Precision medicine has revolutionized the management of breast cancer, shifting the paradigm from a “one-size-fits-all” approach to treatment tailored to the unique genetic and molecular fingerprint of a patient’s tumor. As covered in the Patient Care 2 oncology and personalized medicine modules, a pharmacist’s role now critically involves understanding biomarkers like ER, PR, and HER2 to ensure the safe and effective use of targeted therapies. This quiz will test your knowledge on the key biomarkers and the precision-guided pharmacotherapies that define modern breast cancer treatment.
1. Precision medicine in breast cancer relies on selecting therapies based on:
- a. The patient’s age and weight only.
- b. The specific molecular biomarkers expressed by the tumor.
- c. The cost of the chemotherapy.
- d. A standardized protocol for all patients.
Answer: b. The specific molecular biomarkers expressed by the tumor.
2. A patient’s tumor is found to be Estrogen Receptor-positive (ER+). This means the cancer growth is fueled by estrogen, and the patient is a candidate for what type of therapy?
- a. Anti-HER2 therapy
- b. Endocrine (hormonal) therapy
- c. Immunotherapy
- d. Standard chemotherapy alone
Answer: b. Endocrine (hormonal) therapy
3. Trastuzumab (Herceptin) is a targeted therapy that is only effective against breast cancers that overexpress which receptor?
- a. Estrogen Receptor (ER)
- b. Progesterone Receptor (PR)
- c. Human Epidermal Growth Factor Receptor 2 (HER2)
- d. Vascular Endothelial Growth Factor (VEGF)
Answer: c. Human Epidermal Growth Factor Receptor 2 (HER2)
4. Aromatase inhibitors, like anastrozole, are a cornerstone of precision medicine for which patient population with HR+ breast cancer?
- a. Premenopausal women
- b. Postmenopausal women
- c. All women, regardless of menopausal status
- d. Men with breast cancer
Answer: b. Postmenopausal women
5. A patient must have what biomarker status to be eligible for treatment with an EGFR inhibitor like cetuximab in colorectal cancer, a principle that also applies to targeted therapies in breast cancer?
- a. RAS mutant
- b. RAS wild-type
- c. BRAF mutant
- d. The biomarker does not matter.
Answer: b. RAS wild-type
6. The “Personalized Medicine on Oncology” is a specific learning module in which course?
- a. PHA5782C Patient Care 2
- b. PHA5104 Sterile Compounding
- c. PHA5703 Pharmacy Law and Ethics
- d. PHA5787C Patient Care 5
Answer: a. PHA5782C Patient Care 2
7. Palbociclib is a targeted therapy that works by inhibiting CDK 4/6. This is used to treat which subtype of metastatic breast cancer?
- a. Triple-negative
- b. HER2-positive
- c. Hormone receptor-positive (HR+)
- d. All subtypes
Answer: c. Hormone receptor-positive (HR+)
8. Tamoxifen is a prodrug that requires conversion to its active metabolite, endoxifen, by which CYP enzyme?
- a. CYP3A4
- b. CYP2C19
- c. CYP1A2
- d. CYP2D6
Answer: d. CYP2D6
9. PARP inhibitors like olaparib are effective in patients with breast cancer who have a germline mutation in which gene?
- a. HER2
- b. PIK3CA
- c. BRCA1 or BRCA2
- d. TP53
Answer: c. BRCA1 or BRCA2
10. What is the mechanism of action of an antibody-drug conjugate (ADC) like ado-trastuzumab emtansine (Kadcyla)?
- a. It blocks the HER2 receptor only.
- b. It is a form of chemotherapy only.
- c. It uses an antibody (trastuzumab) to deliver a potent chemotherapy payload directly to HER2-positive cells.
- d. It inhibits the cell cycle.
Answer: c. It uses an antibody (trastuzumab) to deliver a potent chemotherapy payload directly to HER2-positive cells.
11. The management of breast cancer is a topic within the Patient Care 2 curriculum.
- a. True
- b. False
Answer: a. True
12. Triple-Negative Breast Cancer (TNBC) is characterized by the lack of which receptors?
- a. ER, PR, and HER2
- b. ER and PR only
- c. HER2 only
- d. It is positive for all receptors.
Answer: a. ER, PR, and HER2
13. A patient with HER2+ breast cancer should be monitored for what major toxicity associated with anti-HER2 therapies?
- a. Nephrotoxicity
- b. Cardiotoxicity
- c. Hepatotoxicity
- d. Neurotoxicity
Answer: b. Cardiotoxicity
14. A genomic test like Oncotype DX is used in early-stage, ER-positive breast cancer to:
- a. Diagnose the cancer.
- b. Determine if the cancer is HER2-positive.
