77.3 🩺 內科專科考前版

77.3.0.1 📌 䞀頁重點

  • 22E: synthetic lethality (PARP), targeted protein degradation (PROTAC), mRNA cancer vaccines
  • Taiwan: 健保 CDK4/6, BCL-2, BRAF/MEK, PD-1/PD-L1 inhibitors

77.3.0.2 🌟 Pearls (10)

  1. Synthetic lethality: PARP + BRCA = HR-deficient lethal
  2. PROTAC (proteolysis-targeting chimera) emerging for “undruggable” targets
  3. Tumor-agnostic therapies: pembrolizumab MSI-H, larotrectinib NTRK fusion, dabrafenib BRAF V600E
  4. mRNA cancer vaccines (BioNTech, Moderna trials)
  5. CAR-T for hematologic malignancies
  6. BiTE (bispecific T cell engager): blinatumomab, mosunetuzumab
  7. Antibody-drug conjugate (ADC): T-DXd, sacituzumab, polatuzumab
  8. Tumor mutational burden (TMB) predicts immunotherapy response
  9. Microsatellite instability (MSI-H) universal CRC screening
  10. Liquid biopsy ctDNA for monitoring + early detection

77.3.0.3 📍 Taiwan

  • 健保 CDK4/6 (palbociclib, ribociclib, abemaciclib) for breast
  • 健保 BRAF/MEK for melanoma + NSCLC
  • 健保 PD-1/PD-L1 倚 cancer
  • 健保 CGP NGS panel 條件
  • 健保 CAR-T 限制

77.3.0.4 🎓 內專重點

  1. Cell cycle + CDK4/6
  2. Apoptosis + BCL-2
  3. Major signaling (MAPK, PI3K, JAK)
  4. Targeted therapies
  5. Immunotherapy era
  6. Tumor agnostic (22E)

⚠ AI 草皿。