| Question 1: In models describing the combination of RT and immunotherapy discussed today, RT acts on the immune response through: |
| Reference: | Serre, R., Benzekry, S., Padovani, L., Meille, C., André, N., Ciccolini, J., Barlesi, F., Muracciole, X. and Barbolosi, D., 2016. Mathematical modeling of cancer immunotherapy and its synergy with radiotherapy. Cancer research, pp.canres-3567. |
| Choice A: | Decreasing the number of tumor cells, therefore reinforcing terms inversely proportional to tumor load. |
| Choice B: | Reinforcing the immune response directly through release of additional antigens or similar terms. |
| Choice C: | Killing of lymphocytes and other immune cell populations. |
| Choice D: | None of the above. |
| Choice E: | All of the above. |
| Question 2: Lymphocyte counts measured in the blood during/after RT can give: |
| Reference: | Grossman, S.A., Ellsworth, S., Campian, J., Wild, A.T., Herman, J.M., Laheru, D., Brock, M., Balmanoukian, A. and Ye, X., 2015. Survival in patients with severe lymphopenia following treatment with radiation and chemotherapy for newly diagnosed solid tumors. Journal of the National Comprehensive Cancer Network, 13(10), pp.1225-1231. |
| Choice A: | Information about the immune infiltration within the tumor |
| Choice B: | A measure of global immune response in the patient, and correlate with overall survival in a range of indications. |
| Choice C: | Are routinely used as input for immune-RT modeling. |
| Choice D: | None of the above. |
| Choice E: | All of the above. |
| Question 3: According to the hypothesis of immunoediting the immune surveillance of transformed cancer cells can lead to which outcomes as cancer cells evolve under selective pressure from the immune system : |
| Reference: | Dunn et al. Immunity 2004; (21) 137-148 |
| Choice A: | Escape and Equality. |
| Choice B: | Peace, love, and understanding. |
| Choice C: | Elimination, Equilibrium, and Escape. |
| Choice D: | None of the above. |
| Question 4: What are the signals required for proper activation of a naïve T cell (in correct order)? |
| Reference: | Sckisel GD et al. Immunity 2015; 43(2) 240-50 |
| Choice A: | TCR engagement, B7/CD28 co-stimulation, inflammatory cytokines. |
| Choice B: | TCR engagement, PD-1. |
| Choice C: | PD-1, IFN. |
| Choice D: | PD-1, TCR engagement. |
| Choice E: | None of the above. |
| Question 5: Stereotactic ablative radiotherapy can have systemic immune modulatory effects resulting in changes in the profile of circulating immune cells: |
| Reference: | McGee H et al. Int J Radiat Oncol Biol Phys. 2018;101(5):1259-1270 |
| Choice A: | True. |
| Choice B: | False. |
| Choice C: | . |
| Choice D: | . |
| Choice E: | . |
| Question 6: Which of the following are mechanisms whereby radiation can alter the tumor microenvironment? |
| Reference: | Daly ME et al. J Thorac Oncol. 2015;10(12):1685-93 |
| Choice A: | Upregulating immunogenic cell surface markers. |
| Choice B: | Lowering PD-L1. |
| Choice C: | Inducing TILs. |
| Choice D: | All of the above. |
| Choice E: | A and C. |
| Question 7: B7 on APCs can bind CD28 on T cells to provide a positive costimulatory signal or bind _______ on T cells to provide a negative co-stimulatory signal. |
| Reference: | Pardoll D et al. Nature Reviews, 2012 |
| Choice A: | PD-1 |
| Choice B: | PD-L1 |
| Choice C: | CD40 |
| Choice D: | CTLA-4 |
| Question 8: Activation of the immune system by localized radiation of orthotopic pancreatic tumors may be achieved by which of the following methods: |
| Reference: | Cancer Cell. 2013 Nov 11;24(5):589-602. doi: 10.1016/j.ccr.2013.09.014. Epub 2013 Oct 24 |
| Choice A: | Stereotactic radiation therapy that normalizes aberrant vasculature to aid efficient recruitment of tumor-specific T cells. |
| Choice B: | Low dose irradiation that normalizes aberrant vasculature to aid efficient recruitment of tumor- specific T cells. |
| Choice C: | Stereotactic radiation therapy that programs tumor-associated macrophages to recruit Tregs into the tumor. |
| Choice D: | Low dose irradiation that programs tumor-associated macrophages to recruit Tregs into the tumor. |
| Choice E: | Localized radiation that induces iNOS in tumor-associated macrophages which suppresses TH1 chemokine. |
| Question 9: Which of the following targeted agents is an immune checkpoint inhibitor? |
| Reference: | Pardoll D et al. Nature Reviews, 2012 |
| Choice A: | Bevacizumab |
| Choice B: | Imatinib |
| Choice C: | Crizotinib |
| Choice D: | Ipilimumab |
| Choice E: | Cetuximab |
| Question 10: Immunosuppression observed within 24 hours following exposure to a whole body dose of 5 Gy X-rays would be due primarily to: |
| Reference: | McFarland HI et al. PLoS One. 2012;7(6):e39092 |
| Choice A: | Death of hematopoietic progenitor cells. |
| Choice B: | Apoptosis of peripheral blood lymphocytes. |
| Choice C: | A loss of circulating granulocytes. |
| Choice D: | Decreased activity of NK cells. |
| Choice E: | Inactivation of circulating antibodies. |
