| Question 1: True or False: Genomic studies have shown that biological heterogeneity is a hallmark of cancer. |
| Reference: | Lawrence MS, Stojanov P, Polak P, Kryukov GV, Cibulskis K, Sivachenko A, Carter SL, Stewart C, Mermel CH, Roberts SA, Kiezun A, Hammerman PS, McKenna A, Drier Y, Zou L, Ramos AH, Pugh TJ, Stransky N, Helman E, Kim J, Sougnez C, Ambrogio L, Nickerson E, Shefler E, Cortés ML, Auclair D, Saksena G, Voet D, Noble M, DiCara D, Lin P, Lichtenstein L, Heiman DI, Fennell T, Imielinski M, Hernandez B, Hodis E, Baca S, Dulak AM, Lohr J, Landau DA, Wu CJ, Melendez-Zajgla J, Hidalgo-Miranda A, Koren A, McCarroll SA, Mora J, Crompton B, Onofrio R, Parkin M, Winckler W, Ardlie K, Gabriel SB, Roberts CWM, Biegel JA, Stegmaier K, Bass AJ, Garraway LA, Meyerson M, Golub TR, Gordenin DA, Sunyaev S, Lander ES, Getz G. Mutational heterogeneity in cancer and the search for new cancer-associated genes. Nature. 2013 Jul 11;499(7457):214-218. doi: 10.1038/nature12213. Epub 2013 Jun 16. PMID: 23770567; PMCID: PMC3919509. |
| Choice A: | True |
| Choice B: | False |
| Question 2: Studies of the genomic-adjusted radiation dose (GARD), which itself is based on the radiation sensitivity index (RSI), have shown what? |
| Reference: | Scott JG, Berglund A, Schell MJ, Mihaylov I, Fulp WJ, Yue B, Welsh E, Caudell JJ, Ahmed K, Strom TS, Mellon E, Venkat P, Johnstone P, Foekens J, Lee J, Moros E, Dalton WS, Eschrich SA, McLeod H, Harrison LB, Torres-Roca JF. A genome-based model for adjusting radiotherapy dose (GARD): a retrospective, cohort-based study. Lancet Oncol. 2017 Feb;18(2):202-211. doi: 10.1016/S1470-2045(16)30648-9. Epub 2016 Dec 18. Erratum in: Lancet Oncol. 2017 Feb;18(2):e65. PMID: 27993569; PMCID: PMC7771305. |
| Choice A: | Gene expression data is not at all related to radiation sensitivity and is not predictive of clinical outcomes. |
| Choice B: | There is rarely a significant change from the prescription dose to the adjusted dose based on a given patient’s genomic data. |
| Choice C: | Stratifying patients in dose-escalation trials by their genomic predicted adjusted radiation dose reveals a correlation between GARD and outcomes. |
| Question 3: A significant difference between molecularly targeted agents compared to traditional chemotherapy when considering modeling based on clinical data is: |
| Reference: | Zhao, Boyang, Michael T. Hemann, and Douglas A. Lauffenburger. "Modeling tumor clonal evolution for drug combinations design." Trends in cancer 2.3 (2016): 144-158. |
| Choice A: | systemic delivery to the entire body. |
| Choice B: | the timescale of delivery is on the order of days to weeks. |
| Choice C: | pharmacokinetics (ie uptake) need to be considered. |
| Choice D: | genetically distinct subpopulations exist with a great differential in terms of sensitivity (sensitive – resistant). |
| Question 4: 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 the release of additional antigens or similar terms. |
| Choice C: | the killing of lymphocytes and other immune cell populations. |
| Choice D: | none of the above |
| Choice E: | all of the above |
| Question 5: What is the abscopal effect? |
| Reference: | W Ngwa, C Omoruyi, J Schoenfeld, J Hesser, S Demaria, S Formenti, Using immunotherapy to boost the abscopal effect, Nature Review Cancer, 2018 May 18(5) 313-322 PMCID: PMC5912991 |
| Choice A: | The death of cells which occurs as a normal and controlled part of an organism's growth or development. |
| Choice B: | An effect whereby radiotherapy at one site can cause regression of distant untreated tumors or metastasis. |
| Choice C: | The death of most or all tumor cells due to radiation. |
| Question 6: True or False: Nanoparticle drones are designed to provide image-guidance while also sustainably delivering immunotherapy to the tumor sub-volume. |
| Reference: | W Ngwa, C Omoruyi, J Schoenfeld, J Hesser, S Demaria, S Formenti, Using immunotherapy to boost the abscopal effect, Nature Review Cancer, 2018 May 18(5) 313-322 PMCID: PMC5912991 |
| Choice A: | True |
| Choice B: | False |
