Egyptian Board Clinical Oncology key terms

A metabolic emergency after rapid destruction of bulky, chemosensitive tumor cells, producing hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia, with acute kidney injury and arrhythmia risk. Prevention with hydration and allopurinol or rasburicase is central.

A recombinant urate oxidase that converts uric acid to soluble allantoin, rapidly lowering urate in high-risk tumor lysis. It is contraindicated in G6PD deficiency because of hemolysis risk, and blood samples must be kept cold to avoid falsely low urate readings.

Fever of 38.3 C once or 38.0 C sustained over one hour with an absolute neutrophil count below 500 per microliter, or expected to fall below that. It requires urgent cultures and empiric broad-spectrum antipseudomonal antibiotics within one hour.

A validated tool scoring burden of illness, hypotension, active infection, dehydration, outpatient status and age to stratify febrile neutropenia. Scores of 21 or more identify low-risk patients who may be candidates for outpatient oral therapy after careful assessment.

A growth factor that shortens neutropenia duration and reduces febrile neutropenia when given after chemotherapy, either prophylactically when risk exceeds 20 percent or therapeutically. Pegylated forms allow once-per-cycle dosing; bone pain and splenic rupture are recognized adverse effects.

Leakage of a vesicant or irritant chemotherapy drug into perivascular tissue, causing pain, blistering and necrosis. Management depends on the agent and includes stopping the infusion, aspiration, cold or warm compresses, and specific antidotes such as dexrazoxane for anthracyclines.

An iron-chelating agent used both as a cardioprotectant limiting anthracycline-related cardiomyopathy in high cumulative-dose settings and as an antidote for anthracycline extravasation, where early administration reduces tissue necrosis.

Serial assessment of left ventricular ejection fraction, typically by echocardiography, before and during therapy with anthracyclines, trastuzumab and some tyrosine kinase inhibitors. Baseline function, cumulative dose, age and cardiovascular risk factors determine surveillance intervals and decisions to hold treatment.

Autoimmune toxicities from immune checkpoint inhibitors, including colitis, hepatitis, pneumonitis, thyroiditis, hypophysitis and dermatitis. Grading guides management: hold for moderate events and use high-dose corticosteroids, adding infliximab for steroid-refractory colitis.

A monoclonal antibody blocking CTLA-4, PD-1 or PD-L1 that restores T-cell attack on tumor cells. Efficacy depends on tumor type, biomarker expression and mutational burden, and toxicity arises from loss of peripheral immune tolerance.

The number of somatic mutations per megabase of tumor DNA, measured by sequencing. High burden predicts benefit from immune checkpoint blockade in several tumor types and is an approved companion biomarker for some agents, though assay and cutoff standardization remain challenging.

A systemic inflammatory response after T-cell-engaging therapies such as bispecific antibodies and CAR T cells, marked by fever, hypotension, hypoxia and organ dysfunction. Grading drives management with supportive care, tocilizumab and corticosteroids.

Adoptive immunotherapy in which a patient's T cells are engineered to express a chimeric antigen receptor targeting a tumor antigen, then reinfused after lymphodepletion. Used in refractory B-cell lymphomas, acute lymphoblastic leukemia and multiple myeloma, with cytokine release and neurotoxicity as key risks.

Infusion of autologous or allogeneic stem cells to restore marrow function after high-dose therapy or to provide a graft-versus-tumor effect. Key considerations include conditioning intensity, graft source, HLA matching, graft-versus-host disease and infection prophylaxis.

Donor immune cells attacking recipient tissues after allogeneic transplantation, affecting skin, gut and liver in acute forms and causing scleroderma-like or sicca features chronically. Prophylaxis uses calcineurin inhibitors with methotrexate or mycophenolate; treatment is corticosteroid-based.

The presence of genetically and phenotypically distinct subclones within one cancer, driving resistance and discordant biomarker results between primary and metastatic sites. It underpins the rationale for rebiopsy at progression and for combination therapy.

Detection and analysis of circulating tumor DNA or cells in blood to identify actionable mutations, monitor response and detect recurrence. It is useful when tissue is scarce but can yield false negatives in low-shedding tumors.

The reciprocal of absolute risk reduction, expressing how many patients must receive an intervention for one additional benefit. It translates trial relative effects into practical clinical magnitude and depends heavily on baseline risk.

The SI unit of absorbed radiation dose, equal to one joule per kilogram. Prescriptions, tolerance limits and dose constraints in radiation oncology are all expressed in gray, often with fractionation specified.

Linear-quadratic model conversions that express different fractionation schedules in biologically equivalent terms. Biologically effective dose and equivalent dose in 2-Gy fractions allow comparison of altered regimens and estimation of late-tissue tolerance.

Delivery of very high ablative doses in few fractions with steep dose gradients and rigorous immobilization and image guidance. It is standard for medically inoperable early non-small cell lung cancer and selected oligometastases, where tumor control depends on high biological dose.

Quantitative limits on dose or volume to normal structures such as spinal cord, lung, heart, kidney and parotid, used in inverse treatment planning to limit toxicity. Constraints derive from published tolerance data and are traded against target coverage.

A technique using inverse planning and dynamic multileaf collimation to shape dose around concave targets while sparing adjacent organs at risk. It requires careful target delineation and image guidance, and carries low-dose spread that matters in reirradiation.

Assessment of estrogen and progesterone receptor expression by immunohistochemistry in breast cancer, reported as percentage of positive nuclei and intensity. Positivity predicts benefit from endocrine therapy and informs chemotherapy decisions in early disease.

