Mesothelioma Diagnosis & Treatment Flashcards
7 cards from real Mesothelioma Navy practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Mesothelioma Diagnosis & Treatment flashcards as text
Which combination immunotherapy regimen showed improved overall survival versus chemotherapy in the CheckMate 743 trial for pleural mesothelioma?
Answer: Nivolumab + ipilimumab
CheckMate 743 demonstrated that nivolumab (PD-1 inhibitor) plus ipilimumab (CTLA-4 inhibitor) improved median overall survival to 18.1 months versus 14.1 months with chemotherapy.
What is the significance of 'PD-L1 expression' in mesothelioma treatment planning?
Answer: High PD-L1 expression may predict better response to immune checkpoint inhibitor therapy
PD-L1 expression on tumor cells may correlate with response to PD-1/PD-L1 inhibitors, helping guide immunotherapy decisions, though it is not an absolute predictor.
Which palliative intervention is most appropriate for a mesothelioma patient experiencing severe dyspnea due to massive pleural effusion, when long-term surgery is not planned?
Answer: Therapeutic thoracentesis or indwelling pleural catheter placement
Draining the fluid via thoracentesis or placing a permanent drainage catheter rapidly relieves dyspnea caused by large pleural effusions in non-surgical candidates.
A mesothelioma patient on cisplatin-based chemotherapy develops significant nephrotoxicity. Which modification is most appropriate?
Answer: Replace cisplatin with carboplatin, which has lower nephrotoxicity
Carboplatin is less nephrotoxic than cisplatin and is used as a substitution for patients who cannot tolerate cisplatin due to renal impairment.
What is the role of PET-CT in mesothelioma staging and management compared to CT alone?
Answer: PET-CT detects distant metastatic disease and involved lymph nodes not apparent on CT, improving staging accuracy
PET-CT identifies metabolically active metastases and nodal involvement beyond what anatomical CT can show, preventing futile surgery in patients with occult distant disease.
Which organization classifies mesothelioma as a 'presumptive' service-connected condition for veterans with documented asbestos exposure during military service?
Answer: The Department of Veterans Affairs (VA)
The VA recognizes mesothelioma as presumptively service-connected for veterans with in-service asbestos exposure, streamlining the disability claims process.
What does 'multimodality treatment' mean in the context of mesothelioma, and why is it recommended for eligible patients?
Answer: Combining surgery, chemotherapy, and radiation to maximize cytoreduction and local control
Multimodality treatment integrates surgery (EPP or P/D), systemic chemotherapy, and radiation to attack mesothelioma from multiple angles, offering the best chance of extended survival in appropriate candidates.