- c. Predict the risk of recurrence and the potential benefit of adding chemotherapy to hormonal therapy.
- d. Select the appropriate targeted therapy for metastatic disease.
Answer: c. Predict the risk of recurrence and the potential benefit of adding chemotherapy to hormonal therapy.
15. The “Pharmacology of… Small Molecule Inhibitors/Monoclonal Antibodies” is a lecture within the Patient Care 2 curriculum.
- a. True
- b. False
Answer: a. True
16. Pertuzumab is often added to trastuzumab because it:
- a. Binds to a different domain of the HER2 receptor, providing more complete blockade.
- b. Prevents the cardiotoxicity of trastuzumab.
- c. Allows trastuzumab to be given orally.
- d. Is a cheaper alternative.
Answer: a. Binds to a different domain of the HER2 receptor, providing more complete blockade.
17. The primary treatment modality for TNBC is:
- a. Endocrine therapy
- b. Anti-HER2 therapy
- c. Cytotoxic chemotherapy
- d. Aromatase inhibitors
Answer: c. Cytotoxic chemotherapy
18. A postmenopausal woman on an aromatase inhibitor should be counseled on the risk of:
- a. Blood clots
- b. Endometrial cancer
- c. Bone loss and osteoporosis
- d. Hot flashes
Answer: c. Bone loss and osteoporosis
19. The concept of using pharmacogenomics to guide therapy is a key part of:
- a. The “one-size-fits-all” approach.
- b. Precision medicine.
- c. Palliative care only.
- d. Surgical oncology.
Answer: b. Precision medicine.
20. An active learning session on oncology is part of the Patient Care 2 course.
- a. True
- b. False
Answer: a. True
21. A patient with metastatic HR-positive breast cancer is prescribed palbociclib. It will be given in combination with:
- a. Chemotherapy
- b. Trastuzumab
- c. An endocrine therapy agent like letrozole or fulvestrant.
- d. Another CDK 4/6 inhibitor.
Answer: c. An endocrine therapy agent like letrozole or fulvestrant.
22. A patient’s tumor has a PIK3CA mutation. They may be a candidate for which targeted therapy?
- a. Alpelisib (a PI3K inhibitor)
- b. Olaparib
- c. Palbociclib
- d. Trastuzumab
Answer: a. Alpelisib (a PI3K inhibitor)
23. The “Hormonal Agents” lecture is part of the oncology module in Patient Care 2.
- a. True
- b. False
Answer: a. True
24. An active learning session on oncology is part of which course?
- a. PHA5782C Patient Care 2
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5787C Patient Care 5
Answer: a. PHA5782C Patient Care 2
25. A pharmacist’s role in precision medicine for breast cancer is to:
- a. Ensure appropriate biomarker testing has been performed before dispensing a targeted therapy.
- b. Manage side effects unique to targeted therapies.
- c. Screen for drug interactions with oral targeted agents.
- d. All of the above.
Answer: d. All of the above.
26. The term “neoadjuvant” therapy refers to treatment given:
- a. After surgery.
- b. Before surgery, to shrink the tumor.
- c. For at least 5 years.
- d. In place of surgery.
Answer: b. Before surgery, to shrink the tumor.
27. For TNBC tumors that express PD-L1, which class of therapy has shown benefit?
- a. Endocrine therapy
- b. Aromatase inhibitors
- c. Immune checkpoint inhibitors (e.g., pembrolizumab)
- d. Anti-HER2 therapy
Answer: c. Immune checkpoint inhibitors (e.g., pembrolizumab)
28. An active learning session on oncology is part of which course module?
- a. Module 6: Basic Principles of Cancer Treatment
- b. Module 1: Laboratory Diagnostics
- c. Module 3: Introduction to Gram-Positive Bacteria
- d. Module 5: Introduction to Fungal Infections & Antifungals
Answer: a. Module 6: Basic Principles of Cancer Treatment
29. The mechanism of PARP inhibitors relies on a concept called:
- a. Synergistic lethality
- b. Additive toxicity
- c. Synthetic lethality
- d. Competitive inhibition
Answer: c. Synthetic lethality
30. The “Principles of Personalized Medicine” are covered in the Drug Therapy Individualization course.
- a. True
- b. False
Answer: a. True
31. The development of an acneiform rash while taking an EGFR inhibitor for colorectal cancer suggests the drug is working. This type of on-target side effect is a concept in:
- a. Traditional chemotherapy
- b. Precision medicine and targeted therapy
- c. Surgery
- d. Radiation therapy
Answer: b. Precision medicine and targeted therapy
32. A key counseling point for a patient on a CDK 4/6 inhibitor like palbociclib is the risk of:
- a. Diarrhea
- b. Neutropenia
- c. Hypertension
- d. Rash
Answer: b. Neutropenia
33. The choice of endocrine therapy (tamoxifen vs. AI) in HR+ breast cancer depends primarily on the patient’s:
- a. Age
- b. Weight
- c. Menopausal status
- d. Race
Answer: c. Menopausal status
34. A patient receiving trastuzumab must have what monitored at baseline and regularly throughout therapy?
- a. Liver function tests
- b. Renal function
- c. Left Ventricular Ejection Fraction (LVEF)
- d. Serum electrolytes
Answer: c. Left Ventricular Ejection Fraction (LVEF)
35. A “biomarker” in precision oncology is:
- a. A measure of the patient’s overall health.
