88.3 🩺 內科專科考前版

88.3.0.1 📌 䞀頁重點

  • 22E: NALIRIFOX 1st line (NAPOLI-3), olaparib BRCA maintenance, KRAS G12C/G12D drugs emerging, neoadjuvant chemo for resectable, multi-omic profiling
  • Taiwan: 健保 FOLFIRINOX, gem+nab, nano-liposomal irinotecan; BRCA testing 限制

88.3.0.2 🌟 Pearls (10)

  1. NALIRIFOX new 1st line (NAPOLI-3 — improved OS vs gem+nab)
  2. Olaparib maintenance for BRCA mutant (POLO)
  3. Adagrasib + sotorasib for KRAS G12C (rare in PDAC ~1-3%)
  4. KRAS G12D inhibitors in trials
  5. Neoadjuvant chemo preferred for resectable now
  6. Modified FOLFIRINOX adjuvant (PRODIGE 24) — best DFS but toxicity
  7. CA 19-9 trend for response monitoring
  8. Liposomal irinotecan for 2nd line (NAPOLI 1)
  9. Cancer-associated thrombosis prophylaxis (LMWH)
  10. Pancreatic enzyme replacement (PERT) standard post-resection

88.3.0.3 📍 Taiwan

  • 健保 FOLFIRINOX gem+nab adjuvant + advanced
  • 健保 nano-liposomal irinotecan 2nd line
  • 健保 olaparib BRCA 限制
  • 健保 PERT for pancreatic insufficiency
  • 健保 ERCP biliary stent
  • BRCA panel 條件
  • DAA + HBV antiviral 呚邊章節盞關

88.3.0.4 🎓 內專重點

  1. PDAC 預埌差䜆有進展
  2. Risk genes (BRCA, PALB2, Lynch, STK11)
  3. Resectability criteria
  4. FOLFIRINOX vs gem+nab vs NALIRIFOX
  5. POLO maintenance BRCA
  6. KRAS G12C/G12D (22E)
  7. CA 19-9 + Lewis-neg

⚠ AI 草皿。