2022 AAPM 64th Annual Meeting
Back to session list

Session Title: Radiotherapy and the Immune System
Question 1: Targeting the tumor with local radiotherapy during immunotherapy can:
Reference:Formenti SC, Demaria S. Combining radiotherapy and cancer immunotherapy: a paradigm shift. J Natl Cancer Inst. 2013;105(4):256-265.
Choice A:Enhance in field responses
Choice B:Enhance out of the field responses
Choice C:Enhance both in field and out of field responses
Choice D:Reduce toxicity of immune checkpoint blockade strategies
Choice E:None of the above
Question 2: CD8 + T cells are important for:
Reference:Irradiation and Immunotherapy: From Concept to the Clinic, April K. S. Salama, MD; Michael A. Postow, MD; and Joseph K. Salama, MD Cancer, Vol 122, Issue 11, pp 1659-1671, 2016
Choice A:Direct killing of tumor cells
Choice B:Helping B cells produce antibody
Choice C:Are part of the innate immune system
Choice D:Making antibodies
Question 3: Localized Ionizing Radiation has:
Reference:Demaria S, Golden EB, Formenti SC. Role of Local Radiation Therapy in Cancer Immunotherapy. JAMA Oncol. 2015 Aug 13.
Choice A:Pro-immunogenic effects
Choice B:Immunosuppressive effects
Choice C:All of the above
Question 4: Which of the following statements regarding toxicities associated with PD-1 inhibitors is correct?
Reference:Johnson DB, Balko JM, Compton ML, et al. Fulminant myocarditis with combination immune checkpoint blockade. N Engl J Med 2016;375:1749-55. 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:The spectrum and frequency of immune related toxicities observed are very similar among patients treated with CTLA-4 inhibitors and patients treated with PD-1 inhibitors.
Choice B:Rare immune related events, such as myocarditis, have been observed following treatment with immune checkpoint blockade and can be life threatening.
Choice C:Delayed treatment of immune mediated toxicities have been associated with superior outcomes because the use of glucocorticoids is minimized.
Choice D:Pneumonitis is the most common serious immune related toxicity observed following treatment with ipilimumab in melanoma patients.
Question 5: Which of the following results was reported by the pooled analysis of two randomized trials of Pembrolizumab with or without radiotherapy for metastatic non-small-cell lung cancer (Theelen W et al., Lancet Respir Med 2021):
Reference:[1] Theelen W. et al., JAMA Oncol. 2019 Sep 1;5(9):1276-1282. doi: 10.1001/jamaoncol.2019.1478. [2] Theelen W. et al., Lancet Respir Med. 2021 May;9(5):467-475. doi: 10.1016/S2213-2600(20)30391-X.
Choice A:No difference in Overall Survival between the randomized cohorts
Choice B:Worse progression free survival in the patients that received pembrolizumab combined with radiation
Choice C:A statistically significant improvement in median overall survival in the patients that received pembrolizumab plus radiotherapy
Choice D:A non-significant trend towards improved overall survival in the patients that received pembrolizumab plus radiotherapy
Question 6: 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.
Back to session list