Chemotherapy: EGFR inhibitors: 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: EGFR inhibitors

Sample item

A non-smoking woman with lung adenocarcinoma and an EGFR exon 19 deletion is started on oral targeted therapy. Two weeks later she has an acneiform facial rash and diarrhoea. Which drug class was most likely started?

APD-1 antibody such as pembrolizumabBALK inhibitor such as crizotinibCVEGF antibody such as bevacizumabDEGFR tyrosine kinase inhibitor such as gefitinib

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

The answer and the reasoning

D. EGFR tyrosine kinase inhibitor such as gefitinib

EGFR tyrosine kinase inhibitors such as gefitinib, erlotinib and osimertinib are given orally in EGFR-mutant lung cancer. Acneiform rash and diarrhoea are class effects, as the epidermis and gut depend on EGFR signalling. Other targeted classes have different adverse effects.

Option by option

A. PD-1 antibody such as pembrolizumab
Pembrolizumab is given intravenously and causes immune-related events.
B. ALK inhibitor such as crizotinib
ALK inhibitors treat ALK-rearranged tumours and cause visual disturbance and oedema.
C. VEGF antibody such as bevacizumab
Bevacizumab is given intravenously and causes hypertension and bleeding.
D. EGFR tyrosine kinase inhibitor such as gefitinib (correct)
Correct. Rash and diarrhoea are typical class effects of EGFR inhibition.

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.

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, EGFR tyrosine kinase inhibitor such as gefitinib. EGFR tyrosine kinase inhibitors such as gefitinib, erlotinib and osimertinib are given orally in EGFR-mutant lung cancer.

Why is "PD-1 antibody such as pembrolizumab" not the answer?

Pembrolizumab is given intravenously and causes immune-related events.

Why is "ALK inhibitor such as crizotinib" not the answer?

ALK inhibitors treat ALK-rearranged tumours and cause visual disturbance and oedema.

Why is "VEGF antibody such as bevacizumab" not the answer?

Bevacizumab is given intravenously and causes hypertension and bleeding.

What concept does this question test?

It tests Chemotherapy: EGFR inhibitors in Pharmacology. Acneiform rash and diarrhoea are class effects, as the epidermis and gut depend on EGFR signalling. Other targeted classes have different adverse effects.

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: EGFR inhibitors?

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.