Breast cancer pharmacotherapy MCQs With Answer

Breast cancer pharmacotherapy MCQs With Answer is a targeted quiz set designed for M.Pharm students taking Pharmacotherapeutics II (MPP 202T). This collection emphasizes mechanism-based reasoning, clinical application, adverse-effect management, and targeted therapy nuances relevant to modern breast cancer care. Questions cover endocrine agents, HER2-targeted drugs, cytotoxics, CDK4/6 and PARP inhibitors, supportive care measures, and resistance mechanisms. Each MCQ includes concise options and the correct answer to help you self-assess and deepen your conceptual understanding. Use these items to prepare for exams, clinical case discussions, and to reinforce evidence-based pharmacotherapy decisions in breast oncology.

Q1. Optimal endocrine therapy for premenopausal women with high-risk estrogen receptor–positive breast cancer?

• Tamoxifen alone
• Aromatase inhibitor alone
• Ovarian suppression plus aromatase inhibitor
• Fulvestrant alone

Correct Answer: Ovarian suppression plus aromatase inhibitor

Q2. What best describes the pharmacologic action of tamoxifen in breast tissue?

• Nonselective aromatase inhibition
• Selective estrogen receptor modulator: ER antagonist in breast and partial agonist in bone/uterus
• Selective estrogen receptor degrader causing receptor proteolysis
• GnRH agonist causing ovarian suppression

Correct Answer: Selective estrogen receptor modulator: ER antagonist in breast and partial agonist in bone/uterus

Q3. The primary mechanism of action of aromatase inhibitors (e.g., letrozole) in postmenopausal breast cancer is:

• Blocking estrogen receptor DNA binding
• Inhibiting peripheral conversion of androgens to estrogens by aromatase
• Promoting estrogen receptor degradation
• Stimulating hepatic estrogen metabolism

Correct Answer: Inhibiting peripheral conversion of androgens to estrogens by aromatase

Q4. Fulvestrant differs from tamoxifen because it acts principally as:

• A partial ER agonist in bone
• Selective estrogen receptor degrader (SERD) causing receptor downregulation
• Aromatase inhibitor
• Progestin receptor antagonist

Correct Answer: Selective estrogen receptor degrader (SERD) causing receptor downregulation

Q5. Which monoclonal antibody is the established HER2-targeted agent used in early and metastatic HER2‑positive breast cancer?

• Trastuzumab
• Pertuzumab
• Lapatinib
• Bevacizumab

Correct Answer: Trastuzumab

Q6. Which oral tyrosine kinase inhibitor targets the intracellular kinase domain of HER2 and is used in advanced HER2‑positive disease?

• Lapatinib
• Trastuzumab
• Palbociclib
• Fulvestrant

Correct Answer: Lapatinib

Q7. CDK4/6 inhibitors (e.g., palbociclib) exert anticancer effects primarily by:

• Inducing DNA double-strand breaks
• Inhibiting CDK4/6 and preventing Rb phosphorylation leading to G1 cell‑cycle arrest
• Blocking microtubule assembly
• Stimulating apoptosis through death receptor activation

Correct Answer: Inhibiting CDK4/6 and preventing Rb phosphorylation leading to G1 cell‑cycle arrest

Q8. The most clinically significant neurotoxic adverse effect commonly associated with paclitaxel is:

• Severe cardiomyopathy
• Peripheral sensory neuropathy
• Renal tubular necrosis
• Hepatic failure

Correct Answer: Peripheral sensory neuropathy

Q9. The principal dose‑limiting toxicity of anthracyclines (e.g., doxorubicin) in breast cancer therapy is:

• Cumulative, dose-related cardiomyopathy and heart failure
• Severe peripheral neuropathy
• Interstitial lung disease
• Nephrotoxicity with electrolyte wasting

Correct Answer: Cumulative, dose-related cardiomyopathy and heart failure

Q10. Which agent is used as a cardioprotectant to reduce anthracycline-induced cardiotoxicity?

• Dexrazoxane
• Amifostine
• Mesna
• Leucovorin

Correct Answer: Dexrazoxane

Q11. PARP inhibitors (e.g., olaparib) show clinical benefit in BRCA‑mutated breast cancer by which mechanism?

• Direct HER2 inhibition
• Inhibiting PARP leading to accumulation of single‑strand breaks and synthetic lethality in homologous recombination–deficient cells
• Stimulating immune checkpoint blockade
• Inhibiting microtubule polymerization

Correct Answer: Inhibiting PARP leading to accumulation of single‑strand breaks and synthetic lethality in homologous recombination–deficient cells

Q12. Which bisphosphonate is commonly used intravenously to reduce skeletal‑related events in breast cancer bone metastases?

• Zoledronic acid
• Denosumab
• Raloxifene
• Calcitonin

Correct Answer: Zoledronic acid

Q13. Which agent is a monoclonal antibody against RANKL used to prevent skeletal complications in metastatic breast cancer?

• Denosumab
• Zoledronic acid
• Bisphosphonate clodronate
• Teriparatide

Correct Answer: Denosumab

Q14. The principal clinical indication for granulocyte colony‑stimulating factor (filgrastim) in chemotherapy patients is:

• Prevention and treatment of chemotherapy‑induced neutropenia and febrile neutropenia
• Reduction of nausea and vomiting
• Prevention of cardiotoxicity
• Management of chemotherapy‑induced neuropathy

Correct Answer: Prevention and treatment of chemotherapy‑induced neutropenia and febrile neutropenia

Q15. For highly emetogenic chemotherapy regimens used in breast cancer, the recommended antiemetic prophylaxis typically includes:

• Only a benzodiazepine
• 5‑HT3 receptor antagonist + NK1 receptor antagonist + dexamethasone
• Proton pump inhibitor alone
• Aspirin and acetaminophen

Correct Answer: 5‑HT3 receptor antagonist + NK1 receptor antagonist + dexamethasone

Q16. One common molecular mechanism by which HER2‑positive breast cancers acquire resistance to trastuzumab is:

• Loss of PTEN and activation of the PI3K/AKT pathway
• Increased estrogen receptor expression only
• Enhanced drug efflux via P‑glycoprotein strictly for antibodies
• Upregulation of aromatase activity

Correct Answer: Loss of PTEN and activation of the PI3K/AKT pathway

Q17. The most predictive biomarker for benefit from endocrine therapy in breast cancer is:

• HER2 overexpression
• Estrogen receptor (ER) positivity
• BRCA1 mutation alone
• P-glycoprotein expression

Correct Answer: Estrogen receptor (ER) positivity

Q18. Compared with tamoxifen, aromatase inhibitors in postmenopausal women are more strongly associated with which long‑term adverse effect?

• Endometrial carcinoma
• Venous thromboembolism
• Osteoporosis and increased fracture risk
• Hot flashes to a greater extent

Correct Answer: Osteoporosis and increased fracture risk

Q19. The primary therapeutic goal of neoadjuvant chemotherapy in locally advanced breast cancer is to:

• Replace the need for systemic therapy after surgery
• Reduce tumor size to enable breast‑conserving surgery and assess in vivo chemosensitivity
• Prevent bone metastases exclusively
• Increase estrogen production to sensitize tumors

Correct Answer: Reduce tumor size to enable breast‑conserving surgery and assess in vivo chemosensitivity

Q20. Which agent is commonly recommended as adjuvant endocrine therapy for postmenopausal women with hormone receptor–positive early breast cancer?

• Letrozole
• Goserelin
• Fulvestrant as sole adjuvant in all cases
• Bevacizumab

Correct Answer: Letrozole

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