Roundtable Roundup: Stage IIB Lung Cancer

Peers & Perspectives in OncologyFebruary II, 2024
Volume 2
Issue 3
Pages: 46

In 2 separate live virtual events, Firas B. Badin, MD, MBA, and Sandip P. Patel, MD, review a case of a patient with non–small cell lung cancer with their respective groups and discuss the best options for therapy.


History of present illness

  • A 55-year-old man presented to his primary care physician with intermittent cough and dyspnea on exertion.

Past medical and social history

  • Hyperlipidemia well managed on simvastatin
  • Hypothyroidism controlled on levothyroxine
  • Tobacco use: Recently quit smoking with a 25 pack-year history

Physical examination

  • Pulmonary: Intermittent expiratory wheezing on auscultation
  • Otherwise unremarkable
  • ECOG performance status: 1

Laboratory profile results

  • Complete blood count plus differential, chemistries, and serum creatinine: within normal limits
  • Pulmonary function tests: forced expiratory volume, 1.8 L; diffusing capacity of the lungs for carbon monoxide, 35%

Imaging studies

  • Chest CT: 2.8-cm spiculated right upper lobe mass; 2.1 enlarged right hilar lymph nodes measuring 2.0 cm and 1.5 cm
  • PET: confirmed lung lesion and hilar lymphadenopathy without evidence of distant metastases
  • Brain MRI: negative

Exploratory procedure

  • Bronchoscopy with transbronchial lung biopsy of right upper lobe mass and lymph node sampling revealed adenocarcinoma at primary site with positive hilar lymph nodes
  • Staging: T1cN1M0 (stage IIB)

Molecular testing

  • Next-generation sequencing: no actionable mutations
  • PD-L1 expression: 20%
event region map
Badin roundup poll
Patel roundup poll
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