Non-Small Cell Lung Cancer — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateMedical OncologyNon-Small Cell Lung CancerRACP Adult Medicine

A 65-year-old man with metastatic non-small cell lung cancer (adenocarcinoma, PD-L1 TPS ≥50%, no driver mutations) presents for first-line treatment discussion. What is the most appropriate first-line systemic therapy?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Pembrolizumab monotherapy

For metastatic NSCLC with PD-L1 TPS ≥50% and no actionable driver mutations (EGFR, ALK, ROS1), pembrolizumab monotherapy is standard first-line treatment based on the KEYNOTE-024 trial, which demonstrated superior overall survival compared to platinum-based chemotherapy. PBS-listed for this indication in Australia.

Reference: Cancer Council Australia – 2021 – Optimal Care Pathway for Lung Cancer; PBS – 2025 – Pembrolizumab Listing