11 Assessment of Clinical Responses

Vinicius Ernani and Suresh S. Ramalingam

QUESTIONS

Each of the numbered items below is followed by lettered answers. Select the ONE lettered answer that is BEST in each case unless instructed otherwise.

Question 11.1 Which of the following drug acts on a targeted mutation?

A. Docetaxel

B. Navelbine

C. Erlotinib

D. Pemetrexed

Question 11.2 In children with lymphoblastic leukemia, folic acid was observed to:

A. Cause disease proliferation.

B. Cause disease regression.

C. Have no effect.

D. Improve survival.

Question 11.3 Which of the following drug is an antimetabolite chemotherapeutic agent?

A. Gemcitabine

B. Temozolomide

C. Mitoxantrone

D. Bevacizumab

Question 11.4 In patients with advanced or metastatic disease, which of the following has curative potential with primary induction chemotherapy?

A. Germ cell cancer

B. Non–small cell lung cancer

C. Gastric cancer

D. Colorectal cancer

Question 11.5 The goals of therapy in incurable, advanced, metastatic disease include:

A. Obtain a complete response

B. Palliate tumor-related symptoms

C. Deliver higher doses of chemotherapy

D. Never offer therapy

Question 11.6 Neoadjuvant chemotherapy can be utilized in which of the following cancers?

A. Burkitt lymphoma

B. Hodgkin lymphoma

C. Multiple Myeloma

D. Lung cancer

Question 11.7 Which of the following is TRUE regarding the purpose of administering adjuvant chemotherapy?

A. To increase quality of life.

B. To reduce local and distant recurrence.

C. To use as primary therapy instead of surgery.

D. To use as primary therapy instead of radiation.

Question 11.8 Which of the following play essential role in activating apoptosis?

A. Bcl-2

B. NF-κB

C. Caspases

D. Bcl-x_L

Question 11.9 The most important indicator of the effectiveness of chemotherapy is:

A. Achievement of a minor response.

B. Achievement of a partial response.

C. Achievement of a complete response.

D. Achievement of stable disease.

Question 11.10 According to RECIST criteria 1.1, a partial response is defined as:

A. At least a 30% reduction in measurable tumor mass.

B. At least a 10% reduction in measurable tumor mass.

C. Improvement in quality of life.

D. Improvement in survival.

Question 11.11 Anticancer activity of bortezomib is due to the inhibition of:

A. Proteasome.

B. Bcl-2.

C. Thymidylate synthase.

D. MDM2.

Question 11.12 In early-stage colon cancer treated with adjuvant chemotherapy, the majority of relapses occur:

A. Within the first 5 years.

B. Within the first 3 years.

C. Within the first 2 years.

D. Within the first year.

Question 11.13 Gompertzian kinetics are characterized by:

A. Clinically undetectable tumors are at their lowest growth fraction.

B. The growth fraction is stable over time.

C. The growth fraction increases exponentially with time.

D. The growth fraction decreases exponentially with time.

Question 11.14 Which of the following is the most common genetic change associated with development of resistance to tyrosine kinase inhibitors (TKI) in patients with epidermal growth factor receptor (EGFR) mutation?

A. T790M mutation

B. PTEN overexpression

C. D761Y mutation

D. MET gene mutation

Question 11.15 Which of the following is TRUE regarding intention to treat (ITT) analysis?

A. Increases the risk of bias

B. Should not be used in a randomized control trial

C. Small effect on overall survival and progression-free survival

D. All patients randomized to a group will be analyzed

Question 11.16 In patients with colorectal cancer the genetic change associated with resistance to cetuximab is:

A. BRAF mutation.

B. Wild-type KRAS.

C. EGFR-TK mutation.

D. NFκB activation.

Question 11.17 Dose-dense chemotherapy was developed after the observation that:

A. The growth of cells is significantly lower in the early part of the growth curve.

B. The log cell kill is higher in smaller volume tumors, resulting in more rapid growth between chemotherapy cycles.

C. Growth between chemotherapy cycles is halted.

D. More frequent administration of chemotherapy led to less toxicity.

Question 11.18 In most cases, normal bone marrow and gastrointestinal (GI) precursor cells are able to counteract the effects of cytotoxic chemotherapy because:

A. They are not exposed to the chemotherapeutic agent.

B. They have intact mechanisms for apoptosis and cell-cycle arrest.

C. They have rapid turnover.

D. They possess resistance mechanisms.

Question 11.19 Which of the following is TRUE concerning p53?

A. It is a targetable mutation for therapy

B. It is a potent inducer of apoptosis.

C. It causes S-phase arrest in the cell cycle.

D. It can decrease the activity of cytotoxic chemotherapy.

Question 11.20 The final stage of the programmed-cell death pathway is mediated by:

A. Bcl-2.

B. p53.

C. Tumor necrosis factor.

D. Caspase cascade.

Question 11.21 Which of the following is inhibited by imatinib?

A. EGFR

B. BRAF

C. KRAS

D. Bcr-abl

Question 11.22 Cetuximab use in colorectal cancer is characterized by:

A. Approval in the first-line setting.

B. Limited utility as monotherapy.

C. High toxicity.

D. Response rates of 21% to 23% when used with irinotecan.

Question 11.23 Which of the following is characteristic of a randomized discontinuation trial design?

A. Phase 1 study design

B. Phase 2 study design

C. Phase 3 study design

D. Preferred for drugs with preexisting predictive biomarker

Question 11.24 Palbociclib is an inhibitor of :

A. CDK4 and CDK6.

B. FGFR.

C. C KIT.

D. VEGFR2.

Question 11.25 Which of the following is a nonmeasurable lesion, according to RECIST criteria?

A. 3.5 cm × 2.0 cm pancreatic adenocarcinoma

B. 1.7 cm × 1.5 cm invasive ductal carcinoma of the breast

C. 0.8 cm × 0.7 cm right paratracheal lymph node

D. 5.5 cm × 4.0 cm rectal adenocarcinoma

Question 11.26 Computed tomography contrast perfusion and dynamic-contrast magnetic resonance imaging may be useful in evaluating:

A. Response to alkylating agents.

B. Response to antiangiogenic agents.

C. Degree of tumor necrosis.

D. Overall survival.

Question 11.27 Which of the following is TRUE regarding the use of time to progression as an end point in clinical trials?

A. Uses a smaller sample size when compared with using overall survival as an end point.

B. Not confounded by subsequent therapies.

C. The study can be completed in a shorter amount of time.

D. All of the above.

Stay updated, free articles. Join our Telegram channel

Join