Mesothelioma Navy Mesothelioma Diagnosis & Treatment 3

Question 1

Which chemotherapy doublet is FDA-approved as first-line treatment for unresectable pleural mesothelioma?

Accepted Answer

Cisplatin + pemetrexed

Answer

The combination of cisplatin and pemetrexed (an antifolate) is the standard first-line regimen for pleural mesothelioma approved by the FDA.

Question 2

Before receiving pemetrexed, mesothelioma patients are given folic acid and vitamin B12. What is the primary reason for this supplementation?

Accepted Answer

To reduce hematologic and gastrointestinal toxicity

Answer

Folic acid and B12 supplementation significantly reduces the risk of severe neutropenia and mucositis associated with pemetrexed treatment.

Question 3

Which surgical procedure removes the entire lung, pleura, pericardium, and diaphragm in selected mesothelioma patients?

Accepted Answer

Extrapleural pneumonectomy (EPP)

Answer

Extrapleural pneumonectomy (EPP) is the most radical surgery for mesothelioma, removing the lung and all surrounding involved structures.

Question 4

What is the key advantage of pleurectomy/decortication (P/D) over extrapleural pneumonectomy (EPP) for mesothelioma?

Accepted Answer

Preservation of the underlying lung with potentially lower perioperative mortality

Answer

P/D preserves the lung, which is associated with lower operative mortality compared to EPP, while still achieving significant cytoreduction.

Question 5

Immunotherapy with nivolumab plus ipilimumab was approved for which mesothelioma patient population?

Accepted Answer

Previously untreated unresectable pleural mesothelioma (first-line)

Answer

The FDA approved nivolumab plus ipilimumab (CheckMate 743 trial) as first-line treatment for unresectable pleural mesothelioma in 2020.

Mesothelioma Navy Practice Test