27th February 2025

A 45-year-old woman with non-small cell lung cancer is being treated with a combination of chemotherapy

A 45-year-old woman with non-small cell lung cancer is being treated with a combination of chemotherapy and immunotherapy with pemetrexed and pembrolizumab. She presents to hospital with breathlessness and a severe non productive cough. On examination, she appears tachypnoeic and is requiring 15 L oxygen via a non re-breathe face mask to maintain oxygen saturations of 91%. She is afebrile with a temperature of 36 degrees Celsius. On auscultation of her chest she has widespread bilateral crepitations.

You ring the on-call oncologist for advice. Which of the following is not likely to form part of initial management?

Select the SINGLE most appropriate option from the list below. Select ONE option only.