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NSCLC — SCE Medical Oncology MCQ

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HardLung CancerNSCLCSCE Medical Oncology

A patient taking osimertinib for EGFR exon-19-deleted metastatic NSCLC has syncope. ECG shows QTc 525 ms, potassium is 3.0 mmol/L and a new QT-prolonging antiemetic was started yesterday. What is the best immediate oncology action?

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Correct answer: C — Interrupt osimertinib, correct potassium and remove the interacting antiemetic before ECG reassessment

A QTc above 500 ms with syncope and hypokalaemia requires interruption of osimertinib, correction of potassium and interacting QT-prolonging medicines, and repeat assessment. Continuing or increasing treatment is unsafe; an immediate switch before correcting reversible causes is premature, and QT prolongation is a recognised SmPC risk.

Reference: Tagrisso UK SmPC. https://www.medicines.org.uk/emc/product/7615/smpc