Metastatic Lung Cancer: 25 Real Stories

Lung Cancer: Xavier's Patient Story

Patient Info: Xavier Sanders, Male | Stage Metastatic/Advanced

Metastatic Site: kidneys

Xavier’s lung disease had cleared, but cancer in his kidneys remained under treatment with 2 pills daily and checkups every 3 months; he reported major improvement in his mental health after seeking help.

Recurrent squamous lung cancer with tumor emboli, acute limb ischemia, brain metastases, and death

Patient Info: Anonymized, Male, 60s | Stage Metastatic/Advanced

Biomarkers: p40-positive; TTF-1-negative; PD-L1 not expressed / no PD-L1 reported in raw case

Metastatic Site: brain/cerebral metastases; tumor emboli in upper and…

The patient developed recurrent acute limb ischemia from tumor emboli, then new cerebral metastases, and died from advanced disease 7 months after the bilateral lower-limb ischemia presentation.

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Recurrent lung adenocarcinoma with isolated pancreatic metastasis: Whipple resection after discordant tumor-origin testing

Patient Info: Anonymized, Female, 70+ | Stage Metastatic/Advanced

Biomarkers: Pancreatic lesion showed KRAS

Metastatic Site: mediastinal lymph node; pancreas

After prior lung surgery, adjuvant chemotherapy, and later chemoradiation for mediastinal nodal recurrence, an isolated pancreatic lesion was resected by Whipple procedure; post-Whipple recurrence status was not yet reported.

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Small-cell lung cancer: envafolimab response complicated by immune-related diabetes, pneumonitis, and later submandibular progression

Patient Info: Anonymized, Male, 60s | Stage Metastatic/Advanced

Biomarkers: ProGRP and NSE were elevated at diagnosis. Tumor molecular biomarkers were not reported; diabetes antibodies were negative.

Metastatic Site: left submandibular region / adjacent lymph nodes

After initial partial response on envafolimab, carboplatin, etoposide, and thoracic radiotherapy, he developed immune-related diabetes, pneumonitis, and progressive left submandibular metastatic disease requiring iodine-125 seeds and later anlotinib.

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Locally advanced lung adenocarcinoma: neoadjuvant treatment, surgery, and fistula repair

Patient Info: Anonymized, Female, 60s | Stage Metastatic/Advanced

Three months after reconstruction for postoperative esophagopleural fistula, her nutritional status had improved and esophagogram showed no anastomotic leak; long-term lung cancer control was not reported.

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Lung cancer with a rare kidney inflammation, successfully treated with steroids and radiation

Patient Info: Anonymized, Male, 60s | Stage Metastatic/Advanced

Biomarkers: EGFR mutation-negative; TTF-1-positive; CK7-positive; CK20-negative

Radiation produced significant tumor regression, and he remained alive without progression of lung cancer or kidney disease for 5 years after discharge.

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Lung Cancer Metastases to Both Kidneys Causing Kidney Failure

Patient Info: Anonymized, Male, 50s | Stage Metastatic/Advanced

Biomarkers: PD-L1 highly expressed

Metastatic Site: brain|bilateral kidneys|lungs

The cancer progressed in both kidneys and lungs despite treatment, causing dialysis-dependent kidney failure. He later developed severe respiratory illness and died 5 days after readmission.

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Low-dose intrapleural therapy relieved a complex malignant pleural effusion

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

Biomarkers: EGFR mutation-negative; ALK alteration-negative; ROS1 alteration-negative.

Metastatic Site: pleura; adrenal gland; bone

The lung cancer had progressed after initial chemotherapy, but rescue treatment of the infected loculated pleural effusion drained 2,000 mL, resolved the collection, and improved her breathing and fever.

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Lung cancer remission after pembrolizumab despite severe inflammatory arthritis

Patient Info: Anonymized, Male, 50s | Stage Metastatic/Advanced

Biomarkers: PD-L1-positive.

Metastatic Site: brain (temporal and parietal lobes)

The lung adenocarcinoma remained in complete remission 28 months after diagnosis, while the treatment-related arthritis also reached sustained remission and he returned to work and exercise.

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NRG1-Fusion Lung Cancer With a 24-Month Response to Afatinib

Patient Info: Anonymized, Female, 50s | Stage Metastatic/Advanced

Biomarkers: NRG1 fusion; KRAS/EGFR/ALK/ROS1/ERBB2 alterations not detected

Metastatic Site: left lung

Her cancer progressed during atezolizumab, and she died in May 2019.

