In the absence of specific driver mutations, are you routinely offering combination chemotherapy + immunotherapy first-line for metastatic squamous cell carcinoma of the lung in patients with autoimmune disease, but not currently on immunosuppression?   

It depends on the nature of their autoimmune disease. If a patient has antiphospholipid antibody syndrome, it may be quite dangerous. If isolated antibody without clinical syndrome, IO may or may not unmask APLS. That said, metastatic squamous lung cancer is incurable and the only chance for durable...