| Question 1: Which of the following are true in regards to the results of the PACIFIC trial for patients with stage 3 non small cell lung cancer (NSCLC) (Antonia et al. NEJM 2018)? |
| Reference: | Antonia SJ, Villegas A, Danie D, et al. N Engl J Med. 2018 Dec 13;379(24):2342-2350. doi: 10.1056/NEJMoa1809697. Epub 2018 Sep 25. PMID: 30280658 |
| Choice A: | The study was stopped early because of enhanced toxicity with durvalumab following chemoradiation. |
| Choice B: | There were significant benefits to disease free and overall survival with the use of durvalumab as compared to placebo therapy. |
| Choice C: | There were significant benefits to disease free survival but not overall survival with the use of durvalumab as compared to placebo therapy. |
| Choice D: | Increased treatment related deaths in the durvalumab arm negated the clinical benefit provided. |
| Question 2: Which of the following are true in regards to toxicities that occur as a result of immune therapy and radiation therapy? |
| Reference: | Schoenfeld JD, Nishino M, Severgnini M, et al. J Immunother Cancer. 2019 Apr 24;7(1):112. doi: 10.1186/s40425-019-0583-3. PMID: 31014385
Postow MA, Sidlow R, Hellmann MD. Immune-related adverse events associated with immune checkpoint blockade. N. Engl. J. Med. 2018;378:158–168. doi: 10.1056/NEJMra1703481. |
| Choice A: | Immunotherapy toxicity can impact virtually every organ of the body as a result of enhanced auto-immunity |
| Choice B: | It can be difficult to correctly attribute toxicities who receive both immunotherapy and radiation because of overlapping toxicities, i.e. pneumonitis |
| Choice C: | Current clinical data suggest that the combination of radiation and immune checkpoint therapy are generally well tolerated when administered concurrently |
| Choice D: | All of the above |
| Choice E: | None of the above |
| Question 3: Which endpoint correlates with overall survival in patients receiving chemoradiation for glioblastoma multiforma? |
| Reference: | Rudra et al. Int J Radiat Oncol Biol Phys, 101(1):217-225 (2018) |
| Choice A: | Dose to hippocampus |
| Choice B: | Dose to bone marrow |
| Choice C: | Acute severe lymphopenia |
| Choice D: | Older age |
| Question 4: What is the D_50 for T cell lymphocytes (dose at which 50% of cells survive)? |
| Reference: | Nakamura et al. Rad Res, 123:224-227 (1990) |
| Choice A: | 0.2 Gy |
| Choice B: | 2 Gy |
| Choice C: | 20 Gy |
| Choice D: | 2 Gy x 30 |
| Question 5: Lymphocytes circulate from blood into other major immune compartments and back to blood. Which of the following circulation loop has the shortest circulation time? |
| Reference: | Jin, J. et al. A framework for modeling radiation induced lymphopenia in
radiotherapy, Radiother Oncol, 144, 105-113 (2020) |
| Choice A: | Blood to spleen to blood |
| Choice B: | Blood to bone marrow to blood |
| Choice C: | Blood to lymph nodes to blood |
| Choice D: | Blood to lymphatic tissues in other organs to blood |
| Question 6: Which of the following immune system compartment has the largest number of lymphocytes? |
| Reference: | Jin, J. et al. A framework for modeling radiation induced lymphopenia in radiotherapy, Radiother Oncol, 144, 105-113 (2020) |
| Choice A: | Circulating blood |
| Choice B: | Spleen |
| Choice C: | Bone marrow |
| Choice D: | Lymph nodes and ducts, and non-lymphoid tissues in other organs |
