLFOX bevacizumab treatment.  He has mild neuropathy at this time. He is interested in a break from chemotherapy but is willing to follow your advise. You would recommend:
    • A. 

      A. A break from all chemotherapy is reasonable given the results of OPTIMOX2, as reviewed by Dr. Hochster in an editorial in JCO, Dec 1, 2009

    • B. 

      B. Proceeding with 5FU, leucovorin and bevacizumab would be a reasonable option as per the CONCePT trial

    • C. 

      C. Switching him to erlotinib and bevacizumab would be worth pursuing given the known activity of the combination in colon cancer

    • D. 

      D. None of the above are reasonable recommendations

  • 6. 
    A 45 year old man presents with an absolute eosinophil  count of 10,000, congestive heart failure with an echocardiogram showing thickened myocardium consistent with an infiltrating process and bone marrow showing increased atypical eosinophils (40%) and myelofibrosis. Serum troponin levels are elevated and FIP1L1/PDGFRA gene is detected in the peripheral blood.  Your treatment  recommendation is:
    • A. 

      A. Imatinib 400 mg daily

    • B. 

      B. Imatinib 100 mg daily

    • C. 

      C. Imatinib 400 mg daily and methyl-prednisolone 1 mg/kg daily

    • D. 

      D. Alpha interferon therapy

    • E. 

      E. Hydroxyurea

  • 7. 
    The patient obtains a molecular remission with your prescribed treatment. Your recommendation at this time is:
    • A. 

      A. To proceed with allogeneic stem cell transplant since it is the only curative treatment.

    • B. 

      B. To discontinue treatment and proceed with a course of observation

    • C. 

      C. To continue treatment with close follow up.

    • D. 

      D. To switch treatment to a non-cross resistant regimen

    • E. 

      E. None of the above are correct

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