Lung cancer treatment

Question 1

What is a regimen used to treat limited SCLC

Answer 1

Cisplatin + etoposide

(carboplatin + etoposide)

Question 2

Regimen to treat extensive SCLC

Answer 2

No radiation!!

atezolizumb + carboplatin + etoposide

Durvalumab + carboplatin + etoposide

Question 3

WHat are some adjuvant chemo options before surgery for resectable stage III/IV NSCLC pts

Answer 3

for non squamous- cis platin + pemetrexed

for squamous- cisplatin + gemcitabine
cisplatin + docetaxel

Question 4

How to treat unresectable NSCLC stage III/IV

Answer 4

radiation/chemo

cisplatin/paclitaxel
cisplatin/gemcitabine
cisplatin/docetaxel
carboplatin/paclitaxel

Question 5

How to treat metastatic non squamous disease with no targettable mutation

Answer 5

if there is a targetable mutation (T790M, BRAF, ALK) use them before progressing to immunotherapy

if no mutation

Check PDL-1 status

1) if PDL status is between 1-49
a) pembrolizumab (check PS if we can use chemo)

2) if PDL status >50
a) pembrolizumab or
b) Pembrolizumab + chemo
c)atezolizumab

3) if PDL-1 negative,
carboplatin + pemetrexed + pembrolizumab

Question 6

How to treat metastatic squamous NSCLC

Answer 6

if contraindication to immuno therapy- platinum doublet

if no contraindication to immunotherapy
-pembrolizumab + carboplatin + paclitaxel

Question 7

side effects with immunotherapy

Answer 7

• itis

(hepatitis, pneumonitis, nephritis)