EGFR-mutated lung cancer with later small-cell transformation

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

Biomarkers: EGFR L858R mutation; acquired EGFR T790M mutation

Metastatic Site: pleura/chest wall, ribs, brain, meninges,…

Disease progressed through multiple lines of therapy with brain and meningeal involvement. He died in September 2021, more than 9 years after his original 2012 diagnosis.

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Stage IVA lung adenocarcinoma with solitary brain metastasis: pCR after brain surgery, chemoradiation, immunotherapy, and lobectomy

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

Biomarkers: PD-L1 75%; negative for driver gene mutations and translocations

Metastatic Site: brain

As of May 2024, he had no recurrence after brain metastasis resection and radiation, carboplatin/pemetrexed/atezolizumab, robot-assisted right upper lobectomy with pathologic complete response, and 13 cycles of maintenance atezolizumab.

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Stage 4 lung adenocarcinoma: complete response on immunotherapy combination

Patient Info: Anonymized, Male | Stage IV

Biomarkers: No targetable mutation found. Tissue showed TP53/ARID1A; liquid biopsy added KEAP1, and SMARCA4. PD-L1 not evaluable.

Metastatic Site: bilateral lung nodules, left adrenal gland

As of May 2024, metastatic lung adenocarcinoma had a complete radiologic response lasting more than 14 months on pembrolizumab maintenance, and a new PET-avid lung nodule was benign inflammation rather than cancer.

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Small cell lung cancer with SIADH that progressed after an initial response to treatment

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

Metastatic Site: liver

The cancer progressed with disseminated liver metastases, and she died from liver failure in February 2021.

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Stage IV lung adenocarcinoma with brain metastases and an aortic blood clot

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

Biomarkers: KRAS ; EIF1AZ mutation; PD-L1 30%

Metastatic Site: brain

She remained in active care after whole-brain radiation, with systemic chemo-immunotherapy planned for Stage IV lung adenocarcinoma.

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SMARCA4-deficient undifferentiated lung cancer with pleural disease and later spinal metastasis

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

Biomarkers: BRCA1 p.S1796 variant; TP53 p.; tumor mutational burden 12.6

Metastatic Site: spine

After chemotherapy and one cycle of nivolumab, a new 4.5 cm spinal metastasis caused cord compression and required surgery; further outpatient treatment was planned.

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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 II lung adenocarcinoma with severe atezolizumab-related myocarditis after surgery

Patient Info: Anonymized, female, 40s | Stage II

Biomarkers: PD-L1 TPS 50%

More than 1 year after atezolizumab was discontinued, there was no recurrence of the lung cancer.

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Small cell lung cancer with dermatomyositis improving after chemo-immunotherapy

Patient Info: Anonymized, male, 70+

After treatment began, muscle enzymes fell and his strength, skin symptoms, and overall condition improved.

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Small cell lung cancer with dermatomyositis and fatal immune-related toxicity

Patient Info: Anonymized, male, 50s

He died 3 weeks after starting treatment after developing severe skin toxicity thought to be a fatal immune-related adverse event, with possible infection and sepsis.

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Stage IV lung adenocarcinoma complicated by immunotherapy-related perimyocarditis

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

Biomarkers: EGFR-negative; ALK-negative; ROS1-negative; PD-L1 <1%

She died from cancer progression 3 months after recovering from immunotherapy-related perimyocarditis.

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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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Rare lung cancer first discovered as a mass in the skull

Patient Info: Anonymized, Male | Stage IV

Biomarkers: KRAS ; CK7-positive; CDX2-positive; pathology favoured pulmonary enteric adenocarcinoma

Metastatic Site: skull base / sphenoid sinus; right posterior acetabulum

He received palliative radiation and prolonged systemic therapy, completing 35 cycles including 31 maintenance cycles of pemetrexed and pembrolizumab.

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Stage IV lung adenocarcinoma followed without treatment after chemotherapy and pembrolizumab caused kidney injury

Patient Info: Anonymized, female | Stage IV

Metastatic Site: liver, pleura

After stopping antitumor drugs, follow-up imaging and tumor markers showed no evidence suggesting cancer recurrence.

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Lung squamous cell cancer treated with chemotherapy and nivolumab alongside IgG4-related disease

Patient Info: Anonymized, male, 70+

Biomarkers: PD-L1 TPS 65%

Nivolumab was stopped after disease progression, and he died from progressive lung cancer 17 months later.

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Lung cancer with limited spread, treated with a combination of therapies

Patient Info: Anonymized, Female

She remained free of recurrence for 164 months, with excellent quality of life and no neurological after-effects.

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Brain radiation therapy complication (radionecrosis) potentially linked to combined chemo-immunotherapy

Patient Info: Anonymized, Female | Stage IV

Biomarkers: PD-L1 0%; tumour mutational burden 33 mutations/Mb; TP53 mutation at diagnosis; later ctDNA included KEAP1 and NOTCH3 alterations

Metastatic Site: brain; presumed leptomeningeal disease

She recovered completely from surgery for radiation necrosis, resumed cancer treatment and remained neurologically intact at 18 months. She was found deceased 9 months later; the cause of death was unknown.

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Severe colitis from pembrolizumab immunotherapy requiring additional treatment

Patient Info: Anonymized, Male

Infliximab stopped the bleeding and reduced bowel movements from 11–12 to about 3–4 per day within 1 week, allowing discharge. Continued follow-up was needed for the colitis, hepatitis B reactivation risk and lung cancer.

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BRCA2-Mutated Metastatic Lung Adenocarcinoma Controlled for 30 Months With Olaparib

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

Biomarkers: PD-L1-negative; BRCA2 mutation; ATM mutation; EGFR-negative; ALK-negative

Metastatic Site: brain

Olaparib provided about 30 months of disease control, and PET imaging remained overall stable when a separate new breast primary was found in February 2023.

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Lung cancer in a young adult mistaken for recurring pneumonia

Patient Info: Anonymized, Male | Stage III

Biomarkers: KRAS mutation

Two months after discharge, he began carboplatin, pemetrexed and pembrolizumab and had received 2 cycles.

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Lung cancer immunotherapy causing sudden heart inflammation and type 1 diabetes

Patient Info: Anonymized, Female | Stage III

Her acute symptoms resolved, cardiac function returned to her baseline ejection fraction of 32% at 1 month and durvalumab remained permanently discontinued while oncology, endocrine and cardiac follow-up continued.

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HER2-positive metastatic lung cancer treated with trastuzumab deruxtecan (Enhertu)

Patient Info: Anonymized, Female | Stage IV

Biomarkers: ERBB2/HER2 copy-number gain of at least 20 copies; TP53 C242fs; CDK12 copy-number gain; tumour mutational burden 3.2 mutations/Mb

Metastatic Site: lungs / multiple pulmonary nodules

Trastuzumab deruxtecan reduced the pulmonary nodules by more than 50% at 3 months and produced a documented response lasting 13.8 months.

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Severe kidney inflammation after pembrolizumab for lung adenocarcinoma

Patient Info: Anonymized, Male, 60s

The primary lung tumor enlarged after pembrolizumab was stopped, and carboplatin plus paclitaxel was started in October 2021.

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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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