Recent advances in cancer therapy MCQs With Answer

Introduction: This quiz collection on Recent Advances in Cancer Therapy MCQs with Answer is designed for M.Pharm students taking Advanced Pharmacology‑II. It focuses on contemporary pharmacologic strategies — including targeted small molecules, antibody‑drug conjugates, immune checkpoint inhibitors, CAR‑T and other cell therapies, radionuclide and oncolytic approaches, epigenetic and DNA damage response agents, biomarkers and resistance mechanisms. Each question emphasizes mechanistic pharmacology, clinical application, and safety considerations relevant to therapeutic development and patient care. Use these MCQs to deepen understanding of drug action, selection criteria, predictive biomarkers, and emerging modalities so you can critically evaluate literature, design experiments and counsel on pharmacotherapeutic choices in oncology.

Q1. Which monoclonal antibody is an anti‑PD‑1 immune checkpoint inhibitor used in various solid tumors?

• Ipilimumab (anti‑CTLA‑4)
• Pembrolizumab (anti‑PD‑1)
• Atezolizumab (anti‑PD‑L1)
• Rituximab (anti‑CD20)

Correct Answer: Pembrolizumab (anti‑PD‑1)

Q2. CAR‑T cell therapies approved for B‑cell malignancies primarily target which antigen on malignant B cells?

• EGFR
• CD19
• HER2
• VEGFR

Correct Answer: CD19

Q3. An antibody‑drug conjugate (ADC) is composed of which essential components?

• Monoclonal antibody, chemical linker and cytotoxic payload
• Monoclonal antibody, cytokine and radionuclide
• Small molecule drug, antibody and polysaccharide shell
• Nanoparticle core, siRNA and targeting peptide

Correct Answer: Monoclonal antibody, chemical linker and cytotoxic payload

Q4. PARP inhibitors exert anticancer effects mainly by which mechanism in BRCA‑deficient tumors?

• Inhibition of topoisomerase I leading to single‑strand breaks
• Inhibition of PARP causing accumulation of single‑strand breaks and synthetic lethality
• Blockade of PD‑1/PD‑L1 interaction to enhance T‑cell killing
• Direct alkylation of DNA bases causing crosslinks

Correct Answer: Inhibition of PARP causing accumulation of single‑strand breaks and synthetic lethality

Q5. Which agent is a bispecific T‑cell engager (BiTE) that links CD3 on T cells to CD19 on B cells?

• Blinatumomab
• Trastuzumab
• Brentuximab vedotin
• Pembrolizumab

Correct Answer: Blinatumomab

Q6. PROTACs (proteolysis targeting chimeras) achieve target protein elimination by which pharmacologic mechanism?

• Competitive inhibition of enzymatic activity at the active site
• Recruitment of an E3 ubiquitin ligase to induce ubiquitination and proteasomal degradation
• Blocking mRNA translation via ribosome stalling
• Sequestering proteins in lysosomes through endocytosis

Correct Answer: Recruitment of an E3 ubiquitin ligase to induce ubiquitination and proteasomal degradation

Q7. Which biomarker is most commonly used to predict response to PD‑1/PD‑L1 immune checkpoint inhibitors?

• PD‑L1 expression on tumor or immune cells
• EGFR activating mutation
• HER2 gene amplification
• CD20 surface expression

Correct Answer: PD‑L1 expression on tumor or immune cells

Q8. Talimogene laherparepvec (T‑VEC) is an example of which class of cancer therapeutics?

• Oncolytic virus therapy
• Small molecule kinase inhibitor
• Epigenetic methyltransferase inhibitor
• Monoclonal antibody conjugate

Correct Answer: Oncolytic virus therapy

Q9. Which radionuclide is FDA‑approved for treatment of symptomatic bone metastases from castration‑resistant prostate cancer and emits alpha particles?

