Targeted Cancer Therapy

A 52-year-old man with newly diagnosed chronic myeloid leukemia (CML) in chronic phase presents to the oncology clinic. BCR-ABL mutation analysis is negative. He has no contraindications to tyrosine kinase inhibitor (TKI) therapy. What is the most appropriate next step in management?

Which feature best distinguishes tyrosine kinase inhibitors (TKIs) from monoclonal antibodies in targeted cancer therapy?

A 52-year-old Indian woman with newly diagnosed HER2-positive metastatic breast cancer presents to the oncology clinic. She has bony metastases and hepatic involvement. Her baseline LVEF is 55% (normal). She is started on trastuzumab (Herceptin) as part of her chemotherapy regimen. After 3 months of therapy, she develops progressive dyspnea and orthopnea. Echocardiography reveals LVEF of 42% with global hypokinesis. Which of the following best explains the mechanism of this adverse effect?

A 58-year-old Indian man with metastatic renal cell carcinoma (clear-cell type) is initiated on sunitinib, a multi-targeted tyrosine kinase inhibitor. After 2 weeks of therapy, he develops severe hypertension (BP 165/105 mmHg), and after 6 weeks, he complains of hand-foot skin reaction with painful erythema and blistering on his palms and soles. Which of the following best explains the mechanism underlying the hand-foot skin reaction?

A 58-year-old man with metastatic non-small-cell lung cancer (NSCLC) harboring an EGFR exon 19 deletion mutation is referred for targeted therapy. Which is the preferred first-line treatment?