1. Which of the following best describes the pharmacodynamics of sacituzumab govitecan?
A. Binds to extracellular Trop-2 and then is internalized, releasing the SN-38 topoisomerase inhibitor intracellularly
B. Direct inhibition of ERBB-2, ERBB-3, and ERBB4 extracellular binding domains
C. Binds to the CD20 antigen on myeloid on mature B-cells
D. Inhibition of the c-KIT tyrosine kinase
E. Unsure
2. Which of the following agents is expected to have activity that would inhibit cancer cells with an ERBB3 mutation?
A. Erlotinib
B. Gefitinib
C. Cetuximab
D. Afatinib
E. Unsure
3. Which of the following does the investigational agent U3-1402 target?
A. BCR-ABL
B. ERBB3
C. SRC
D. Trop-2
E. Unsure
4. Which of the following is a potential toxicity that requires close monitoring for patients receiving sacituzumab govitecan?
A. Cardiomyopathy
B. Pneumonitis
C. Neutropenia
D. Pancreatitis
E. Unsure
5. Which of the following technologies is most often used by commercial laboratories for genomic sequencing in patients with cancer?
A. Whole exome sequencing
B. Sanger method
C. Germline testing
D. Immunohistochemistry
E. Unsure
6. Which of the following represents a common grouping of medical professionals on a molecular tumor board?
A. Medical oncologist, genetic scientist, pharmacist, pathologist
B. Pulmonologist, thoracic surgeon, pharmacist, research nurse
C. General surgeon, gastroenterologist, interventional radiologist, research nurse
D. Urologist, radiologist, biostatistician, pathologist
E. Unsure
7. Which of the following represents the most appropriate value-added role can a pharmacist play on a molecular tumor board?
A. Distinguish between discrepancies in pathologic and genomic findings to clarify a cancer diagnosis
B. Solicit a consultation by the molecular tumor board for a patient who has a cancer diagnosis in question
C. Assist in recommendations for treatment selection based on the presence of genomic aberrations and patient-specific factors such as end-organ function
D. Coordination of follow-up clinic visits to discuss results of the tumor board discussions
E. Unsure
8. Which of the following is the best role for a pharmacist in a precision genomics program with regard to drug procurement?
A. Fill out an application for the patient to obtain manufacturer assistance drug
B. Manage the prior authorization process for all oral oncolytic agents recommended by the molecular tumor board
C. Oversee the dispensing procedures for oral oncolytic agents recommended by the molecular tumor board
D. Write a letter of medical necessity for patients whose molecular tumor board–recommended therapy was denied
E. Unsure
9. Which of the following best describes how a pharmacist working with a precision medicine program can liaison with the pharmacy department to promote rational drug prescribing decision making?
A. Based on genomic findings, assess eligibility of patients for open clinical trials at an institution
B. Managing contracting issues with wholesalers for all of oral oncolytic agents
C. Work collaboratively with a hospital medication prescribing oversight committee to establish standards of practice for prescribing drug therapy for commonly encountered somatic mutations in patients with cancer
D. Ensuring that prescribing of any medications be directed to pharmacies that are 340B eligible
E. Unsure
10. Which of the following best describes how a precision genomics pharmacist can add the most value with regard to obtaining cancer tissue for genomic sequencing?
A. Working with the pathology department to ascertain which tissue sample to send for sequencing
B. Reconcile out-of-pocket expenses for genomic testing at an outside commercial laboratory
C. Craft a bridge for anticoagulant therapy for a patient who needs a liver biopsy for tissue to be sent for sequencing
D. Deciding when the patient needs a consult with a genetic counselor
E. Unsure