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Metastatic NRG1-Fusion Lung Cancer Responding to Long-Term Afatinib

Patient Info: Anonymized, Female, 60s | Stage Metastatic/Advanced

Biomarkers: CD74-NRG1 fusion

Metastatic Site: lungs

As of February 2020, she remained on afatinib 30 mg daily with an ongoing partial response after 27 months.

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Recurrent NRG1-Fusion Lung Cancer After Surgery and Immunotherapy

Patient Info: Anonymized, Male, 60s | Stage Metastatic/Advanced

Biomarkers: SDC4-NRG1 fusion

He chose no further treatment after rapid progression on afatinib and died shortly afterward in hospice.

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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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Right Small Cell Lung Cancer Progressing During Pembrolizumab

Patient Info: Anonymized, Male, 70+ | Stage Metastatic/Advanced

Metastatic Site: pleura|liver

The right small cell lung cancer progressed with malignant pleural effusion and liver metastases. His condition declined rapidly, and he died on March 8, 2018.

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Small Cell Lung Cancer With Unusual Colon Metastases After Afatinib

Patient Info: Anonymized, Female, 60s | Stage Metastatic/Advanced

Biomarkers: EGFR exon 19 deletion

Metastatic Site: liver|adrenal glands|bone|brain|ascending…

The cancer progressed after an initial response to afatinib, with new brain and colon metastases. She died from respiratory failure on August 1, 2016.

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ROS1-positive lung adenocarcinoma presenting with cancer spread across the abdomen

Patient Info: Anonymized, Male, 50s | Stage Metastatic/Advanced

Biomarkers: ROS1 rearrangement-positive; high PD-L1 expression.

Metastatic Site: peritoneum and omentum; pleura

Crizotinib relieved his respiratory and abdominal symptoms, and six-month imaging showed no residual disease or progression while treatment continued.

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Speech and Swallowing Support After Lung Cancer Relapse

Patient Info: Anonymized, 70+ | Stage Metastatic/Advanced

Metastatic Site: both lungs

The lung cancer relapsed with mediastinal and supraclavicular lymph-node involvement and metastases in both lungs. Ongoing speech and swallowing support prevented reported dysphagia complications.

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Metastatic Lung Adenocarcinoma Presenting After Kidney Transplant

Patient Info: Anonymized, Male, 50s | Stage Metastatic/Advanced

Biomarkers: TTF-1 positive

Metastatic Site: bone marrow|spine|bony pelvis

His condition deteriorated rapidly, and he died 1 week after the lung-cancer diagnosis.

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Lung Cancer With a Kidney Metastasis Treated by Cryoablation

Patient Info: Anonymized, Male, 60s | Stage Metastatic/Advanced

Metastatic Site: left kidney

The renal metastasis was treated with CT-guided cryoablation.

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A Second Lung Cancer Case With Renal Metastasis Treated by Cryoablation

Patient Info: Anonymized, Male, 50s | Stage Metastatic/Advanced

Metastatic Site: left kidney

The renal lesion was treated with CT-guided cryoablation.

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Lung Cancer: Diego's Patient Story

Patient Info: Diego, Male | Stage Metastatic/Advanced

Metastatic Site: Hip / left iliac region pain treated with radiotherapy

On 27 March 2017, Diego was recovering from hospitalization and radiotherapy for severe hip/left iliac-region pain, with pain improved and pemetrexed chemotherapy planned after his next oncology visit.

Lung cancer progression with T790M-positive tissue result and AZD9291 trial start

Patient Info: Anonymized, Male | Stage Metastatic/Advanced

Biomarkers: resistance detected in tissue biopsy

On 5 June 2016, CT showed lung tumor progression after afatinib, but a tissue T790M result allowed entry into an AZD9291 clinical trial and treatment had just started.

Lung cancer progression on afatinib with T790M testing for AZD9291 trial eligibility

Patient Info: Anonymized, Male | Stage Metastatic/Advanced

Biomarkers: resistance testing pending

On 14 April 2016, CT showed the right upper-lobe lung tumor had grown despite afatinib/Giotrif, prompting T790M testing and discussion of AZD9291 trial eligibility or radiotherapy.

Lung cancer with acquired T790M resistance: erlotinib switched to afatinib while AZD9291/TAGRISSO trial was considered

Patient Info: Anonymized, Male | Stage Metastatic/Advanced

Biomarkers: Acquired resistance detected; other resistance findings also mentioned

As of January 2016, he had reached 2 years of survival but had confirmed acquired resistance including T790M, worsening symptoms, and a treatment change from erlotinib to afatinib while a TAGRISSO/AZD9291 trial was being considered.