First-line treatment with HDACis plus tislelizumab combined with chemotherapy in advanced NSCLC a single-arm phase II study Quiz

Mr. Chen is a 62-year-old male recently diagnosed with stage IV non-small cell lung cancer (NSCLC), driver-gene negative, with PD-L1 expression of 5%. He has no prior systemic therapy and presents to the oncology pharmacy for counseling on his new treatment regimen. His oncologist has prescribed chidamide (an HDAC inhibitor) combined with tislelizumab and platinum-based chemotherapy for 4 cycles, followed by maintenance therapy. Mr. Chen is concerned about the potential side effects and treatment efficacy.

Question: Based on the phase II study by Wang et al., what key counseling point should the pharmacist emphasize regarding the expected efficacy and safety profile of this triplet regimen?

Mrs. Li is a 70-year-old female with advanced NSCLC undergoing first-line treatment with chidamide, tislelizumab, and chemotherapy. After her third cycle, she develops Grade 3 neutropenia. She is concerned about continuing therapy and potential complications. Her current medications include prophylactic antiemetics and supportive care agents.

Question: According to the findings from Wang et al.’s phase II study, what is the most appropriate pharmacist recommendation regarding management of her neutropenia during this regimen?

Mr. Zhang is a 65-year-old man with newly diagnosed metastatic NSCLC, driver-gene negative, and PD-L1 expression less than 1%. His oncologist is considering first-line treatment options including the novel combination of chidamide, tislelizumab, and chemotherapy. Mr. Zhang asks about the likelihood of benefit given his low PD-L1 status.

Question: What does the current evidence from Wang et al.’s study suggest regarding the efficacy of the HDACi plus tislelizumab and chemotherapy regimen in patients with low or intermediate PD-L1 expression?