AOCNP EXAM STUDY GUIDE 2026 –
ADVANCED ONCOLOGY REVIEW
QUESTIONS & VERIFIED ANSWERS (A+
GUARANTEE)
1. A patient with metastatic non-small cell lung cancer (NSCLC) tests positive for a ROS1
rearrangement. Which of the following targeted therapies is the most appropriate first-line
treatment?
A. Osimertinib
B. Dabrafenib
C. Alectinib
D. Crizotinib
Answer: D
Conceptual Explanation: Crizotinib is FDA-approved for the first-line treatment of ROS1-
positive metastatic NSCLC. Osimertinib is for EGFR, Alectinib for ALK, and Dabrafenib for
BRAF V600E mutations.
2. Which of the following laboratory findings is characteristic of Tumor Lysis Syndrome (TLS)?
A. Hypokalemia, Hypouricemia, and Hypercalcemia
B. Hyperkalemia, Hyperphosphatemia, and Hypocalcemia
,C. Hypernatremia, Hypercalcemia, and Hypophosphatemia
D. Hypokalemia, Hyperphosphatemia, and Hypercalcemia
Answer: B
Conceptual Explanation: TLS is characterized by the release of intracellular contents,
leading to hyperuricemia, hyperkalemia, hyperphosphatemia, and secondary hypocalcemia
due to phosphorus binding with calcium.
3. A patient receiving a checkpoint inhibitor (anti-PD-1) presents with Grade 2 immune-
related colitis (4-6 stools per day over baseline). What is the appropriate initial management
step?
A. Continue immunotherapy and start loperamide
B. Withhold immunotherapy and initiate 0.5-1 mg/kg/day of prednisone
C. Permanently discontinue immunotherapy and start infliximab
D. Continue immunotherapy and start budesonide
Answer: B
Conceptual Explanation: For Grade 2 irAE colitis, the recommendation is to withhold the
agent and start corticosteroids (prednisone/methylprednisolone). If symptoms resolve to
Grade 1, a taper can begin. Grade 3/4 requires discontinuation and higher dose steroids.
, 4. The CYP2D6 enzyme is critical for the metabolic activation of which hormonal agent used in
breast cancer?
A. Letrozole
B. Anastrozole
C. Exemestane
D. Tamoxifen
Answer: D
Conceptual Explanation: Tamoxifen is a prodrug that requires conversion to its active
metabolite, endoxifen, primarily via the CYP2D6 pathway. Inhibitors of CYP2D6 (like
certain SSRIs) can decrease tamoxifen efficacy.
5. A patient with Multiple Myeloma presents with a new onset of severe back pain, lower
extremity weakness, and urinary retention. What is the gold-standard diagnostic tool for this
suspected emergency?
A. Plain radiographs of the spine
B. Bone scan
C. MRI of the entire spine
D. CT scan of the abdomen and pelvis
Answer: C
ADVANCED ONCOLOGY REVIEW
QUESTIONS & VERIFIED ANSWERS (A+
GUARANTEE)
1. A patient with metastatic non-small cell lung cancer (NSCLC) tests positive for a ROS1
rearrangement. Which of the following targeted therapies is the most appropriate first-line
treatment?
A. Osimertinib
B. Dabrafenib
C. Alectinib
D. Crizotinib
Answer: D
Conceptual Explanation: Crizotinib is FDA-approved for the first-line treatment of ROS1-
positive metastatic NSCLC. Osimertinib is for EGFR, Alectinib for ALK, and Dabrafenib for
BRAF V600E mutations.
2. Which of the following laboratory findings is characteristic of Tumor Lysis Syndrome (TLS)?
A. Hypokalemia, Hypouricemia, and Hypercalcemia
B. Hyperkalemia, Hyperphosphatemia, and Hypocalcemia
,C. Hypernatremia, Hypercalcemia, and Hypophosphatemia
D. Hypokalemia, Hyperphosphatemia, and Hypercalcemia
Answer: B
Conceptual Explanation: TLS is characterized by the release of intracellular contents,
leading to hyperuricemia, hyperkalemia, hyperphosphatemia, and secondary hypocalcemia
due to phosphorus binding with calcium.
3. A patient receiving a checkpoint inhibitor (anti-PD-1) presents with Grade 2 immune-
related colitis (4-6 stools per day over baseline). What is the appropriate initial management
step?
A. Continue immunotherapy and start loperamide
B. Withhold immunotherapy and initiate 0.5-1 mg/kg/day of prednisone
C. Permanently discontinue immunotherapy and start infliximab
D. Continue immunotherapy and start budesonide
Answer: B
Conceptual Explanation: For Grade 2 irAE colitis, the recommendation is to withhold the
agent and start corticosteroids (prednisone/methylprednisolone). If symptoms resolve to
Grade 1, a taper can begin. Grade 3/4 requires discontinuation and higher dose steroids.
, 4. The CYP2D6 enzyme is critical for the metabolic activation of which hormonal agent used in
breast cancer?
A. Letrozole
B. Anastrozole
C. Exemestane
D. Tamoxifen
Answer: D
Conceptual Explanation: Tamoxifen is a prodrug that requires conversion to its active
metabolite, endoxifen, primarily via the CYP2D6 pathway. Inhibitors of CYP2D6 (like
certain SSRIs) can decrease tamoxifen efficacy.
5. A patient with Multiple Myeloma presents with a new onset of severe back pain, lower
extremity weakness, and urinary retention. What is the gold-standard diagnostic tool for this
suspected emergency?
A. Plain radiographs of the spine
B. Bone scan
C. MRI of the entire spine
D. CT scan of the abdomen and pelvis
Answer: C
