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EGFR-mutant metastatic NSCLC — SCE Respiratory MCQ

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HardLung CancerEGFR-mutant metastatic NSCLCSCE Respiratory

A 59-year-old never-smoker has metastatic lung adenocarcinoma with an EGFR exon 19 deletion. PD-L1 is 10%, brain MRI shows small asymptomatic metastases and performance status is 1. What is the most appropriate management?

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Correct answer: C — Start first-line EGFR tyrosine kinase inhibitor therapy

Metastatic EGFR-mutant NSCLC is treated first-line with an EGFR tyrosine kinase inhibitor, with CNS-active agents favoured when brain metastases are present. Immunotherapy alone is less effective as initial treatment in EGFR-driven disease. Pneumonectomy is not appropriate for disseminated metastatic cancer.

Reference: NICE NG122 Lung Cancer; NICE Technology Appraisals for EGFR-mutant NSCLC