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EGFR-mutated metastatic NSCLC — SCE Respiratory MCQ

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HardLung CancerEGFR-mutated metastatic NSCLCSCE Respiratory

A 72-year-old man with metastatic lung adenocarcinoma has EGFR exon 19 deletion on molecular testing. ECOG performance status is 1 and brain MRI shows two small asymptomatic metastases. What is the most likely diagnosis?

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Correct answer: E — EGFR-mutated metastatic lung adenocarcinoma with CNS involvement

The histology, metastatic distribution and EGFR exon 19 deletion define EGFR-mutated metastatic lung adenocarcinoma with brain metastases. Small-cell cancer and ALK-rearranged disease are different molecular and histological entities. Stage I disease and benign adenoma are excluded by metastatic CNS involvement and malignant histology.

Reference: NICE NG122; NICE EGFR inhibitor technology appraisals