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NSCLC — SCE Medical Oncology MCQ

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HardLung CancerNSCLCSCE Medical Oncology

After R0 lobectomy and systematic nodal staging, a fit patient has a 2.5 cm pT1cN0M0 lung adenocarcinoma with no actionable alteration. What postoperative systemic treatment is indicated?

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Correct answer: E — No adjuvant systemic therapy; enter surveillance after recovery

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

E is correct. Completely resected stage IA2 pT1cN0 NSCLC does not meet UK criteria for adjuvant platinum chemotherapy, targeted therapy or adjuvant immunotherapy. Grade contributes prognostic information but does not override stage and size eligibility. Atezolizumab and pembrolizumab are used only in defined higher-risk resected populations, and osimertinib requires an eligible EGFR mutation. Surveillance is active follow-up rather than therapeutic nihilism and should include smoking support and management of postoperative health. The original concept was sound; this version removes ambiguous references to broad stage I disease and makes the ineligibility determinants explicit.

Reference: NICE NG122 lung cancer management: https://www.nice.org.uk/guidance/ng122/chapter/Management