Devita, Hellman, and Rosenberg's Cancer

LWBK1006-08 LWW-Govindan-Review December 12, 2011 18:49

100 DeVita, Hellman, and Rosenberg’s CANCER: Principles and Practice of Oncology Review

ANSWERS

Answer 8.1. The answer is D.

Alkylating agents were first used as antineoplastic agents after observing

bone marrow and lymphoid hypoplasia in soldiers exposed to nitrogen

mustard in World War II.

Answer 8.2. The answer is A.

Folic acid has been observed to have a significant proliferative effect in

children with lymphoblastic leukemia. This led to the development of

folic acid analogues as antineoplastic agents.

Answer 8.3. The answer is C.

Fluoropyrimidines, gemcitabine, and cytarabine are considered

antimetabolites because of their ability to inhibit the normal path-

ways involved in purine and pyrimidine synthesis. They are the first

examples of “targeted” therapy. Mitoxantrone is an anthracycline.

Answer 8.4. The answer is A.

Germ cell cancers are curable with primary induction chemotherapy in a

subset of patients presenting with advanced or metastatic disease. In the

metastatic setting, non-small cell lung cancer, gastric cancer, and colorec-

tal cancer are not considered curable with conventional chemotherapy

alone.

Answer 8.5. The answer is B.

In most cases, the goals of chemotherapy in patients with advanced or

metastatic malignancies include palliation of tumor-related symptoms,

improvement in quality of life, and prolongation of time to tumor pro-

gression. Eradication of all evidence of disease, although it may occur, is

not generally the goal of therapy in this setting.

Answer 8.6. The answer is C.

Neoadjuvant chemotherapy is used in a variety of locally advanced

solid tumors in an effort to confer possible future surgical resectability.

Chemotherapy is the primary treatment modality in patients with hema-

tologic malignancies.

Answer 8.7. The answer is C.

Adjuvant chemotherapy is used as an adjunct to surgery and/or radi-

ation to reduce the risk of local or distant recurrence from occult

micrometastatic disease. Randomized Phase III data support the use of

adjuvant chemotherapy in breast cancer, colorectal cancer, non-small cell

lung cancer, gastric cancer, Wilms’ tumor, and osteogenic sarcoma.