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Exam Review

Key Facts: BCOP Exam

150

Total Questions

BCOP format

3h 45m

Exam Time

BCOP format

500/800

Passing Score

Scaled scoring

49%

Therapeutics Domain

Largest domain

$600

Exam Fee

BPS 2026

7 years

Certification Valid

Recertification cycle

The BCOP exam has 150 multiple-choice items (125 scored, 25 unscored) in 3 hours 45 minutes, scored on a 200-800 scale with 500 to pass. The current content outline covers Oncology Diagnosis and Testing (23%), Therapeutics and Patient Management (49%), and Professional Practice (28%). BPS reported a 47.9% pass rate for first-time BCOP candidates in 2025 continuous testing. Eligibility requires an active pharmacist license plus, within the past 7 years, 4 years of oncology practice, a PGY1 residency and 2 years of oncology practice, or a PGY2 oncology residency. Certification runs on a 7-year recertification cycle.

Sample BCOP Practice Questions

Try these sample questions to review concepts for the BCOP exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 244+ question experience with AI tutoring.

1Which proto-oncogene, when mutated, is most commonly associated with non-small cell lung cancer (NSCLC) and is a target for tyrosine kinase inhibitors?
A.KRAS
B.EGFR
C.BRAF
D.ALK
Explanation: EGFR (Epidermal Growth Factor Receptor) mutations are found in approximately 10-15% of NSCLC cases in Western populations and up to 40% in Asian populations. EGFR tyrosine kinase inhibitors (TKIs) like osimertinib, gefitinib, and erlotinib are first-line treatments for EGFR-mutant NSCLC. KRAS mutations are also common but were historically undruggable until recent KRAS G12C inhibitors.
2Which tumor marker is elevated in ovarian cancer and is used primarily for monitoring response to therapy and detecting recurrence?
A.CA 19-9
B.CEA
C.CA 125
D.AFP
Explanation: CA 125 (Cancer Antigen 125) is the primary tumor marker for epithelial ovarian cancer. It is elevated in approximately 80% of advanced ovarian cancers and is used to monitor treatment response and detect recurrence. It is not used for screening due to low specificity. CA 19-9 is primarily used for pancreatic cancer, CEA for colorectal cancer, and AFP for hepatocellular carcinoma and germ cell tumors.
3Which genetic syndrome is associated with mutations in the BRCA1 or BRCA2 genes and significantly increases the risk of breast and ovarian cancers?
A.Lynch syndrome
B.Hereditary Breast and Ovarian Cancer syndrome
C.Li-Fraumeni syndrome
D.Familial adenomatous polyposis
Explanation: Hereditary Breast and Ovarian Cancer (HBOC) syndrome is caused by pathogenic variants in BRCA1 or BRCA2 genes. BRCA1 carriers have up to 72% lifetime risk of breast cancer and 44% risk of ovarian cancer. BRCA2 carriers have approximately 69% and 17% risks respectively. Lynch syndrome is associated with colorectal and endometrial cancer (MLH1, MSH2, MSH6, PMS2, EPCAM).
4What is the mechanism by which p53 functions as a tumor suppressor gene?
A.Promoting cell cycle progression
B.Inducing apoptosis in response to DNA damage
C.Activating angiogenesis
D.Inhibiting DNA repair mechanisms
Explanation: The p53 tumor suppressor gene, often called the "guardian of the genome," induces cell cycle arrest and apoptosis in response to DNA damage. When activated by cellular stress, p53 can halt the cell cycle to allow DNA repair or trigger programmed cell death if damage is irreparable. Loss of p53 function is one of the most common genetic alterations in human cancers.
5Which molecular alteration defines Philadelphia chromosome-positive (Ph+) chronic myeloid leukemia (CML)?
