1. Which of the following is true about immuno-oncology (IO) agents?
A. IO agents are associated with high response rates
B. Some patients experience durable responses to IO agents
C. Side effects seen with IO agents are similar to those seen with cytotoxic agents
D. Timing of side effects onset with IO agents is similar to that seen with cytotoxic agents
2. The role of checkpoint inhibitory pathways in the T-cell activation pathway is to:
A. Help maintain immunologic homeostasis and limit autoimmune disease
B. Promote T-cell proliferation and differentiation
C. Improve antigen-specific targeting seen with the major histocompatibility complex
D. Exhaust T-cells to ensure optimal coverage
3. Which of the following describes why combination regimens that include an immuno-oncology (IO) agent can improve responses and the durations of response?
A. They combine a precision targeted medicine with a high response and an IO therapy with a long-lasting response
B. They combine 2 IO therapies that work on different pathways
C. They use 1 agent to kill tumor cells to produce tumor antigens and neoantigens and a checkpoint inhibitor to promote long-term responses with T-cells
D. All of the above
4. In patients with metastatic urothelial cancer, the rate of response for the 5 checkpoint immune inhibitors as a second-line treatment is:
A. 5% to 12%
B. 15% to 23%
C. 25% to 31%
D. 33% to 41%
5. RF is a 75-year-old man diagnosed with non-small cell lung cancer. He has a tumor proportion score of 50% or greater and no epidermal growth factor (EGFR)-anaplastic lymphoma kinase (ALK) genomic tumor aberrations. Which of the following treatments would be appropriate as first-line therapy according to its indications?
A. Nivolumab
B. Crizotinib
C. Pembrolizumab
D. Bevacizumab
6. A 16-year-old girl with acute lymphoblastic leukemia is treated with the chimeric antigen receptor (CAR)-T-cell therapy tisagenlecleucel. She has been shown to have a high tumor burden before beginning the treatment. What supportive measures should be considered?
A. No supportive care is generally needed for a patient with these characteristics
B. Only standard supportive care measures will be needed
C. Corticosteroids should be given prophylactically
D. Standard supportive care and the anti-interleukin-6 monoclonal antibody tocilizumab should be used, if needed, for cytokine release syndrome
7. JP is a 62-year-old woman with metastatic melanoma. She is being treated with the combination of nivolumab and ipilimumab as first-line therapy. A few weeks after starting treatment, a scan shows that her disease has progressed. She asks what this means about her treatment. What response would you consider?
A. Her treatment may be failing and she should consider a clinical trial
B. This may be a pseudoprogression and she should expect to wait longer for a response
C. It is too early to determine what is going on with her treatment
D. None of these responses is appropriate
8. Which of the following is true about the mutational burden found in human cancers?
A. Mutational burden can be affected by genetic factors, as well as environmental ones
B. In some studies, mutational burden can be correlated with clinical response
C. Human cancers are known to have high rates of mutation
D. All of the above
9. What percentage of patients treated with immune checkpoint inhibitors are likely to experience grade 3 or 4 side effects?
A. 5%
B. 10%
C. 20%
D. 30%
10. What are the general American Society of Clinical Oncology recommendations for treating grade 2 toxicities associated with immune checkpoint inhibitors?
A. Suspend immune checkpoint inhibitors and use corticosteroids if needed
B. Continue treatment and use corticosteroids if needed
C. Monitor for continued symptoms and consider treatment suspension if toxicities continue
D. Discontinue therapy until toxicity subsides to grade 1
Evaluation Questions
11. In your practice, how often do you currently consider a combination of immuno-oncology (IO) therapies that work on different pathways working through immune checkpoint inhibition to increase response rates?
A. Always
B. Most of the time
C. Sometimes
D. Never
12. In your practice, how often do you currently review organ-specific recommendations before developing treatment plans?
A. Always
B. Most of the time
C. Sometimes
D. Never
13. In you practice, how often do you educate patients receiving IO therapies about pseudoprogression and that time is needed to generate an effective immune response?
A. Always
B. Most of the time
C. Sometimes
D. Never