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Oncology > Melanoma > Flashcards

Flashcards in Melanoma Deck (17)
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1
Q

Incidence of BRAF in melanoma

A

50% of melanomas positive for BRAF -most common V600E

No prognostic value, predictive of response to BRAF

2
Q

BRAF inhibitors

A

Dabrafenib(inhibits all V600 mutations),
vemurafenib (selective V600E mutations)
encorafenib
Response rate 48% in metastatic disease

3
Q

BRAF side effects

A

Rash, diarrhoea, photosensitivity

squamous cell CA (In patients with RAS)

4
Q

Mek inhibitors

A

Trametinib, cobimetinib, binimetinib

5
Q

Immunotherapy of choice for melanoma

A

Pembrolizumab

6
Q

Clinical TLS

A

Lab TLS along with either increased serum creatinine, seizure, cardiac arrhythmia or sudden death

7
Q

Most common subtype of melanoma

A

Superficial spreading

8
Q

Melanoma with worst prognosis

A

Nodular

9
Q

Immunohistochemistry markers of melanoma

A

S-100, Melan A

10
Q

Feature of melanoma that causes upgradation of staging

A

Presence of ulceration

11
Q

Stage 1 and 2 treatment

A

Surgery+ SLNB

12
Q

Management of positive SLNB

A

Total LN dissection done only if clinically positive nodal basin
Else - strict follow up protocol
Completion LN dissection on clinical or radiological progression

13
Q

Role of CTLA4 inhibitor in adjuvant setting

A

Adjuvant Nivolumab better than Ipilimumab for resected Stage 3 disease

14
Q

Management of stage 4 disease

A

Metastasectomy - in absence of locoregional disease and metastasis confined to single site
Mutation testing - targeted tgerapy if mutation positive
Anti PDI - Pembrolizumab or Nivolumab
Ipilimumab + Nivo if LDH high

15
Q

TKI in RCC

A

Sunitinib, Sorafenib - VEGF inhibition
HTN is predictive marker (More with sorafenib)
Rash is predictive marker -more the rash, more response

16
Q

A/E Sorafenib

A

HTN
Handfoot skin reaction
Diarrhoea, rash, alopecia

17
Q

mTOR inhibitors in RCC

A

Everolimus