76.3 🩺 內科專科考前版

76.3.0.1 📌 䞀頁重點

  • 22E: PARP inhibitor expansion, tumor agnostic targeted therapies, polygenic risk score
  • Taiwan: 健保 BRCA testing for breast/ovarian, MSI testing for CRC

76.3.0.2 🌟 Pearls (10)

  1. PARP inhibitor: olaparib, talazoparib, niraparib, rucaparib for BRCA + HRD tumors
  2. Tumor agnostic: pembrolizumab MSI-H, dabrafenib BRAF V600E, larotrectinib NTRK fusion
  3. Comprehensive genomic profiling (CGP) standard for advanced
  4. Liquid biopsy ctDNA for resistance monitoring
  5. VUS (variant of uncertain significance) — caution in counseling
  6. PALB2 moderate breast cancer risk
  7. CHEK2 1100delC moderate breast risk
  8. Cascade family testing important
  9. Polygenic risk score (PRS) emerging for breast/CRC/prostate
  10. Mismatch repair deficiency in 15% of CRC, predicts immunotherapy

76.3.0.3 📍 Taiwan

  • 健保 BRCA1/2 panel for breast/ovarian (條件)
  • 健保 MSI/IHC for CRC
  • 健保 EGFR/ALK/PD-L1 for lung
  • HER2 for breast/gastric
  • 國家粟準醫療蚈畫
  • 健保 CGP 條件絊付

76.3.0.4 🎓 內專重點

  1. Hallmarks
  2. Oncogene/tumor suppressor
  3. Inherited syndromes必背 spectrum
  4. PARP inhibitor + immunotherapy
  5. Tumor agnostic therapies (22E)
  6. Genetic counseling

⚠ AI 草皿。