NSCLC — SCE Medical Oncology MCQ

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HardLung CancerNSCLCSCE Medical Oncology

A 69‑year‑old man with stage III NSCLC has completed concurrent platinum‑based chemoradiation and is being considered for durvalumab consolidation. PD‑L1 TPS is <1%. According to current UK (NICE/EMA) guidance, is he eligible for durvalumab?

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Correct answer: D — No — durvalumab requires PD‑L1 TPS ≥1%

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

NICE TA798 (June 2022) recommends durvalumab only for patients whose tumours express PD‑L1 ≥1% and who have no disease progression after concurrent platinum‑based chemoradiation ([nice.org.uk](https://www.nice.org.uk/guidance/ta798/chapter/1-Recommendations?utm_source=openai)). The UK SmPC (eMC) equally specifies indication limited to PD‑L1 ≥1% following chemoradiation ([medicines.org.uk](https://www.medicines.org.uk/emc/product/9495/smpc?utm_source=openai)). Therefore, with PD‑L1 TPS <1%, the patient is not eligible (Option A). Options B, C and D conflict with both guidance and licensing. Option E incorrectly applies a ≥50% threshold which is not relevant to this setting.

Reference: NICE TA798 (Durvalumab after platinum-based chemoradiation for unresectable stage III NSCLC, June 2022) and Imfinzi SmPC (eMC, current), https://www.nice.org.uk/guidance/ta798/chapter/1-Recommendations