Devita, Hellman, and Rosenberg's Cancer

LWBK1006-27 LWW-Govindan-Review December 12, 2011 19:32

Chapter 27•Cancer of the Skin and Melanoma 377

Question 27.10. Which of the following statements regarding adjuvant therapy is TRUE?

A. Isolated limb perfusion has been shown to increase the overall sur-

vival for patients with surgically resected stage III melanoma in ran-

domized clinical trials.

B. High-dose interferon has been shown to increase the relapse-free sur-

vival for patients with surgically resected stage III melanoma.

C. Radiation therapy has been shown to increase the overall survival for

patients with surgically resected stage III melanoma.

D. High-dose chemotherapy with hematopoietic stem cell transplanta-

tion can increase the overall survival for patients with stage III surgi-

cally resected melanoma.

Question 27.11. Surgical resection for metastatic melanoma may be appropriate in which

of these instances?

A. Symptomatic brain metastases

B. Bowel obstruction caused by small bowel metastases

C. Symptomatic adrenal metastases

D. All of the above

Question 27.12. Ipilimumab (human anti-CTLA-4 monoclonal antibody) was approved

in 2011 for the treatment of unresectable or metastatic melanoma. Ipil-

imumab is administered intravenously over 90 minutes, every 3 weeks

(for up to 4 doses). Which of the following statements is TRUE regarding

ipilimumab?

A. Immune-mediated enterocolitis is the most common serious adverse

event seen in patients treated with ipilimumab.

B. Premedication with ondansetron and dexamethasone is recom-

mended prior to each dose of ipilimumab.

C. Weekly monitoring of complete blood count (CBC) is recommended

during treatment with ipilimumab.

D. Ipilimumab is contraindicated in patients over 65 years of age due to

poor efficacy.

Question 27.13. Which of the following statements regarding BRAF is TRUE?

A. The BRAF mutation V600E is more common in chronically sun-

damaged skin.

B. BRAF is a downstream target of the phosphatidylinositol 3-kinase

(PI3K) pathway.

C. The response rate to PLX4032 (the oral BRAF inhibitor, vemu-

rafenib), in patients with metastatic melanoma, is 50%, using the

RECIST criteria.

D. A and C.