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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
The patient begins carboplatin plus pemetrexed while broad-panel NGS results are pending. After the first cycle, his cough and dyspnea are modestly improved, and he has no new neurologic symptoms. The nurse practitioner explains that chemotherapy was started promptly because of his symptom burden, but immunotherapy was intentionally deferred while molecular testing was pending.

Approximately 2 weeks later, tissue-based molecular profiling identifies an EML4-ALK rearrangement, KRAS is wild-type, EGFR is wild-type, and ROS1 is negative. He remains neurologically stable with an ECOG performance status of 1 and can start oral systemic therapy. The patient and his spouse ask whether this result changes his treatment plan.

Now that broad molecular profiling has identified an ALK rearrangement in this patient with metastatic lung adenocarcinoma, high PD-L1 expression (50%), and brain metastases, which treatment option would you discuss as the most appropriate biomarker-driven therapy?