Journey of Resilience
Stage IV NSCLC and Brain Metastases: From Heavy Smoker to 7-Year Survivor
Complete Brain and Body Response – Immunotherapy Triumph
Marco G. (a pseudonym) experienced a seizure that led to the discovery of three brain tumors and a lung mass. Further work-up revealed stage IV NSCLC with high-volume metastases to the brain, lymph nodes, and other organs. As a smoker of 35 pack-years, his prognosis appeared poor – median survival with brain metastases was only ~6 months.
Marco’s oncologists employed a multi-modality approach: first, whole-brain radiotherapy (WBRT) to control the brain lesions, followed by platinum chemotherapy as first-line systemic treatment.
Despite these efforts, the cancer persisted. Marco then started immunotherapy (a checkpoint inhibitor) as second-line treatment. To his and his doctors’ astonishment, the immunotherapy yielded a dramatic and durable response. Scans showed all brain metastases shrinking and eventually disappearing, and the lung and lymph node tumors also regressed completely.
By late 2018, Marco’s MRI and PET scans indicated no evidence of disease. He remained on immunotherapy for two years and has now been off treatment for several years with sustained remission.
Diagnosis
Stage IV NSCLC (lung adenocarcinoma), with three brain metastases (16–17 mm and smaller) and extensive lung/lymph spread
Biomarker profile: EGFR/ALK wild-type, PD-L1-positive (high expression)
Treatment
Whole-brain radiation therapy (2015) for brain metastases; chemotherapy and then immunotherapy
Outcome
Achieved 87 months of overall survival and 73 months of progression-free survival with optimal quality of life at the latest evaluation
Source: Costa, M., & Magalhães, H. (2024). Complete and long-lasting response to immunotherapy in a stage IV non-small cell lung cancer with brain metastasis. Oncoscience, 11, 92.
