Correct!
4. Cisplatin + premetrexed
Premetrexed plus a platinum-based antineoplastic agent such as cisplatin or carboplatin is considered to be the first-line therapy for non-small cell lung cancer (3). Addition of EGFR receptor monoclonal antibodies can improve survival in EGFR+ lung cancers. Similarly, crizotinib, an ALK inhibitor, can be added for ALK+ lung cancers. The patient was treated with radiation therapy which was completed on 6/7/12. Radiation therapy was followed by 4 cycles of cisplatinum plus pemetrexed concluding in September 2012. She was seen in October 2012 and doing well. However, in late December 2012 she was having nonspecific aches and pains and some shortness of breath. She received amoxicillin for a few days with minimal improvement. The nitrofurantoin was discontinued.
Which of the following are diagnostic considerations as a cause of her shortness of breath? (click on correct answer to move to next panel)