Determination of human epidermal growth factor receptor 2 amplification or overexpression by immunohistochemistry and in situ hybridization. Scoring categories guide anti-HER2 therapy eligibility, including newer classifications for low and ultralow expression relevant to antibody-drug conjugates.

A HER2-directed antibody-drug conjugate with a topoisomerase I payload and membrane-permeable linker, active in HER2-positive and HER2-low breast cancer and in gastric and lung cancers. Interstitial lung disease is its most important serious toxicity and requires prompt recognition.

A 21-gene recurrence score assay performed on early hormone receptor-positive, HER2-negative breast tumor tissue. It estimates distant recurrence risk and predicts chemotherapy benefit, helping select patients who can safely avoid adjuvant chemotherapy.

Identification and removal of the first draining node or nodes using dye or radiotracer to stage the axilla or other regional basins while avoiding full dissection. In breast cancer it guides axillary management and reduces lymphedema risk.

Molecular profiling of advanced non-small cell lung cancer for EGFR, ALK, ROS1, BRAF, KRAS G12C, MET, RET and NTRK alterations to guide targeted therapy. It should be completed before first-line systemic treatment in nonsquamous histology.

A third-generation EGFR tyrosine kinase inhibitor that irreversibly targets sensitizing and T790M resistance mutations with good central nervous system penetration. It is standard first-line therapy for EGFR-mutant non-small cell lung cancer and is used adjuvantly after resection.

Pleural fluid containing malignant cells or attributable to cancer, most often from lung or breast cancer, causing dyspnea. Management includes thoracentesis, indwelling pleural catheters and pleurodesis, guided by lung re-expansion and prognosis.

Obstruction of superior vena cava flow by tumor or thrombus, producing facial swelling, distended neck veins and dyspnea, most often from lung cancer or lymphoma. Urgent imaging and tissue diagnosis guide steroids, radiotherapy, stenting or systemic therapy.

Extradural tumor pressure on the spinal cord or cauda equina causing back pain, weakness, sensory loss and sphincter dysfunction. It is an emergency requiring immediate corticosteroids and MRI, followed by surgery or radiotherapy before neurologic deficit becomes irreversible.

A hypermutable state from defective DNA mismatch repair, detected by microsatellite instability testing or loss of mismatch repair protein expression. High instability predicts strong benefit from immune checkpoint inhibitors across tumor types, independent of histology.

An inherited mismatch repair gene defect causing early colorectal and endometrial cancer and other tumors, with microsatellite instability in tumors. Universal tumor screening and germline testing allow surveillance and cascade testing of relatives.

A composite score of bilirubin, albumin, prothrombin time, ascites and encephalopathy that grades hepatic reserve. It determines prognosis and eligibility for resection, transplantation or systemic therapy in hepatocellular carcinoma and guides dose selection.

Locoregional treatment for intermediate-stage hepatocellular carcinoma delivering chemotherapy and embolic particles through hepatic arterial branches, exploiting the tumor's arterial supply. It palliates and prolongs survival in preserved liver function and is combined with systemic agents in selected cases.

A serine protease produced by prostate epithelium, measured in serum for screening, staging and monitoring prostate cancer. Rising levels after local therapy define biochemical recurrence; its lack of specificity for cancer underlies shared decision-making in screening.

Suppression of testicular androgen production by GnRH agonists or antagonists, or surgical orchiectomy, forming the backbone of advanced prostate cancer treatment. Adverse effects include osteoporosis, metabolic syndrome, hot flashes and cardiovascular risk.

Positron emission tomography using ligands binding prostate-specific membrane antigen to localize prostate cancer with high sensitivity, including at low PSA levels. It is used for staging high-risk disease, biochemical recurrence and selecting patients for radioligand therapy.

Classification of epithelial ovarian cancer by interval to recurrence after platinum-based therapy: platinum-sensitive if six months or more, resistant if less. It determines whether retreatment with platinum or alternative agents is appropriate.

An oral agent blocking poly-ADP ribose polymerase, causing synthetic lethality in tumors with homologous recombination deficiency such as BRCA-mutated ovarian, breast and pancreatic cancers. Maintenance therapy prolongs progression-free survival; anemia and myelodysplasia are concerns.

A serum glycoprotein antigen used to monitor epithelial ovarian cancer response and recurrence, though it lacks specificity and can rise with benign conditions. It is not a reliable screening test alone and is interpreted with imaging and clinical status.

Simultaneous delivery of radiation and radiosensitizing chemotherapy, such as cisplatin, used to improve local control in head and neck, cervical, esophageal and lung cancers. It increases mucosal and hematologic toxicity and requires supportive care planning.

Painful inflammation and ulceration of oral or gastrointestinal mucosa from chemotherapy or radiation, impairing nutrition and increasing infection risk. Prevention includes oral care and palifermin in selected settings; management is analgesia, hydration and nutritional support.

Drugs such as all-trans retinoic acid and arsenic trioxide that induce maturation of leukemic cells in acute promyelocytic leukemia, converting a highly fatal disease into one with excellent cure rates. They are combined with aggressive supportive care for coagulopathy.

Structured long-term follow-up for cardiotoxicity, endocrinopathy, growth failure, neurocognitive deficits and second malignancies after pediatric cancer treatment. Risk-adapted guidelines based on cumulative dose and radiation fields guide screening and transition to adult care.

Switching from one opioid to another, or between routes, using equianalgesic dose ratios and then reducing for incomplete cross-tolerance. It is used for uncontrolled pain or dose-limiting toxicity and requires reassessment after 24 hours.

Proportional or continuous use of sedating medication to relieve refractory suffering at the end of life, distinct from euthanasia because intent is symptom relief. It requires informed consent, multidisciplinary agreement and documented goals of care.