Chemotherapy: ALK-positive lung cancer: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Chemotherapy: ALK-positive lung cancer

Sample item

A 45-year-old woman who has never smoked has lung adenocarcinoma with an EML4-ALK fusion on molecular testing. EGFR mutation is absent. Which oral targeted drug is appropriate?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Crizotinib

EML4-ALK fusions drive a subset of lung adenocarcinomas, typically in young never-smokers. Crizotinib inhibits ALK and ROS1 tyrosine kinases, and newer ALK inhibitors such as alectinib are used in the same setting.

Option by option

  • A. Erlotinib

    Erlotinib targets EGFR, and the EGFR mutation is absent here.

  • B. Vemurafenib

    Vemurafenib inhibits BRAF V600E, which is not the driver in this tumour.

  • C. Crizotinib (correct)

    Correct. Crizotinib inhibits the ALK fusion kinase.

  • D. Imatinib

    Imatinib inhibits BCR-ABL, KIT and PDGFR, not ALK fusions.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pharmacology questions

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is C, Crizotinib. EML4-ALK fusions drive a subset of lung adenocarcinomas, typically in young never-smokers.

Why is "Erlotinib" not the answer?

Erlotinib targets EGFR, and the EGFR mutation is absent here.

Why is "Vemurafenib" not the answer?

Vemurafenib inhibits BRAF V600E, which is not the driver in this tumour.

Why is "Imatinib" not the answer?

Imatinib inhibits BCR-ABL, KIT and PDGFR, not ALK fusions.

What concept does this question test?

It tests Chemotherapy: ALK-positive lung cancer in Pharmacology. Crizotinib inhibits ALK and ROS1 tyrosine kinases, and newer ALK inhibitors such as alectinib are used in the same setting.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Chemotherapy: ALK-positive lung cancer?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.