Oncology Quiz #1

A 78-year-old patient with small cell lung cancer is ready to begin cycle 2 of cisplatin 80 mg/m2 intravenously on day 1 and etoposide 80 mg/m2/day intravenously on days 1–3. His laboratory values are creatinine 1.4 mg/dl with an estimated creatinine clearance of 40 mL/minute. Which will require a dose reduction?

Large cell lymphoma is considered intermediate (between indolent and highly aggressive) in tumor growth and biology. Large cell lymphoma is sensitive to chemotherapy and potentially curable. Metastatic colorectal cancer is considered slow growing. Although responses to chemotherapy commonly occur and chemotherapy can prolong survival (by months), metastatic colorectal cancer is not generally considered curable with chemotherapy. Based on these differences between large cell lymphoma and metastatic colorectal cancer, which one of the following statements is most accurate?

A 63-year man with metastatic prostate cancer presents to the emergency department with severe bone pain (pain rating 9 on a 10-point scale). He has been taking acetaminophen 650 mg orally every 6 hours around the clock at home without much pain relief.

A 62-year-old man recently received a diagnosis of hepatocellular carcinoma. He will be initiated on sorafenib 400 mg twice daily. Which one of the following treatment recommendations is most appropriate regarding this patient's therapy?

A 57-year-old woman was recently given a diagnosis of non-Hodgkin lymphoma. She is treated with six cycles of R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). At her most recent treatment, she developed a red, swollen area around her intravenous site while being administered vincristine. Which one of the following statements is most appropriate?

A 71-year old man has metastatic castrate-resistent prostate cancer. The main site of metastatic disease is the bone (femur lesion). On reviewing his chart, the oncologist notes that the patient has a history of falls and he has chronic kidney disease (creatinine clearance of 35 ml/minute). Because of his increased risk of fractures, the physician would like to initiate a medication to decrease his risk of SREs (skeletal-related events). Which treatment recommendation is most appropriate regarding this patient’s therapy?

If GE had an echocardiogram indicating an ejection fraction (EF) of 35% prior to initiation of the dose-dense portion of the doxorubicin and cyclophosphamide (AC) chemotherapy regimen, which of the following is correct?

GE comes to the clinic one week after 3 cycles of doxorubicin and cyclophosphamide, and you are alerted by the lab that her INR today is 4. After talking to GE who is having no significant bruising or bleeding, you determine that the probable cause of her INR elevation is her:

Which of the following prophylactic antiemetic therapies should GE receive prior to her first dose of weekly paclitaxel?

GE called into the clinic to report breakthrough nausea and vomiting with two episodes of emesis (although she denies dehydration) after receiving dose-dense doxorubicin and cyclophosphamide (AC) yesterday. She received appropriate prophylaxis with a neurokinin-NK1 antagonist (fosaprepitant 150 mg IV on day 1), 5HT3 antagonist (ondansetron 8 mg IV on day 1), and corticosteroid (dexamethasone 12 mg IV on day 1 followed by 4 mg orally twice daily on days 2-4). Which of the following would you recommend to treat her breakthrough nausea and vomiting?