American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the preferred treatment for metastatic non-small cell lung cancer following progression on a platinum-based chemotherapy regimen?

1. Docetaxel

2. Bevacizumab

3. Atezolizumab

4. Cetuximab

The correct answer is: Atezolizumab

The preferred treatment for metastatic non-small cell lung cancer (NSCLC) after progression on a platinum-based chemotherapy regimen is typically immunotherapy, specifically checkpoint inhibitors. Atezolizumab is an example of an immune checkpoint inhibitor that targets PD-L1, which has shown significant efficacy in patients whose disease has progressed after initial treatment. In the context of this question, Atezolizumab has been shown to improve overall survival in patients with previously treated metastatic NSCLC, particularly in those with high PD-L1 expression. Its mechanism of action allows it to enhance the body's immune response against cancer cells, making it a valuable option in the treatment paradigm for this type of lung cancer after traditional chemotherapy has failed. The other agents listed have different roles or are not first-line in this situation. Docetaxel, while it is one of the chemotherapy options for second-line treatment, does not have the same efficacy as immune checkpoint inhibitors in this specific scenario. Bevacizumab is a vascular endothelial growth factor (VEGF) inhibitor that is more commonly used in combination with chemotherapy for certain types of NSCLC rather than as a standalone treatment following progression. Cetuximab, an epidermal growth factor receptor (EGFR) inhibitor, is indicated only in cases