• Iodine‑131
• Radium‑223 dichloride
• Lutetium‑177 dotatate
• Yttrium‑90 microspheres

Correct Answer: Radium‑223 dichloride

Q10. A common mechanism by which tumors develop resistance to targeted kinase inhibitors is:

• Increased renal elimination of the drug
• Secondary (gatekeeper) mutations in the target kinase that prevent drug binding
• Global upregulation of tumor suppressor genes
• Complete loss of antigen presentation machinery only

Correct Answer: Secondary (gatekeeper) mutations in the target kinase that prevent drug binding

Q11. Which ADC couples trastuzumab to the microtubule‑inhibitor DM1 and is used in HER2‑positive breast cancer?

• Trastuzumab emtansine (T‑DM1)
• Brentuximab vedotin
• Trastuzumab deruxtecan
• Ado‑trastuzumab duocarmazine

Correct Answer: Trastuzumab emtansine (T‑DM1)

Q12. Which oral small‑molecule inhibitor irreversibly targets Bruton’s tyrosine kinase (BTK) and is used in B‑cell malignancies?

• Ibrutinib
• Lapatinib
• Osimertinib
• Vemurafenib

Correct Answer: Ibrutinib

Q13. High tumor mutational burden (TMB) in a cancer generally correlates with which clinical observation?

• Improved response rates to immune checkpoint inhibitors
• Reduced sensitivity to DNA‑damaging chemotherapy across all tumors
• Lower neoantigen load and diminished immune recognition
• Absolute resistance to radiotherapy

Correct Answer: Improved response rates to immune checkpoint inhibitors

Q14. Which CAR‑T product targets BCMA and has been approved for relapsed/refractory multiple myeloma?

• Idecabtagene vicleucel (ide‑cel)
• Tisagenlecleucel
• Axicabtagene ciloleucel
• Blinatumomab

Correct Answer: Idecabtagene vicleucel (ide‑cel)

Q15. Which approved agent is a DNA methyltransferase (DNMT) inhibitor used in myelodysplastic syndromes and acute myeloid leukemia?

• Azacitidine
• Vorinostat
• Sorafenib
• Olaparib

Correct Answer: Azacitidine

Q16. In precision oncology, a “liquid biopsy” most commonly analyzes which circulating analyte to detect tumor‑derived genetic alterations?

• Circulating tumor DNA (ctDNA)
• Serum albumin levels
• Red blood cell counts
• Mitochondrial RNA in platelets

Correct Answer: Circulating tumor DNA (ctDNA)

Q17. CTLA‑4 inhibitors such as ipilimumab enhance antitumor immunity primarily by:

• Blocking CTLA‑4 to enhance T‑cell priming in lymphoid organs
• Directly lysing tumor cells through complement activation
• Inhibiting PD‑1/PD‑L1 mediated effector phase in the tumor microenvironment
• Stimulating B cells to produce tumor‑specific antibodies

Correct Answer: Blocking CTLA‑4 to enhance T‑cell priming in lymphoid organs

Q18. Lutetium‑177 DOTATATE (Lu‑177 DOTATATE) is an example of which therapeutic modality?

• Peptide receptor radionuclide therapy (PRRT) for neuroendocrine tumors
• Systemic chemotherapy for small cell lung cancer
• Topical immunomodulator for skin cancers
• PARP inhibitor used in ovarian cancer

Correct Answer: Peptide receptor radionuclide therapy (PRRT) for neuroendocrine tumors

Q19. The most common severe acute toxicity after CAR‑T cell infusion that requires prompt management is:

• Cytokine release syndrome (CRS)
• Hand‑foot syndrome
• Interstitial lung disease
• Delayed nephrotoxicity

Correct Answer: Cytokine release syndrome (CRS)

Q20. Personalized neoantigen vaccines are designed based on which of the following steps?

• Tumor genomic sequencing to identify patient‑specific somatic mutations and predicted neoepitopes
• Selection of viral‑derived peptides common to all cancers
• Using tumor histology alone without sequencing
• Administering off‑the‑shelf bacterial antigens to stimulate innate immunity

Correct Answer: Tumor genomic sequencing to identify patient‑specific somatic mutations and predicted neoepitopes

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