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EGFR-mutated metastatic NSCLC — SCE Respiratory MCQ

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ModerateLung CancerEGFR-mutated metastatic NSCLCSCE Respiratory

A 58-year-old woman with metastatic lung adenocarcinoma has no smoking history. Biopsy confirms non-squamous NSCLC and molecular testing shows an EGFR exon 19 deletion. PD-L1 is 10%. ECOG performance status is 1. What is the most appropriate management?

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Correct answer: A — First-line EGFR tyrosine kinase inhibitor therapy

EGFR-mutated metastatic non-squamous NSCLC should receive first-line EGFR-targeted therapy when suitable. Immunotherapy monotherapy is not preferred when an actionable EGFR driver is present and PD-L1 is low. Surgery is not curative in metastatic disease, and pleurodesis may palliate effusion but is not systemic treatment.

Reference: NICE NG122 Lung cancer; NICE technology appraisals for EGFR-mutated NSCLC