Carboplatin for Stage 4 Lung Cancer: 104 Real Stories

Extensive-stage small-cell lung cancer with serplulimab-associated diabetes: care ongoing

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

Biomarkers: Tumor biomarkers not reported. Diabetes workup after immunotherapy: autoantibodies negative, C-peptide very low.

After 11 days in the hospital, diabetic ketoacidosis was controlled; he continued insulin therapy with good glucose control and resumed serplulimab plus levothyroxine.

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Extensive-stage small-cell lung cancer with serplulimab-associated diabetes

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

Biomarkers: Tumor biomarkers not reported. Diabetes autoantibodies were negative, C-peptide was low, and hypothyroidism labs were severe.

After 10 days of hospitalization, diabetic ketoacidosis was controlled; he was discharged on insulin therapy and resumed serplulimab immunotherapy.

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Stage IV lung adenocarcinoma with paraneoplastic nephrotic syndrome during pembrolizumab therapy

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

Biomarkers: PD-L1 tumor proportion score >50% by Roche SP263 assay; KRAS exon 3 mutation; NGS/FISH did not identify targets for first-line targeted therapy

Metastatic Site: brain, bone

Pembrolizumab produced partial response and improved nephrotic-syndrome parameters, but bone metastases progressed in September 2022 and the right upper-lobe target lesion progressed 2 months later, leading to carboplatin plus pemetrexed.

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Stage IVA right lung squamous cell carcinoma: partial response complicated by camrelizumab-related pneumonitis and pulmonary bullae

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

Biomarkers: Squamous lung cancer marker profile: P40/CK5/6 positive, TTF-1/Napsin A negative. CEA/CYFRA tumor markers were elevated. PD-L1 not reported.

Metastatic Site: suspected pleural involvement / right pleural effusion

The cancer had a partial response to albumin-bound paclitaxel, carboplatin, and camrelizumab; camrelizumab was stopped after suspected immune-related pneumonitis, pulmonary embolism, and reversible pulmonary bullae, which improved after methylprednisolone was resumed.

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Extensive-stage small-cell lung cancer with immune-related diabetes and stable disease at 2 years

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

Biomarkers: Tumor PD-L1 not reported. Immune-related diabetes showed very low C-peptide and negative diabetes autoantibodies; thyroiditis also occurred.

Metastatic Site: pancreas; pleura/pleural effusion; mediastinal lymph…

Two years after the SCLC diagnosis, she was alive with stable oncologic disease after later brain metastases were treated with whole-brain radiotherapy, and she remained insulin-dependent.

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Metastatic lung adenocarcinoma with brain and iliac bone response to chemoimmunotherapy

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

Biomarkers: PD-L1-negative; no EGFR, ALK, ROS1, RET, KRAS, BRAF, MET, HER2, or NTRK alteration detected; TP53 mutation found.

Metastatic Site: left iliac bone, brain

Brain metastases achieved complete remission without cranial irradiation, and lung, bone, and brain lesions remained stable at last follow-up, with PFS of 35 months and OS exceeding 40 months.

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Stage IVA lung cancer with small-cell and adenocarcinoma components: mixed response before infection halted treatment

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

Biomarkers: PD-L1 <1%

Metastatic Site: bone (C2, T10, sacral vertebrae); malignant pleural…

The lung cancer showed mixed responses, with right-lung small-cell progression after chemotherapy/immunotherapy and later treatment interruption because of severe lung infection and respiratory failure.

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Metastatic lung adenocarcinoma with HER2 V659E/amplification responding to trastuzumab deruxtecan

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

Biomarkers: Initial lung testing showed no EGFR/ALK/ROS1 and PD-L1 TPS 3%. Later biopsy found HER2 V659E plus HER2 amplification.

Metastatic Site: liver, bone, brain

As of September 2024, metastatic lung adenocarcinoma had a sustained partial response to trastuzumab deruxtecan after HER2 V659E mutation and HER2 amplification were identified.

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ALK-rearranged Stage IVA lung adenocarcinoma: partial response to pembrolizumab as eighth-line treatment

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

Biomarkers: ALK strongly positive by IHC 3+; ALK rearrangement confirmed by FISH; PD-L1 expression 95% by 22C3 immunostaining; CEA 2.3 ng/mL at diagnosis

Metastatic Site: brain

Nine months after pembrolizumab was started as eighth-line therapy, he maintained a partial response after prior progression on multiple ALK inhibitors and chemotherapies.

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Metastatic NSCLC with ATM mutations: 28-month response to olaparib before progression

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

Biomarkers: cfDNA showed ATM and ATM mutations. Common NSCLC drivers were negative; initial tumor markers were negative.

