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
  • EGFRnegative,KRASnegative
  • IHC negative forALK-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