APP Intensive on Early-stage NSCLC

CE / CME

ONC APPs Intensive: Adjuvant and Neoadjuvant Therapy in Early-Stage NSCLC: Best Practices for Safe and Effective Delivery of Care

Physician Assistants/Physician Associates: 1.00 AAPA Category 1 CME credit

Nurse Practitioners: 1.00 Nursing contact hours, includes 1.00 hour of pharmacotherapy credit

Released: October 30, 2024

Expiration: October 29, 2025

Tiffany Apana
Tiffany Apana, MSN, FNP-BC
Beth Sandy
Beth Sandy, MSN, CRNP, FAPO

Pretest

Progress
1 2 3
Course Completed
Please answer the questions below.
1.

Case 1: Patient With Localized NSCLC Considering Neoadjuvant/Perioperative Therapy



  • 79-yr-old female with cough, long-term history of smoking

  • CT chest: 5.4 x 4.3 cm left upper lobe (LUL) mass and significant adenopathy

  • PET confirmed avidity

  • Bronchoscopy EBUS: LUL mass

  • Transbronchial lung biopsy (TBBx): adenocarcinoma, 11R, 7, 4L, 11L, negative

  • T3N0M0, stage IIB

  • Plan for neoadjuvant or perioperative therapy

Current minimum recommended biomarker testing to guide treatment decisions for patients with early-stage NSCLC includes which of the following? 

2.

Case 1 Continued: Patient With Localized NSCLC Considering Neoadjuvant/Perioperative Therapy



  • PD-L1 95%

  • Since adenocarcinoma: need to rule out EGFR and ALK

    • Real world delays in biomarker testing

    • Heavy smoker

    • Expedite just EGFR and ALK?



Expedited EGFR and ALK tests were negative. Which of the following would you consider to be the optimal treatment for this patient?

3.

Case 2: Patient Receiving ICI Experiencing Diarrhea



  • A 46-yr-old woman with early-stage NSCLC presents for a routine visit 8 wk after starting ICI monotherapy

  • She reports that she has been experiencing cramping, stomach pain, and 5 episodes per day over baseline of watery, non-bloody diarrhea (grade 2)

  • A colonoscopy suggests immune processes, and her infectious workup is negative

Along with supportive care, which of the following is the optimal next step for management of this patient’s diarrhea?