Devita, Hellman, and Rosenberg's Cancer

LWBK1006-18 LWW-Govindan-Review November 24, 2011 11:24

Chapter 18•Cancer of the Lung 209

Question 18.15. A 65-year-old Caucasian man, who is a never smoker, presents to your

office for consultation regarding therapy for metastatic adenocarcinoma

of the lung. He was initially treated with cisplatin and pemetrexed, but

developed progressive disease. EGFR mutational analysis on his tumor

revealed exon 19 deletion, and he received second-line erlotinib therapy.

Despite initial response, he had disease progression 10 months later. The

patient is now inquiring about EML4–ALK testing. Which of the follow-

ing is INCORRECT regarding ALK testing for NSCLC?

A. The frequency of EML4–ALK translocations in never smokers is 4%.

B. EGFR mutations and ALK rearrangements are for the most part

mutually exclusive.

C. The gold standard for diagnosing ALK-positive NSCLC is the ALK

Dual Color break-apart probe.

D. Most tumors with EML4–ALK translocations are adenocarcinomas.

Question 18.16. A 65-year-old man, who is a former smoker presents for consultation

regarding management of unresectable stage IIIB adenocarcinoma of the

lung. He has a PS of 0 and adequate blood counts, hepatic and renal

function. Which of the following would you recommend?

A. Concurrent definitive cisplatin and etoposide therapy, no consolida-

tion therapy, no PCI

B. Concurrent definitive cisplatin and etoposide therapy, consolidation

docetaxel therapy, no PCI

C. Concurrent definitive cisplatin and etoposide therapy, consolidation

gefitinib therapy, no PCI

D. Concurrent definitive cisplatin and etoposide therapy, consolidation

gefitinib therapy, followed by PCI

Question 18.17. A 48-year-old man, presents to your office for consultation regarding

management of newly diagnosed extensive-stage SCLC. He has a PS of

0 and adequate blood counts, hepatic and renal function. Which of the

following would be a reasonable first-line treatment option for him?

A. Cisplatin and irinotecan

B. Cisplatin and etoposide

C. Cisplatin and topotecan

D. Cisplatin, paclitaxel, and etoposide