Continuing Medical Education Pre-Activity Questions

Continuing Medical Education Pre-Activity Questions Record your answers in the Pre-Activity Answers section of the evaluation form on page S20. 1. Which of the following is true about metastatic urothelial carcinoma? a. More than 60% of new cases of urothelial carcinoma are diagnosed at this stage b. The standard first-line treatment is cisplatin-based chemotherapy c. The 5-year survival rate is 62% to 95% d. The 15-year survival rate is about 20% 2. Immune checkpoint proteins: a. Stop urothelial carcinoma cells from evading the immune system b. Have antitumor activity in patients with urothelial carcinoma c. Promote the therapeutic activity of Bacillus CalmetteeGuérin d. Help the body modulate inflammation and autoimmunity 3. Compared with cytotoxic T-lymphocyteeassociated antigen 4 (CTLA-4), programmed cell death protein 1 (PD-1): a. Is expressed on fewer types of immune cells b. Is expressed on fewer types of solid tumors c. Operates at a later stage of immune response d. Is inhibited by ipilimumab whereas CTLA-4 is not 4. Monoclonal antibodies that block PD-L1 or its ligand PD-L1 do all of the following EXCEPT: a. Allow activation of T cells b. Allow T cells to remain activated c. Restore the activity of nonfunctional T cells d. Reduce immunosuppression produced by T-regulatory cells 5. Which of the following statements about response to immune checkpoint inhibitors is FALSE? a. Initial tumor enlargement does not necessarily represent disease progression b. Tumor shrinkage is sometimes delayed until after the appearance of new lesions c. Durable stable disease may represent antitumor activity d. Tumor shrinkage is generally faster than with cytotoxic chemotherapy 6. Immune-related adverse events of grade 2 or above: a. Can occur after immune checkpoint inhibitor therapy is stopped b. Are more likely with anti-PD-1 and anti-PD-L1 agents than with antieCTLA-4 agents c. Require permanent discontinuation of the immune checkpoint inhibitor d. Are more likely to affect the lungs and kidneys than other organ systems 7. Both atezolizumab and nivolumab are approved by the Food and Drug Administration as: a. First-line therapy for all patients with locally advanced or metastatic urothelial carcinoma b. First-line therapy for patients with locally advanced or metastatic urothelial carcinoma, as long as at least 5% of their tumorinfiltrating immune cells are PD-1 positive c. Second-line therapy, following platinum-containing chemotherapy, for all patients with locally advanced or metastatic urothelial carcinoma d. Second-line therapy, following platinum-containing chemotherapy, only for patients with locally advanced or metastatic urothelial carcinoma in whom at least 5% of tumor-infiltrating immune cells are PD-1 positive 8. A key advantage of therapeutic cancer vaccines, compared with monoclonal antibodies, is that they: a. Can prevent tumor growth b. Are more specific to tumor cells c. Have more potent tumor cellekilling activity d. Provide more rapid immune response

9. A key advantage of adoptive T-cell therapies, compared with other types of immunotherapy, is that they: a. Can prevent tumor growth b. Are more specific to tumor cells c. Have more potent tumor cellekilling activity d. Provide more rapid immune response 10. Urothelial carcinoma carries a high mutation rate, which is a strong rationale for treating it with: a. Antibody-drug conjugates b. Immune checkpoint inhibitors c. Recombinant Bacillus CalmetteeGuérin d. Vaccines