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Case Challenge: NSCLC

CE / CME

Biomarker Testing in Patients With Solid Tumors: Interactive Case Challenge for NSCLC

Nurse Practitioners/Nurses: 0.50 Nursing contact hours, includes 0.50 hour of pharmacotherapy credit

Physician Assistants/Physician Associates: 0.50 AAPA Category 1 CME credit

Released: June 16, 2026

Expiration: December 15, 2026

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Case Follow-up 2
At her 2-week follow-up, the patient confirms she received and is taking her EGFR-targeted therapy once daily as prescribed. She reports no missed doses, no new or worsening respiratory symptoms, and no concerning adverse events (AEs). Laboratory results are acceptable, so therapy will continue. She will return in approximately 1 month for reassessment, with restaging imaging planned approximately 6 weeks later, roughly 3 months after treatment initiation, unless earlier evaluation is needed.

At a much later follow-up visit, after approximately 2 years on EGFR-directed therapy, routine imaging shows asymptomatic disease progression with new liver metastases. The nurse practitioner explains that the cancer may have developed resistance to treatment and discusses the need for additional biomarker testing before choosing the next therapy.

What would you tell her is the next best step in her care after asymptomatic disease progression while receiving osimertinib for EGFR-mutated metastatic lung cancer?