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Lung Cancer Case Studies

Case Studies: Considering Triplet Therapy for Nondriver NSCLC

Anne Tsao, MD, reviews the case of a 64-year-old woman who presents with nondriver non–small cell lung cancer and provides considerations for treatment.

Considering Triplet Therapy for Nondriver NSCLC

A 64-Year-Old Woman With Metastatic NSCLC

  • A 64-year-old woman reported having cough and shortness of breath on exertion for the past 2 years, but now having persistent symptoms even without exertion.
    • PE: revealed diminished breath sounds and minimal expiratory wheezing in right lung; not physically fit
    • PMH: mild hypertension well managed on lisinopril
    • SH: smoker, 15 pack-years
  • CT scan revealed 2 masses in RUL and several small masses in the liver
  • Biopsy of right lung mass confirmed grade 2 adenocarcinoma
    • EGFR negative, KRAS negative
    • IHC negative for ALK-rearrangement, ROS1-rearrangement
    • PD-L1 TPS: 56%
  • PET scan showed multiple areas of FDG uptake in liver, SUVmax, 7.8
  • Brain MRI, negative for metastases
  • Diagnosis: stage IV lung adenocarcinoma
  • Patient started on treatment with pembrolizumab/pemetrexed/carboplatin
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