Chapter 99. Supportive Care in Oncology
A patient has been prescribed crizotinib 250 mg twice daily for anaplastic lymphoma kinase (ALK)-positive NSCLC. This oral anticancer agent has a moderate/high risk for causing emesis. This patient does not have any additional risk factors for CINV. Which of the following is the best approach to manage CINV for this patient?
A. NK1 antagonist, 5HT3 antagonist, and dexamethasone on the first 3 days of each cycle
B. Prochlorperazine every 4 to 6 hours as needed
C. Ondansetron daily before each dose of crizotinib
D. Olanzapine and dexamethasone for the first 5 days of each cycle
Which of the following ingredients should be part of a mouth rinse recommended for any patient who is at risk for developing mucositis to lessen its severity if it occurs?
Which of the following patients is at low risk for developing febrile neutropenia?
A. A 45-year-old woman with depression, anxiety, and stage 2 breast cancer receiving adjuvant therapy with doxorubicin and cyclophosphamide who has temperature of 99.3°F (37.4 °C)
B. A 75-year-old man with COPD and stage 4 esophageal cancer treated with cisplatin and fluorouracil who develops oral candidiasis from concurrent radiation and has temperature of 100.6°F (38.1 °C)
C. A 65-year-old man with diabetes and blast phase CML treated with nilotinib for the past 4 months who has temperature 99°F (37.2 °C)
D. A 73-year-old man with CHF and stage 4 prostate cancer treated with docetaxel who required pegfilgrastim 24 hours after each dose for the last three cycles 99.9°F (37.7 °C).
How should a chemotherapy patient with ANC 1250/mm3 (1.25 × 109/L) and temperature 100°F (37.8°C) with adequate renal and hepatic function who is determined to be at low risk for infection according to the MAASC assessment tool be treated?
A. Hospitalized for immediate parenteral administration of broad-spectrum antibacterials before culture results are obtained
B. Treated as an outpatient with fluoroquinolones and granulocyte colony-stimulating factors
C. Hospitalized and treated with granulocyte colony-stimulating factors while culture results are pending
D. Treated as an outpatient with ...