A patient with metastatic PD-L1-high NSCLC has Hashimoto hypothyroidism controlled on a stable levothyroxine dose, no other autoimmune disease and

Question

A patient with metastatic PD-L1-high NSCLC has Hashimoto hypothyroidism controlled on a stable levothyroxine dose, no other autoimmune disease and normal performance status. What is the best interpretation when considering pembrolizumab?

Accepted Answer

Proceed with pembrolizumab after risk discussion, baseline assessment and enhanced monitoring

Answer

Delay systemic therapy until thyroid autoantibodies become undetectable on treatment

Answer

Proceed with pembrolizumab only while receiving prophylactic prednisolone and thyroid replacement

Answer

Use platinum chemotherapy first and reserve pembrolizumab for disease progression

Answer

Proceed with pembrolizumab using the same monitoring schedule as any patient

NSCLC — SCE Medical Oncology MCQ

A patient with metastatic PD-L1-high NSCLC has Hashimoto hypothyroidism controlled on a stable levothyroxine dose, no other autoimmune disease and normal performance status. What is the best interpretation when considering pembrolizumab?