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PD-L1 high metastatic NSCLC — SCE Respiratory MCQ

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ModerateLung CancerPD-L1 high metastatic NSCLCSCE Respiratory

A 66-year-old woman with metastatic squamous NSCLC has PD-L1 tumour proportion score 80%, no targetable driver alteration and ECOG performance status 0. She has no autoimmune disease. What is the most appropriate management?

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Correct answer: C — First-line immune checkpoint inhibitor-based systemic therapy

High PD-L1 metastatic NSCLC without a driver mutation is a setting where immune checkpoint inhibitor-based therapy is appropriate if performance status is good. EGFR inhibitors require an EGFR mutation and surgery is not curative in metastatic disease. Steroids are not anticancer therapy and squamous histology does not exclude immunotherapy.

Reference: NICE NG122; NICE immunotherapy technology appraisals