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metastatic colorectal cancer

Total questions: 5

Worksheet time: 3mins

Name
Class
Date
1.

Which statement best distinguishes  the predictive value of RAS mutation from its prognostic role in metastatic colorectal cancer

a)

 RAS mutation predicts poor survival regardless of therapy.

b)

 RAS mutation predicts benefits from bevacizumab.

c)

 RAS mutation is prognostic but not predictive.

d)

 RAS mutation predicts lack of response to anti-EGFR

2.

 A patient has left sided metastatic CRC, RAS wild type but also harbors a BRAF V600E mutation. The most appropriate first line systemic therapy is?

a)

 FOLFIR + cetuximab.

b)

 FOLFOX + panitumumab.

c)

 Encorafenib + cetuximab.

d)

 Chemotherapy doublet or triple + bevacizumab

3.

 Which statement best reflects the clinical implication of FIRE-3 trial rather than its raw results?

a)

 cetuximab is superior to bevacizumab in all RAS wild type.

b)

 Bevacizumab should never be used in left sided tumor.

c)

 tumor sidedness modifies the survival benefits of biologic agents more than response rate

d)

 Anti-EGFR therapy improves progression free survival more than overall survival.

4.

 A patient with MSS/pMMR metastatic colorectal cancer received FOLFOX +bevacizumab as first line therapy and now has disease progression. The most evidence based next step is:

a)

 Continue with FOLFOX and stop bevacizumab.

b)

 Switch to pembrolizumab.

c)

 Switch to FOLFIRI and continue or re-introduce bevacizumab

d)

 Add cetuximab regardless of RAS mutation.

5.

 Which mechanism best describe why MSI-H/dMMR tumor respond poorly to chemotherapy but exceptionally well to immune check point inhibitors?

a)

 Reduced angiogenesis within the tumor.

b)

 Increased EGFR expression.

c)

 High neoantigen load leading to immune recognition once PD-1 inhibition is applied

d)

 Increased tumor hypoxia.