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NSCLC — SCE Medical Oncology MCQ

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HardLung CancerNSCLCSCE Medical Oncology

A patient with untreated metastatic squamous NSCLC has PD-L1 TPS 75%, no actionable driver, ECOG 1 and rapidly worsening central airway obstruction requiring a prompt response. Which first-line approach best reflects the clinical distinction discussed in NICE TA770?

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Correct answer: B — Pembrolizumab plus carboplatin-paclitaxel for the required rapid response

For metastatic squamous NSCLC with PD-L1 TPS at least 50%, pembrolizumab monotherapy is often appropriate. TA770 nevertheless records that clinicians use pembrolizumab plus carboplatin-paclitaxel when a rapid response is required. The airway obstruction supplies that discriminator. Platinum chemotherapy alone omits an indicated active component, while docetaxel and nivolumab monotherapy are not the relevant first-line choices.

Reference: NICE TA770 pembrolizumab with carboplatin and paclitaxel for untreated metastatic squamous NSCLC (Published March 2022): https://www.nice.org.uk/guidance/ta770/chapter/3-Committee-discussion