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BCOP Exam Questions And Answers| Latest Update

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JJ is a 57-year-old female who presented to the ED with 17 days of abdominal distention and 3
days of abdominal pain. Physical exam reveals a mass in her right lower abdomen. Lab results
are notable for Hgb 7.1 g/dl and CA-125 of 212 U/mL. Ultrasound confirmed presence of a
mass; additional imaging ruled out distant metastases. She is clinically staged with 1B, high
grade serous ovarian cancer and underwent adequate surgical cytoreduction.


Which of the following is the most appropriate management for JJ at this time?


a) observation
b) carboplatin/paclitaxel for 3 cycles
c) carboplatin/paclitaxel for 6 cycles

d) carboplatin/paclitaxel/bevacizumab for 6 cycles c


(high grade and serous)


SM presents for a pelvic ultrasound that confirms a left adnexa mass 3 x 2.6 x 2.3 cm;
subsequent biopsies confirm high-grade serous carcinoma. Additional staging confirms SM has
clinical stage IVB (pleural effusions and liver lesions) ovarian cancer. Upon imaging and in
consultation with surgery she is unlikely to be optimally cytoreduced.


Which of the following is the most appropriate initial therapy for SM?


a) Staging TAH/BSO --> adjuvant chemo
b) IP/IV carbo/taxol --> debulking surgery
c) Dose dense paclitaxel + carbo --> debulking surgery

d) Carbo + gemcitabine + bevacizumab c

,(SM has stage IVB ovarian cancer and was unfortunately deemed to be unlikely to attain
optimal cytoreduction. Neoadjuvant chemotherapy followed by interval debulking surgery is
most appropriate.)


SM completed 3 cycles of neoadjuvant chemo, underwent debulking surgery attaining optimal
cytoreduction and subsequently completed 3 more cycles of adjuvant chemo with paclitaxel,
carboplatin and bevacizumab. Her response to therapy was a partial response. Following
genetic testing, she was found to have a deleterious germline BRCA1 mutation.


What maintenance strategy do you recommend?


a) niraparib 300 mg once daily + bevacizumab 15 mg/kg every 3 weeks
b) rucaparib 600 mg twice daily
c) olaparib 300 mg twice daily + bevacizumab 15 mg/kg every 3 weeks
d) PARP inhibitor maintenance not recommended following bevacizumab-based primary
therapy c


(BRCA mutation, olaparib is the only PARP inhibitor approved in combo with bevacizumab)


SM presents to clinic 3 months after completing adjuvant chemotherapy which was
complicated by grade 2 peripheral neuropathy. She completed 3 months of maintenance
olaparib and bevacizumab prior to developing worsening abdominal distention. A CT scan
revealed lymphadenopathy and confirmed disease recurrence.


Which of the following regimens is most appropriate for SM?


a) carbo + gemcitabine
b) gemcitabine
c) niraparib + bevacizumab

d) dostarlimab b

,(SM experienced progression of disease 3 months following completion of initial platinum
based adjuvant chemotherapy, indicating a platinum-resistant recurrence. Gemcitabine
monotherapy is a category 2A, preferred therapy for platinum-resistant recurrence.)


WW is a 56 year old male with metastatic colon cancer who is starting FOLFIRI (fluorouracil,
oxaliplatin, leucovorin). On the first night of chemotherapy, he begins experiencing severe
abdominal cramping and diarrhea. Which of the following treatments is most appropriate for
WW at this time?


a) loperamide
b) atropine
c) octreotide

d) tincture of opium b


(Irinotecan may cause acute or delayed diarrhea. The immediate onset diarrhea is associated
with cholinergic symptoms, and atropine is the drug of choice.)


HT is a 54 year old male with metastatic colorectal cancer who is receiving cetuximab. Which of
the following side effects should he be counseled on?


a) QTc prolongation
b) Hypomagnesemia
c) Arterial thromboembolism

d) Bleeding b


(Although not as common as other side effects, hypomagnesemia has been associated with
cetuximab and panitumumab. Patient's electrolytes should be frequently monitored during the
duration of EGFR inhibitor treatment and for approximately 8 weeks afterwards.)

, AL is a Caucasian 42 year old female who has a history of a gastric ulcer secondary to
Helicobacter pylori infection. When questioned about her dietary habits, AL replies that she
eats a burger and fries daily at the cafeteria and drinks 1-2 beers/week socially. In addition, her
father was diagnosed with gastric cancer at age 51. Which of the following risk factors dose AL
have for gastric cancer?
a) Ethnicity, H. pylori infection, diet
b) H. pylori infection, alcohol use, family history
c) Ethnicity, H. pylori infection, alcohol use

d) H. pylori infection, diet, family history d


(Risk factors for gastric cancer include H. pylori infection, smoking, a diet high in salted, fried or
preserved foods and low in fruits and vegetables, positive family history, and heavy alcohol
use.)


A 30 year old female presents with bilateral adnexal masses, and is found to have stage IB,
grade 3 ovarian cancer. She expresses her desire to have children in the future if possible.
Which of the following treatments is most appropriate?
a) Bilateral salpingo-oophorectomy (BSO), then observation
b) BSO, then IV paclitaxel/carboplatin x 6 cycles
c) BSO, then intraperitoneal (IP) paclitaxel/cisplatin x 6 cycles

d) Total abdominal hysterectomy (TAH)/BSO, then IV and IP paclitaxel/cisplatin x 6 cycles b


(All ovarian cancer patients should receive comprehensive surgical staging, which differ based
on fertility sparing vs. non-fertility sparing methods; For stage IA or IB disease, adjuvant IV
taxane/carboplatin x 3-6 cycles is recommended for patients with grade 2 and 3 tumors; TAH
does not preserve fertility)


TS is a 36-year-old premenopausal white female who presents with a diagnosis of lobular
carcinoma in situ (LCIS). She has a significant family history of breast cancer including her
mother, maternal grandmother, and maternal aunt who were all diagnosed prior to 60 years of
age. TS had one child at age 31 and no history of oral contraceptive use or estrogen

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