American Board of Internal Medicine (ABIM) Certification Practice Exam

What is an effective treatment for adenocarcinoma of the lung with an EGFR mutation?

1. Cisplatin chemotherapy

2. EGFR tyrosine kinase inhibitor

3. Surgery

4. Immunotherapy

The correct answer is: EGFR tyrosine kinase inhibitor

An effective treatment for adenocarcinoma of the lung with an EGFR mutation is a targeted therapy utilizing an EGFR tyrosine kinase inhibitor. This class of medications specifically interferes with the signaling pathways that promote cancer cell proliferation and survival, particularly in tumors with specific genetic alterations such as EGFR mutations. The presence of an EGFR mutation indicates that the tumor is likely to be driven by abnormal signaling through the epidermal growth factor receptor pathway, making it responsive to EGFR inhibitors. This type of treatment has been shown to significantly improve clinical outcomes, including progression-free survival and overall survival, compared to traditional chemotherapy approaches. While other treatment options such as chemotherapy, surgery, and immunotherapy can be relevant for lung cancer management, they may not be as effective in this context when a specific mutation is present. For instance, cisplatin chemotherapy is often considered for various types of lung cancer but does not target the underlying mutation directly. Similarly, surgery might be applicable in early-stage disease without metastasis but is not a suitable systemic treatment for advanced adenocarcinoma with a mutation. Immunotherapy can be beneficial for some lung cancers, particularly those with high PD-L1 expressivity, but may not be the optimal choice for a patient whose