Melanoma

Melanoma

Flashcards
Melanoma

What is the most common treatable immune related adverse event with nivolumab plus ipilumumab in metastatic melanoma ?

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Dermatitis

Melanoma
Melanoma

What is the most common immune related adverse event with nivolumab in metastatic melanoma ?

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Dermatitis

Melanoma
Melanoma

Do elderly patients with metastatic melanoma have a worse outcome with immunotherapy?

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No

Melanoma
Melanoma

What peripheral blood marker can be a surrogate for immunotherapy response in metastatic melanoma?

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Eosinophil elevation

Melanoma
Melanoma

What is the intracranial response rate of ipilimumab + nivolumab for metastatic melanoma ?

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50%

Melanoma
Melanoma

Which BRAF/MEK inhibitor combination has the most data for melanoma with brain metastases ?

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Dabrafenib/trametinib

Melanoma
Melanoma

For BRAF V600 mutated melanoma patients with brain metastases, should targeted therapy be continued after radiotherapy, if it was used before?

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Yes, there is a survival advantage

Melanoma
Melanoma

What percent grade 3 or 4 toxicity can be expected when combining BRAF/MEK inhibitors and PDL1 targeting therapy ?

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75% Pyrexia and LFT elevations

Melanoma
Melanoma

Does prior BRAF/MEK therapy worsen the response to nivolumab in metastatic melanoma?

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No

Melanoma
Melanoma

Is there any data to suggest the use of frontline immune therapy for BRAF V600 mutated patients over targeted therapy?

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Yes

Melanoma
Melanoma

Which biomarker is both prognostic and predictive for metastatic melanoma with regards to treatment response to ipilimumab and nivolumab ?

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Elevated LDH

Melanoma
Melanoma

Is there are 5-year overall survival advantage with a combination of ipilimumab + nivolumab versus single agent nivolumab in metastatic melanoma?

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Yes, 52% versus 26%, hazard ratio 0.5

Melanoma
Melanoma

Under what conditions can one consider discontinuing pembrolizumab for metastatic melanoma?

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Complete response confirmed on at least 2 serial scans or partial response / stable disease consider max 2 years

Melanoma
Melanoma

Which pathway is downstream from BRAF/MEK ?

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MAPK

Melanoma
Melanoma

Is there potential survival advantage with metastatectomy in patients with oligometastatic melanoma?

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Yes

Melanoma
Melanoma

For patients with metastatic melanoma (BRAF V600 mutated) and heavy tumor burden with symptoms, is targeted therapy or immunotherapy preferred as first line treatment?

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Targeted therapy as it can produce a faster response

Melanoma
Melanoma

Is there activity with imatinib in metastatic melanoma with activating mutations of cKIT?

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Very little

Melanoma
Melanoma

What is the approximate 5-year progression free survival for patients with BRAF V600 mutations undergoing therapy with BRAF/MEK inhibitors?

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20%

Melanoma
Melanoma

What is the prevalence of NRAS mutations in cutaneous melanoma?

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15-20%

Melanoma
Melanoma

What surgical margin is recommended for cutaneous melanomas up to 1 mm thick (T1 lesions) ?

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1 cm margin

Melanoma
Melanoma

What surgical margin is recommended for melanoma in situ?

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5-10 mm

Melanoma
Melanoma

What is the single most important predictor of recurrence of head and neck melanomas?

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Positive sentinel lymph node

Melanoma
Melanoma

Melanomas arising from which part of the body have a higher propensity for recurrence ?

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Face/scalp

Melanoma
Melanoma

What margins are recommended for T2 melanomas ?

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2cm

Melanoma
Melanoma

What defines T2 melanoma ?

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>1mm to 2mm

Melanoma
Melanoma

Which type of melanoma arises from chronically sun damaged areas of the skin in older individuals?

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Lentigo maligna melanoma

Melanoma
Melanoma

Which type of melanoma is the most common with dark skinned individuals?

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Acral lentiginous melanoma

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Melanoma

What is the second most common subtype of melanoma?

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Nodular melanoma

Melanoma
Melanoma

Which subtype of melanoma is the most common?

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Superficial spreading

Melanoma
Melanoma

What is the difference in 10 year survival for a localized melanoma with a thickness of 1 mm versus 4 mm ?

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90% versus 50%

Melanoma
Melanoma

What is the single most important prognostic variable for localized melanoma?

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Tumor thickness

Melanoma
Melanoma

What is the most common driver mutation in melanoma besides BRAF ?

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cKIT

Melanoma
Melanoma

Which growth pattern in melanoma confers a poor prognsosis?

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Vertical

Melanoma
Melanoma

Which cKIT exons are mutated in melanoma?

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Exon 11 and exon 13

Melanoma
Melanoma

What cardiovascular side effect can occur with vemurafenib?

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QT prolongation

Melanoma
Melanoma

Is there a role of BRAF/MEK inhibition in the adjuvant setting of BRAF V600E non-mutated stage III melanoma patients?

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No

Melanoma
Melanoma

Which type of biopsy should be performed on a suspicious melanoma lesion to establish a diagnosis?

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Punch biopsy

Melanoma
Melanoma

Which therapy can be used in patients with cKIT exon 11 mutated melanoma?

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Imatinib

Melanoma
Melanoma

Where is the location of the mechanism of action of Ipilimumab?

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Lymph node not tumor site

Melanoma
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