AOCNP Immunotherapy and Targeted Therapy 4

Question 1

A patient on pembrolizumab develops grade 3 immune-mediated hepatitis (AST 8x ULN). What is the most appropriate management?

Accepted Answer

Hold pembrolizumab and start high-dose corticosteroids (1–2 mg/kg prednisone)

Answer

Grade 3 immune-mediated hepatitis requires holding the checkpoint inhibitor and starting systemic corticosteroids at 1–2 mg/kg/day prednisone equivalent.

Question 2

Which biomarker is most predictive of response to olaparib in ovarian cancer?

Accepted Answer

BRCA1/2 mutation

Answer

Olaparib is a PARP inhibitor with the strongest efficacy evidence in BRCA1/2-mutated ovarian cancer due to synthetic lethality.

Question 3

A patient receiving nivolumab reports new-onset shortness of breath and ground-glass opacities on CT. Which immune-related adverse event is most likely?

Accepted Answer

Immune-mediated pneumonitis

Answer

New respiratory symptoms with ground-glass opacities on CT in a patient on a checkpoint inhibitor are classic for immune-mediated pneumonitis.

Question 4

Venetoclax targets which anti-apoptotic protein overexpressed in CLL?

Accepted Answer

BCL-2

Answer

Venetoclax is a selective BCL-2 inhibitor that restores apoptosis in CLL cells that overexpress this anti-apoptotic protein.

Question 5

A nurse practitioner is counseling a patient starting erlotinib for EGFR-mutant NSCLC about the most common side effect. Which should be emphasized?

Accepted Answer

Acneiform rash and diarrhea

Answer

Acneiform rash and diarrhea are the most common side effects of EGFR tyrosine kinase inhibitors such as erlotinib.

AOCNP - Advanced Oncology Certified Nurse Practitioner Practice Test

AOCNP - Advanced Oncology Certified Nurse Practitioner Practice Test

AOCNP Immunotherapy and Targeted Therapy 4