A 28-year-old man with cystic fibrosis presents for routine spirometry. His current FEV1 is 27% predicted, as shown in the diagram marked **A**. He is homozygous for the F508del mutation and has been on inhaled dornase alfa and hypertonic saline for 5 years but has never received CFTR modulator therapy. His sweat chloride is 95 mmol/L. Which of the following interventions would most significantly improve his FEV1 and reduce his risk of progressive lung function decline?
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