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SCLC — SCE Medical Oncology MCQ

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HardLung CancerSCLCSCE Medical Oncology

A patient with untreated extensive-stage small-cell lung cancer, liver metastases and ECOG performance status 1 is suitable for combination treatment. Which first-line regimen is NICE recommended?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Atezolizumab with carboplatin and etoposide, followed by atezolizumab maintenance

Explanation lettering: E = shown as A · D = shown as B · A = shown as D · B = shown as E

A is correct. NICE TA638 recommends atezolizumab with carboplatin and etoposide for untreated extensive-stage SCLC in adults with ECOG 0 or 1, followed by maintenance atezolizumab according to the regimen. Topotecan is a relapse treatment, chemotherapy alone omits an available survival-improving component in an eligible patient, pembrolizumab-irinotecan is not the commissioned regimen, and pemetrexed has no maintenance role in SCLC. Brain imaging, thoracic-radiotherapy and prophylactic-cranial-irradiation decisions remain separate and depend on response, age, fitness and surveillance strategy.

Reference: NICE TA638 atezolizumab in extensive-stage SCLC: https://www.nice.org.uk/guidance/ta638/chapter/1-Recommendations