ALK-positive lung cancer spreading to both breasts after years of targeted therapy

Patient Info: Anonymized, Male, 50s | Stage IV

Biomarkers: ALK-positive, ALK mutation

Metastatic Site: bilateral breasts

At age 51, about 10 years after his Stage IV diagnosis, he remained alive with stable disease 8 months after removal of bilateral breast metastases while continuing maintenance therapy.

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RET-fusion lung adenocarcinoma responding to pralsetinib and bevacizumab

Patient Info: Anonymized, Male, 50s | Stage IV

Biomarkers: KIF13A-RET fusion

Metastatic Site: pleura

He had 27 months of disease-free survival on pralsetinib before pleural and nodal recurrence. After bevacizumab was added, imaging showed reduction of the pleural lesion and mediastinal nodes and circulating tumor DNA became undetectable in December 2023.

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Stage IV pulmonary mucoepidermoid carcinoma with an ALK fusion responding to targeted therapy

Patient Info: Anonymized, female, 50s | Stage IV

Biomarkers: EML4-ALK fusion; PD-L1 <1%

Metastatic Site: liver

By December 2023, oral ALK-targeted therapy was ongoing with a partial response, improved symptoms, weight gain, and marked shrinkage of lung and metastatic disease.

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Stage IV BRAF-mutated lung adenocarcinoma responding to second-line chemo-immunotherapy

Patient Info: Anonymized, female, Under 40 | Stage IV

Biomarkers: BRAF exon 15 p.T599dup; PD-L1 5%

Metastatic Site: pleura, pericardium

After progression on BRAF/MEK-targeted therapy, second-line chemo-immunotherapy produced a partial response that was still ongoing after about 1 year of second-line treatment.

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Stage IV enteric-type lung adenocarcinoma with EGFR mutations and MSI-high disease

Patient Info: Anonymized, male, 60s | Stage IV

Biomarkers: EGFR exon 19 deletion; acquired EGFR T790M; MSI-high; high tumor mutation burden; MLH1 mutation; pMMR; PD-L1-negative

Metastatic Site: lung, pleura

The cancer progressed through multiple targeted, chemotherapy, and immunotherapy regimens. He died about 30 months after the initial diagnosis.

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Afatinib-related kidney injury during treatment for EGFR-positive metastatic lung cancer

Patient Info: Anonymized, Male, 50s | Stage IV

Biomarkers: EGFR-positive.

Metastatic Site: pleura

He continued maintenance bevacizumab and atezolizumab after four combination courses for metastatic disease while his renal function remained impaired but stable.

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Stage IV Mucinous Lung Cancer Treated With Afatinib and Surgery

Patient Info: Anonymized, Female, 40s | Stage IV

Biomarkers: CD74-NRG1 fusion; ALK/ROS1/EGFR/BRAF/KRAS/MET/HER2 wild type; PD-L1 initially not expressed and later 0%-20%

Metastatic Site: bilateral lungs|bone|right adrenal gland

She was alive and receiving treatment after bone and right-adrenal progression at the latest follow-up.

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Recurrent Mucinous Lung Cancer With Dose-Dependent Afatinib Responses

Patient Info: Anonymized, Female, Under 40 | Stage Metastatic/Advanced

Biomarkers: SDC4-NRG1 fusion; PD-L1 not expressed; low tumor mutation burden

Metastatic Site: bilateral lungs

She had progressive lung disease after several targeted-treatment attempts and was receiving paclitaxel with bevacizumab as of February 2020.

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Lung Cancer Metastasis to the Iris Treated With Bevacizumab

Patient Info: Anonymized, Male, 60s | Stage IV

Metastatic Site: right iris

The iris lesion and eye symptoms improved after bevacizumab, but he later died from systemic complications of metastatic lung cancer.

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Osimertinib Improved Spinal Cord Metastases in Long-Standing Lung Cancer

Patient Info: Anonymized, Male, 50s | Stage IV

Biomarkers: Initial surgical specimen: no detected EGFR mutation and ALK-negative. Later pleural-fluid tumor: acquired EGFR T790M mutation with no other detected EGFR mutation.

Metastatic Site: cervical and mediastinal lymph nodes; bone; brain;…

Osimertinib improved neurologic function and kept the lung cancer stable for 14 months; he later died from bacterial pneumonia.

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Hormone Problems During Nivolumab Treatment for Advanced Lung Cancer

Patient Info: Anonymized, Female, 60s | Stage IV

Biomarkers: EGFR/ALK/ROS1/BRAF wild type

Metastatic Site: abdominal wall|brain

She was living with Stage IVA lung cancer after about 1 year of nivolumab. Thyroid levels normalized after levothyroxine adjustment, and continued endocrine monitoring was planned for treatment-related pituitary dysfunction.

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Autoimmune hemolytic anemia after 39 cycles of nivolumab for metastatic lung cancer

Patient Info: Anonymized, Male, 70+ | Stage IV

Metastatic Site: liver, bone

While nivolumab remained on hold, his lung cancer was stable on imaging and clinically, and hemoglobin had recovered to 14.6 g/dL about 4 months after high-dose prednisone and rituximab began.

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ERBB2-Mutated Stage III Lung Cancer With Liver Recurrence and Multiple Lines of Therapy

Patient Info: Anonymized, female, 60s | Stage IV

Biomarkers: ERBB2 exon 20 insertion

Metastatic Site: liver

After 6 months of disease control on vinorelbine plus trastuzumab, the cancer progressed in all sites and she chose hospice care.

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Stage IV ERBB2-Mutated Lung Cancer With Extensive Bone Metastases

Patient Info: Anonymized, female, 60s | Stage IV

Biomarkers: ERBB2 exon 20 insertion. A PIK3CA mutation was later detected at progression and considered a possible resistance mechanism.

Metastatic Site: bone

After progression on pemetrexed following several earlier treatment lines, she transitioned to hospice care.

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Stage IV ERBB2-Mutated Lung Adenocarcinoma With Brain Metastases and Multiple Targeted Therapies

Patient Info: Anonymized, female, Under 40 | Stage IV

Biomarkers: ERBB2 exon 20 insertion, exact sequence not specified. ERBB2 copy-number gain was identified during progression on afatinib.

Metastatic Site: brain, adrenal gland, liver

The final documented afatinib plus bevacizumab rechallenge produced a mixed response followed by liver progression after 3 months.

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ERBB2-Mutated Metastatic Lung Adenocarcinoma With Limited Disease Control Across Multiple Therapies

Patient Info: Anonymized, female

Biomarkers: ERBB2 V776delinsVC mutation

After temporary stable disease when bevacizumab was added to chemotherapy, the cancer progressed on trastuzumab plus paclitaxel and then erlotinib.

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EGFR L858R-mutant Stage IV lung adenocarcinoma managed after gefitinib-induced lung injury

Patient Info: Anonymized, Male, 40s | Stage IV

Biomarkers: EGFR L858R mutation

Metastatic Site: liver, bone, hilar lymph nodes, mediastinal lymph…

Gefitinib produced early tumor shrinkage but was stopped for interstitial lung disease; subsequent carboplatin, pemetrexed, and bevacizumab produced a good response, while variceal bleeding was controlled with endoscopic treatment.

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Stage IV NSCLC with choroidal metastasis responding to intravitreal bevacizumab

Patient Info: Anonymized, Female, 50s | Stage IV

Metastatic Site: choroid of right eye

The right-eye choroidal metastasis showed complete local response after intravitreal bevacizumab, with pain resolution, vision improvement to 20/20, and no residual ocular tumor detected 10 months after treatment began.

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