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Chapter 90. Lung Cancer

Student Questions

All of the following scenarios are consistent with a recommendation to be screened with a low-dose CT scan for lung cancer (according to the recent guidelines)?

A. A 45-year-old man who has smoked a pack a day since the age of 13 years

B. A 65-year-old woman with a 40 pack–year smoking history, who quit smoking 10 years ago

C. A 50-year-old coal miner whose father and brother died of lung cancer in their 60s

D. All of the above fit the screening criteria

Answer: B

Option A: Incorrect. This patient is too young to meet the screening criteria.

Option B: Correct. This patient meets the inclusion criteria for the lung cancer screening trial and the subsequent recommendations.

Option C: Incorrect. This person does not meet the smoking risk requirements for the screening criteria.

Option D: Incorrect. Since answer options A and C are wrong, this option is incorrect.

Treatment options for a patient with stage IV adenocarcinoma and an ECOG PS score of 3 may include all of the following EXCEPT:

A. Palliative radiotherapy

B. Surgical resection of a distant metastasis causing symptoms

C. Platinum-containing doublet chemotherapy

D. Single agent targeted agent

E. Treatment of comorbidities to improve performance

Answer: C

Option A: Incorrect. Palliative radiation to help with symptoms like pain is appropriate.

Option B: Incorrect. Surgery to relieve symptoms due to a metastatic lesion is appropriate.

Option C: Correct. A platinum doublet should not be given to a lung cancer patient with an ECOG performance status of 3 due to little/no benefit, but almost certain toxicity.

Option D: Incorrect. A targeted agent with a high response rate and less toxicity than cytotoxic therapy could appropriately be used.

A newly diagnosed well-performing stage IV adenocarcinoma NSCLC patient with a mutation in exon 19 of the EGFR gene should be treated with:

A. Cetuximab

B. Cisplatin-gemcitabine

C. Afatinib

D. Alectinib

E. Osimertinib

Answer: C

Option A: Incorrect. Cetuximab is not used to treat ...

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