Molecular Markers and Targeted Therapies in the Management of Non-Small Cell Lung Cancer
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Viola W. Zhu, MD, PhD
Assistant Clinical Professor of Medicine, Chao Family Comprehensive Cancer Center, Division of Hematology/Oncology, University of California, Irvine School of Medicine, Orange, CA; and Hematology/Oncology Section, VA Long Beach Healthcare System, Long Beach, CA

Sai-Hong Ignatius Ou, MD, PhD
Clinical Professor of Medicine, Chao Family Comprehensive Cancer Center, Division of Hematology/Oncology, University of California, Irvine School of Medicine, Orange, CA

Question 1 of 5

Questions 1 and 2 refer to the following case:

A 58-year-old Hispanic man who is a nonsmoker presents to the emergency room for shortness of breath and left-sided shoulder pain for several months. A computed tomography (CT) scan of the chest with contrast shows a large pleural effusion and multiple pleural nodular masses up to 3.5 cm. He undergoes diagnostic bronchoscopy and left-sided video-assisted thoracoscopic surgery, drainage of the pleural effusion, and placement of a tunneled pleural catheter. Pathology from the pleural mass biopsy reveals adenocarcinoma of lung primary. Comprehensive molecular profiling shows EGFR L858R mutation. Staging workup including positron emission tomography (PET)/CT and magnetic resonance imaging (MRI) of the brain with and without contrast does not show any distant metastases.

Which of the following would be the most appropriate next step?  

PDL-1 testing on biopsied specimen

Consult radiation oncology

Initiate elotinib or gefitinib

Initiate platinum doublet chemotherapy

Initiate crizotinib

Hospital Physician: Hematology/Oncology. 2017 July;12(4)

This quiz is not accredited for CME.

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