- a. A measurable characteristic (like a gene mutation or protein expression) that indicates a particular biological process or disease state.
- c. A vital sign like blood pressure.
- d. The cost of a medication.
Answer: b. A measurable characteristic (like a gene mutation or protein expression) that indicates a particular biological process or disease state.
36. Trastuzumab deruxtecan (Enhertu) is a next-generation ADC that can be used in patients with what level of HER2 expression?
- a. Only HER2-positive
- b. HER2-negative
- c. Both HER2-positive and “HER2-low”
- d. Only in triple-negative breast cancer
Answer: c. Both HER2-positive and “HER2-low”
37. Unlike chemotherapy, targeted therapies have no side effects.
- a. True
- b. False
Answer: b. False
38. The lecture “Management of Breast Cancer” is part of the Patient Care 2 curriculum.
- a. True
- b. False
Answer: a. True
39. A patient’s tumor is ER+, PR+, and HER2-. What is the most appropriate type of targeted therapy?
- a. Anti-HER2 therapy
- b. Immunotherapy
- c. Endocrine therapy +/- CDK 4/6 inhibitor
- d. A PARP inhibitor
Answer: c. Endocrine therapy +/- CDK 4/6 inhibitor
40. An active learning session covering oncology is part of which course?
- a. PHA5782C Patient Care 2
- b. PHA5163L Professional Skills Lab 3
- c. PHA5781 Patient Care I
- d. PHA5787C Patient Care 5
Answer: a. PHA5782C Patient Care 2
41. The role of the pharmacist in precision medicine is to:
- a. Interpret genomic test results.
- b. Recommend appropriate targeted therapy.
- c. Manage unique side effects and drug interactions.
- d. All of the above.
Answer: d. All of the above.
42. The term “adjuvant” refers to therapy given after the primary treatment (surgery).
- a. True
- b. False
Answer: a. True
43. A premenopausal woman with ER+ breast cancer may be offered ovarian suppression in addition to tamoxifen to:
- a. Improve her quality of life.
- b. Essentially make her postmenopausal from a hormonal standpoint, which can improve outcomes.
- c. Preserve her fertility.
- d. Prevent hot flashes.
Answer: b. Essentially make her postmenopausal from a hormonal standpoint, which can improve outcomes.
44. Which of the following is NOT a targeted therapy?
- a. Trastuzumab
- b. Palbociclib
- c. Tamoxifen
- d. Doxorubicin
Answer: d. Doxorubicin
45. Precision medicine aims to deliver the right ____ to the right ____ at the right time.
- a. drug, pharmacist
- b. treatment, patient
- c. dose, hospital
- d. hospital, patient
Answer: b. treatment, patient
46. A “liquid biopsy” is a test that looks for tumor DNA:
- a. In a tissue sample.
- b. In a blood sample.
- c. In a urine sample.
- d. In a saliva sample.
Answer: b. In a blood sample.
47. Understanding the pharmacology of monoclonal antibodies is a key part of the curriculum.
- a. True
- b. False
Answer: a. True
48. An active learning session on oncology is part of which course module?
- a. Module 6: Basic Principles of Cancer Treatment
- b. Module 1: Laboratory Diagnostics
- c. Module 3: Introduction to Gram-Positive Bacteria
- d. Module 5: Introduction to Fungal Infections & Antifungals
Answer: a. Module 6: Basic Principles of Cancer Treatment
49. The overall management of breast cancer with precision medicine requires:
- a. A one-size-fits-all approach.
- b. A multidisciplinary team and careful consideration of tumor biomarkers.
- c. The use of chemotherapy for every patient.
- d. A focus only on hormonal therapy.
Answer: b. A multidisciplinary team and careful consideration of tumor biomarkers.
50. The ultimate goal of precision medicine in breast cancer is to:
- a. Make treatment more expensive.
- b. Improve efficacy and reduce toxicity by matching targeted treatments to specific tumor vulnerabilities.
- c. Use as many new drugs as possible.
- d. Replace the need for surgeons and radiation oncologists.
Answer: b. Improve efficacy and reduce toxicity by matching targeted treatments to specific tumor vulnerabilities.