Mesothelioma Therapy Chemotherapy for Mesothelioma 2 — Questions and Answers
Question 1: What is the most common dose-limiting toxicity of pemetrexed in mesothelioma treatment?
- Alopecia
- Myelosuppression (neutropenia) (Correct answer)
- Peripheral neuropathy
- Hepatotoxicity
Correct answer: Myelosuppression (neutropenia)
Myelosuppression, particularly neutropenia, is the most common dose-limiting toxicity of pemetrexed, requiring careful monitoring of blood counts.
Question 2: Cisplatin-based chemotherapy requires adequate pretreatment hydration primarily to prevent which toxicity?
- Hepatotoxicity
- Nephrotoxicity (kidney damage) (Correct answer)
- Cardiotoxicity
- Neurotoxicity
Correct answer: Nephrotoxicity (kidney damage)
Cisplatin is highly nephrotoxic, and aggressive IV hydration before and after administration is required to protect kidney function.
Question 3: Which chemotherapy drug combination was approved for second-line mesothelioma in the US after initial chemotherapy failure?
- Nivolumab + ipilimumab (Correct answer)
- Pemetrexed monotherapy
- Ramucirumab + gemcitabine
- Vinorelbine monotherapy
Correct answer: Nivolumab + ipilimumab
Nivolumab combined with ipilimumab gained FDA approval for first-line mesothelioma treatment and is also used in subsequent lines after chemotherapy failure.
Question 4: What is the purpose of corticosteroid premedication before pemetrexed infusion?
- To enhance anticancer activity
- To prevent skin rash (Correct answer)
- To reduce nausea
- To improve renal clearance
Correct answer: To prevent skin rash
Dexamethasone premedication is given before pemetrexed to prevent the skin rash that commonly occurs without prophylaxis.
Question 5: In neoadjuvant chemotherapy for mesothelioma, when is chemotherapy administered relative to surgery?
- After surgery
- During surgery
- Before surgery (Correct answer)
- Only if surgery is refused
Correct answer: Before surgery
Neoadjuvant chemotherapy is administered before surgery to shrink the tumor and assess chemosensitivity before planned surgical resection.
Question 6: Which organ function must be closely monitored during cisplatin-based chemotherapy for mesothelioma?
- Liver
- Kidneys (Correct answer)
- Spleen
- Pancreas
Correct answer: Kidneys
Kidney function must be closely monitored during cisplatin therapy because cisplatin causes significant nephrotoxicity and requires dose adjustment for renal impairment.
Mesothelioma Therapy Chemotherapy for Mesothelioma 2
What is the most common dose-limiting toxicity of pemetrexed in mesothelioma treatment?