1What are hyperplastic polyps?
Polyps with a low chance of progressing to cancer
2What are adenomatous polyps?
Polyps with a high chance of progressing to cancer
3What is the most common type of colon cancer?
Adenocarcinoma (>90%)
4When is surgery used in colon cancer patients?
Curative for stages I-III
Palliative for stages III-IV
5When is radiation used in colon cancer patients?
Rarely as adjuvant (after surgery) therapy for stages I-III
Palliative for all stages
6When is chemotherapy used in colon cancer patients?
Adjuvant therapy in stages III and II (too many side effects for stage I)
Treatment in stage IV
7When is targeted therapy used in colon cancer?
Stage IV
8When is surgery used in rectal cancer
Only stage I primarily. Rectum is small and later stages remove too much of it, can be done in stage II and III after neoajuvant therapy if needed.
Stage IV treated with systemic therapy.
9What is the primary treatment for stage I colon cancer?FOL
Surgery and survalence, no adjuvant therapy
10What is the primary treatment for stage II colon cancer?
Surgery and survalence, possibly adjuvant therapy for high risk patients.
11What is the primary treatment for stage III colon cancer?
Surgery, and then 6 months of one of the following regimens
mFOLFOX6
CAPEOX (may consider just 3 months)
12What drugs are used in mFOLFOX6?
Oxaliplatin
Leucovorin
5Fu
13What drugs are used in CAPEOX
Oxaliplatin
Capecitabine
14What is the primary treatment for stage IV colon cancer?
No surgery, FOLFOX or CAPEOX
Can also use FOLFIRI, or FOLFIRINOX
Can add bevacizumab
15What is FOLFIRI?
Irinotecan instead of oxaliplatin
16What is FOLFIRINOX
FOLFOX + Irinotecan
17What genotypes are tested for in colon cancer?
RAS testing
BRAF testing
MSI/MMR
18If a patient has a KRAS wildtype, what is indicated
May respond well to EGFR inhibitors, don't use EGFR inhibitors in patients with a KRAS mutation
19What does a BRAF V600E indicate?
Don't use EGFR inhibitors
20If a patient has MSI/MMR, what should they be given?
Pembrolizumab
21How is LEVOleucovorin dosed?
50% dose