A.BCR-ABL1 fusion
B.JAK2 V617F mutation
C.FLT3-ITD mutation
D.PML-RARA fusion
Explanation: The Philadelphia chromosome results from a reciprocal translocation t(9;22)(q34;q11) creating the BCR-ABL1 fusion gene. This produces a constitutively active tyrosine kinase that drives CML pathogenesis. Tyrosine kinase inhibitors (TKIs) like imatinib, dasatinib, and nilotinib target this fusion protein. JAK2 V617F is associated with myeloproliferative neoplasms, and PML-RARA is found in acute promyelocytic leukemia.
6Which tumor marker is most appropriate for monitoring response to treatment in testicular germ cell tumors?
A.PSA
B.CA 125
C.LDH, β-hCG, and AFP
D.CEA
Explanation: Testicular germ cell tumors are monitored using a combination of tumor markers: lactate dehydrogenase (LDH), beta-human chorionic gonadotropin (β-hCG), and alpha-fetoprotein (AFP). AFP is elevated in non-seminomatous germ cell tumors, β-hCG in both seminomas and non-seminomas, and LDH indicates tumor burden. PSA is used for prostate cancer monitoring.
7What is the primary mechanism of carcinogenesis associated with chronic Helicobacter pylori infection?
A.Direct DNA damage by bacterial toxins
B.Chronic inflammation leading to cellular proliferation
C.Insertion of viral oncogenes
D.Inhibition of apoptosis via p53 mutation
Explanation: Chronic H. pylori infection causes chronic gastritis, leading to increased cellular proliferation, oxidative stress, and DNA damage over time. This chronic inflammatory environment promotes carcinogenesis. H. pylori is classified as a Class I carcinogen and is associated with gastric adenocarcinoma and MALT lymphoma. Eradication therapy can reduce cancer risk.
8Which gene fusion is characteristic of acute promyelocytic leukemia (APL) and is targeted by all-trans retinoic acid (ATRA)?
A.BCR-ABL1
B.PML-RARA
C.AML1-ETO
D.CBFB-MYH11
Explanation: APL is defined by the t(15;17) translocation creating the PML-RARA fusion gene. The PML-RARA protein blocks myeloid differentiation. All-trans retinoic acid (ATRA) overcomes this blockade, inducing differentiation of leukemic promyelocytes. Arsenic trioxide is also highly effective in APL. APL is a medical emergency due to risk of disseminated intravascular coagulation.
9What percentage of cancer cases are estimated to be attributable to inherited genetic mutations?
A.Less than 5%
B.5-10%
C.15-20%
D.25-30%
Explanation: Approximately 5-10% of all cancers are caused by inherited genetic mutations (germline mutations). The majority of cancers (90-95%) result from somatic mutations acquired throughout life due to environmental factors, aging, and random errors during DNA replication. However, understanding hereditary cancer syndromes is critical for risk assessment and prevention.
10Which angiogenic factor is the primary target of bevacizumab in cancer therapy?
A.EGFR
B.HER2
C.VEGF-A
D.PDGFR
Explanation: Bevacizumab is a monoclonal antibody that targets Vascular Endothelial Growth Factor A (VEGF-A), inhibiting angiogenesis (new blood vessel formation) required for tumor growth. It is approved for multiple cancers including colorectal, lung, ovarian, and glioblastoma. Common adverse effects include hypertension, proteinuria, and increased risk of bleeding.

About the BCOP Exam

The BCOP certification is a specialized credential for pharmacists specializing in oncology pharmacy. The exam covers 4 domains: Pathophysiology and Molecular Biology of Cancer (20%), Therapeutics, Patient Management, and Education (38%), Healthcare Systems and Professional Practice (17%), and Emerging Topics (25%). The exam consists of 150 items over 3 hours 40 minutes.

