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NSCLC — SCE Medical Oncology MCQ

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ModerateLung CancerNSCLCSCE Medical Oncology

A 60-year-old man with stage II-IIIA NSCLC (EGFR/ALK wild-type) is discussed at the lung MDT. Recent trial data supports a perioperative immunotherapy approach. The KEYNOTE-671 trial evaluated which strategy?

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Correct answer: D — Neoadjuvant pembrolizumab + cisplatin-based chemotherapy followed by surgery and adjuvant pembrolizumab

KEYNOTE-671 evaluated the perioperative approach: neoadjuvant pembrolizumab + cisplatin-doublet chemotherapy (4 cycles pre-op) followed by surgery then adjuvant pembrolizumab (up to 13 cycles post-op). It demonstrated significant EFS and OS benefit over neoadjuvant chemotherapy alone in resectable stage II-IIIB(N2) NSCLC. This differs from CheckMate 816 (neoadjuvant only) and IMpower010 (adjuvant only). The perioperative approach addresses both micrometastatic and residual disease.

Reference: ESMO 2024 NSCLC Guidelines; KEYNOTE-671 Wakelee et al NEJM 2024