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histologic subtypes of non small cell lung cancer
- squamous
- adenocarcinoma
- large cell
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sites of metastatic disease
- brain
- bone
- liver
- adrenal gland
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what does wet mean
pleural or pericardial effusion
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when can cetuximab not be used
K-ras mutation
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what are the poor prognostic factors
- poor PS (ECOG 3-4)
- activation of k-ras
- mutation in p53
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when is surgery indicated for cancer pts
stage I-IIIA are considered surgical candidates
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what is the gold standard for surgery
sleeve lobectomy
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what are contraindications for surgery
- poor performance
- compromised cardiovascular function
- poor pulmonary function
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what is anastomosis
a surgical connection between two structures
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what is neoadjuvant mean
intervention before chemotherapy
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what is the recommended drug regimen for resectable cancer pts
- cisplatin 50 mg/m2 days 1 and 8
- vinorelbine 25 mg/m2 days 1, 8, 15, 22
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what is the recommended tx for unresectable stage IIIB cancer pts
- chemotherapy along with radiation:
- Cisplatin 50 mg/mg2 day 1, 8, 29, 36
- Etoposide 50 mg/mg2 day 1-5, 29-33
- followed by chemo alone:
- docetaxel 75 mg/m2 q 21 days x 3 doses
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after unresectable pts have been treated with chemotherapy and/or radiation, what is the next step ?
re-evaluate pts for surgical resection
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what is the second option treatment for unresectable cancer pts
- cisplatin 100 mg/m2 days 1, 29
- vinblastine 5 mg/m2 weekly x 5
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recommended platinum doublet tx for pts staged IV and IIIB (wet)
- cisplatin 100 mg/m2 day 1 and
- gemcitabine 1000mg/m2 day 1, 8, 15, q 4 wks
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which agent is used for cancer pts with mesothelioma
pemetrexed
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in which cancer pts does cisplatin/pemetrexed show superiority in NSCLC
- pts who do not have squamous:
- adenocarcinoma
- large cell
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where does bevacizumab target
VEGF - vascular endothelial growth factor
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what is bevacizumab
humanized monoclonal antibody (93 - 95% human)
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what is Erlotinib and when is it used
it is a small molecule inhibitor (works inside cell) and it is used in pts with EGFR mutation (k-ras)
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what is the second line option used in cancer pts for relapse/progressive disease
topotecan
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what is the median amt of treatment for unresectable cancer pts
4 cycles
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