1. Use the following CASE to answer questions 1 through 5:
JS is a 63-year-old male with newly diagnosed metastatic non-squamous non–small-cell lung cancer (NSCLC). His past medical history includes benign prostatic hypertrophy, depression, hypertension, and hyperlipidemia. His liver biopsy reveals that the metastatic lung tumor is negative for EGFR, ALK, ROS1, RET, MET, and BRAF mutations. His Eastern Cooperative Oncology Group (ECOG) performance status is 1. PD-L1 testing showed PD-L1 expression of 5%. A brain magnetic resonance imaging (MRI) study is negative. His organ and laboratory function are within normal limits.

Based on the information provided, which of the following is the most appropriate treatment for JS’s metastatic non-squamous NSCLC?

2. The combination of Nivolumab and Ipilimumab relative to chemotherapy alone for the frontline treatment of advanced NSCLC with PD-L1>1% has been associated with which of the following outcomes?

3. JS is deciding which treatment he would like to pursue and he is concerned about the potential toxicity associated with adding chemotherapy to immunotherapy. Which of the following statements is TRUE regarding the side effects associated with combination chemotherapy/immunotherapy compared to chemotherapy alone in the KEYNOTE-189 trial?

4. After multiple discussions with his oncologist, JS decides to initiate treatment with carboplatin + pemetrexed + pembrolizumab. Prior to the initiation of his 3rd cycle of chemo/immunotherapy, JS reports significant abdominal cramping and 5 loose bowel movements (BMs) daily over the last 3 days. JS reports his baseline is 1 BM daily. After evaluation by his oncologist, he is diagnosed with grade 2 colitis. What would be the appropriate next step?

5. After 72 hours of prednisone therapy, JS reports he is now having 6 BMs daily. What would be an appropriate next step for the treatment of JS's colitis?

Evaluation Questions

6. How confident are in your treatment management of JS in the post-test?

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