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Stage III NSCLC — SCE Respiratory MCQ

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HardLung CancerStage III NSCLCSCE Respiratory

A patient with asthma has a first acute exacerbation of newly diagnosed allergic bronchopulmonary aspergillosis without bronchiectatic infection or contraindication. Which initial disease-directed treatment is acceptable?

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Correct answer: B — Oral prednisolone or oral itraconazole monotherapy

Current specialist guidance accepts a finite course of oral prednisolone or itraconazole monotherapy for an acute ABPA episode. Combination therapy is generally reserved for recurrent exacerbations or selected high-risk disease. Total IgE is followed as a response marker but does not need to normalise.

Reference: BTS Clinical Statement on Aspergillus-related chronic pulmonary disease (Published May 2025): https://www.brit-thoracic.org.uk/document-library/clinical-statements/aspergillus-related-chronic-pulmonary-disease/aspergillus-related-chronic-pulmonary-disease/; Revised ISHAM-ABPA working-group guideline (Published 2024): https://pmc.ncbi.nlm.nih.gov/articles/PMC10991853/