Exam sponsor: Board of Pharmacy Specialties (BPS). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

150 questions

Time Limit

3 hours 45 minutes

Passing Score

500/800 (scaled)

Exam / Certification Fees

$600

Exam sponsor website

Reported exam pass rate: 54-65%. varies by testing cycle This describes exam candidates, not OpenExamPrep users or results from using our resources. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

23%

Oncology Diagnosis and Testing

Oncology diagnosis (9%); oncology testing, including genomics, prognostic and predictive tests, next-generation sequencing and biomarkers (9%); cancer detection and prevention (5%)

49%

Therapeutics and Patient Management

Treatment planning, including supportive, end-of-life and survivorship care (16%); therapeutic implementation, including pharmacotherapy, pharmacogenomics and patient education (16%); cancer outcomes and treatment monitoring, including toxicities, oncologic emergencies and cellular therapy complications (17%)

28%

Professional Practice

Clinical trials and research, including statistics, IRBs, drug approval and investigational drug management (14%); practice management, including quality, hazardous drug handling, REMS, compassionate use and biosimilars (14%)

Preparing for the BCOP Exam

What You Need to Know

  • Passing score: 500/800 (scaled)
  • Exam length: 150 questions
  • Time limit: 3 hours 45 minutes
  • Exam / certification fees: $600 Official sources

Using Our Practice Resources

  • Work through all 244 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

BCOP: Suggested Study Strategy

1Master molecular biology and genetic testing - understand EGFR, ALK, BRAF, KRAS, PIK3CA and their targeted therapies
2Know chemotherapy mechanisms, toxicities, and management (anthracycline cardiotoxicity, platinum neurotoxicity, etc.)
3Study immunotherapy mechanisms and immune-related adverse events (irAEs) management
4Understand supportive care: antiemetics (NCCN guidelines), growth factors, bone-modifying agents
5Stay current with emerging therapies: CAR-T, bispecific antibodies, ADCs, KRAS inhibitors, and tumor-agnostic approvals

Frequently Asked Questions

What is the BCOP pass rate?

BPS reported a 47.9% pass rate for first-time BCOP candidates (225 of 470) in its 2025 continuous testing results, and 42.9% across all certification candidates. Scores are scaled from 200 to 800, and 500 is required to pass.

How many questions are on the BCOP exam?

The BCOP exam has 150 multiple-choice items (125 scored and 25 unscored) and an administration time of 3 hours 45 minutes. It covers three domains: Oncology Diagnosis and Testing (23%), Therapeutics and Patient Management (49%), and Professional Practice (28%).

What are the BCOP eligibility requirements?

To sit for the BCOP exam you need (1) graduation from an ACPE-accredited pharmacy program, or a program outside the US that qualifies you to practice, (2) a current, active pharmacist license or registration, and (3) within the past 7 years, one of: at least 4 years of oncology pharmacy practice, a PGY1 residency plus at least 2 years of oncology pharmacy practice, or a PGY2 oncology pharmacy residency. Practice experience must come after licensure, with at least 50% of time in the scope of the exam content outline.

How long is BCOP certification valid?

BCOP certification runs on a 7-year cycle. For cycles beginning January 1, 2024 or later, you recertify either by passing the recertification exam and reporting 20 units of continuing professional development, or by earning 100 units (at least 80 units of assessed CPE from BPS-approved ASHP/ACCP or HOPA programs and up to 20 units of self-reported CPD). At least two units must be reported each year.

What are the best study resources for BCOP?

Recommended BCOP study resources include: NCCN Guidelines, ASCO Education materials, BCOP Review Course by HOPA, Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice, and specialty pharmacy oncology resources. Plan for 4-6 months of study time. Focus on molecular biology, novel therapeutics, and supportive care.

How should I prepare for the BCOP exam?

Study systematically across all three domains: Oncology Diagnosis and Testing (23%), Therapeutics and Patient Management (49%), and Professional Practice (28%). Focus on molecular targets, chemotherapy mechanisms, targeted therapy, immunotherapy, and supportive care. Stay current with new approvals and emerging therapies. Complete at least 2000 practice questions.