Mar 07, 2021
The most common feedback ASCO eLearning receives is a plea for more questions, more questions, more questions—and the platform is delivering on that request this year with a new customizable quiz builder.
The ASCO Quiz Builder is a robust tool on ASCO eLearning that learners can use to generate personalized quizzes from a large bank of patient case–based, multiple-choice questions. Questions cover all major cancer types as well as supportive care, developmental therapeutics, genetics and genomics, and more. Learners can select parameters such as topic(s) and number of questions to generate quizzes, as well as create quizzes from new questions or questions they previously attempted. Each question includes a rationale and references.
The Quiz Builder includes a dashboard to easily identify areas that would benefit from additional study. Quizzes can be completed at any time, and for every 6 correctly answered questions, learners can claim 1 CME credit/MOC point. The ASCO Quiz Builder is available as an annual subscription and new questions will be added regularly. Learn more and subscribe.
Test your knowledge now with a sample question from the ASCO Quiz Builder. The correct answer and rationale are listed at the bottom of the page.
A 69-year-old man with a history of hypertension, diabetes, and HIV presents with a rapidly enlarging lesion over his left shoulder. He reports a significant history of sun exposure. On examination, he has a 2-cm non-tender, raised, lightly pigmented lesion over the left shoulder. Left axillary lymphadenopathy is palpated. Biopsy of the skin lesion shows a dermal mass extending into the subcutis, composed of strands of uniform, round, blue cells, positive for CK20 perinuclear staining, CD56, chromogranin, and synaptophysin, and negative for S100, CK7, and thyroid-transcription factor-1. Fluorodeoxyglucose (FDG)-PET/CT shows hypermetabolic enlarged left axillary nodes and numerous pulmonary and liver lesions. A percutaneous biopsy of a liver lesion shows similar findings to the skin lesion biopsy.
Which of the following is the recommended first-line treatment?
A. Carboplatin, etoposide, and atezolizumab
D. Ipilimumab and nivolumab
The answer is B. This is a patient with metastatic Merkel cell carcinoma (MCC). He has several risk factors, including older age (>50), immunosuppression (HIV), and a history of significant sun exposure. The described pathologic findings are typical for this tumor type, including features of both epithelial and neuroendocrine cells, particularly CK20 positivity. Negativity for TTF-1 and S100 help exclude small cell carcinoma of the lung and melanoma, respectively. Avelumab is a monoclonal anti-PDL1 antibody with demonstrated activity in advanced MCC and is currently approved in the first-line setting. Ipilimumab and the combination of ipilimumab and nivolumab are not approved in the first-line setting for advanced MCC at this time. Carboplatin, etoposide, and atezolizumab are currently approved first-line regimens for the lung’s extensive-stage small cell carcinoma. It is not approved at this time in the first-line setting for advanced MCC.