Metastatic Site: liver, left pubic bone, bilateral pulmonary nodules,…

After 28 months of remission and improved quality of life on olaparib, June 2024 PET-CT showed progression with a new 1.2 cm hypermetabolic left lower-lobe pulmonary nodule; olaparib was still being continued at the October 2024 clinic visit.

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Stage IVA EGFR L858R lung adenocarcinoma with malignant effusions and thrombosis

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

Biomarkers: EGFR exon 21 L858R mutation; TTF-1 weak positive; Napsin A positive; p40 negative; Ki-67 about 10%

Metastatic Site: malignant pleural effusion; malignant pericardial…

As of May 2025, abdominal pain had resolved, splenic infarction had not progressed, thromboembolic events were regressing, no new thrombus formation was seen, and outpatient follow-up continued while he remained on cancer and anticoagulation management.

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Extensive-stage small cell lung cancer with brain and adrenal progression after prolonged disease control

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

Biomarkers: Small-cell lung cancer markers included CD56, CgA and TTF-1; Ki-67 was 80%.

Metastatic Site: brain, right adrenal gland, left adrenal gland

After 31 months of stability on second-line anlotinib with palliative chemoradiotherapy, disease progressed in July 2024 with new brain lesions and adrenal progression; the patient declined additional systemic options and continued anlotinib.

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Stage IV ALK Non-Small Cell Lung Cancer: Alisa's Patient Story

Patient Info: Alisa Secaida, Female, Under 40 | Stage IV

Biomarkers: ALK-positive / ALK-rearranged

Metastatic Site: Brain; lymph nodes

As of May 2025, after alectinib and lung surgery, pathology still showed active tumor and lymph-node cancer cells, and Alisa was receiving IMRT for remaining disease.

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Metastatic lung squamous cell carcinoma: no recurrence after chemoimmunotherapy and pembrolizumab maintenance

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

Biomarkers: EGFR exon 19 deletion; PD-L1 TPS 95%; TTF-1-negative; p40-positive

Metastatic Site: mediastinal lymph nodes; bilateral lung nodules

As of April 2025, PET/CT 3 years after treatment initiation showed no sign of recurrence after carboplatin, nab-paclitaxel, pembrolizumab, and 2 years of pembrolizumab monotherapy.

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Small-Cell Lung Cancer With Later Brain and Other Metastases in a Woman With COPD

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

Metastatic Site: central nervous system

Her neurologic condition progressively worsened after immune-related encephalitis and extensive metastatic progression. She died from sepsis 8 months after the lung-cancer diagnosis.

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Small Cell Lung Cancer That Spread to the Ear Canal

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

Metastatic Site: external auditory canal, middle ear, pancreas, bone

The metastatic lesions initially shrank and his hearing and ear pain improved, but he died 15 months after diagnosis.

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Stage 4 SMARCA4-deficient lung cancer: ongoing treatment response

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

Biomarkers: SMARCA4-deficient lung cancer with BRG-1 loss, CK/CK7 positive, Ki-67 >40%. CEA

Metastatic Site: sigmoid colon, left adrenal gland

After colon metastasis surgery, continued radiotherapy, and later gemcitabine/nedaplatin/bevacizumab/camrelizumab for adrenal metastasis, the cancer showed a favorable response with no further recurrence or new metastasis reported.

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Stage IV ROS1 Lung Adenocarcinoma: Luna's Patient Story

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

Biomarkers: ROS1 rearrangement; EGFR negative; ALK negative

Metastatic Site: liver; bones

Luna had Stage IV ROS1-positive lung adenocarcinoma with liver and bone metastases. After progression on initial chemotherapy, crizotinib led to tumor shrinkage and controlled her cancer for almost 12 years as of March 2025.

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Extended-stage small cell lung cancer with breast metastasis: complete response after pembrolizumab

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

Biomarkers: TMB-high, microsatellite stable; TP53/PTEN mutations, and SOX2/PIK3CA/FGF12 amplifications.

Metastatic Site: breast

As of March 2025, she had maintained complete response for more than 18 months on pembrolizumab monotherapy after prior cisplatin/irinotecan response.

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Etoposide Desensitization After Cardiac Arrest in Metastatic Small Cell Lung Cancer

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

Metastatic Site: brain

After later tumor progression and further systemic treatment, she died in September 2021 from multifactorial progressive leukoencephalopathy, meningopyoventriculitis, and brain atrophy.

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Metastatic Lung Cancer With Pulmonary Embolism, Cardiac Tamponade, and Recurrent Stroke

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

Metastatic Site: leptomeninges

After the lung cancer was diagnosed, she developed leptomeningeal metastases and recurrent ischemic strokes and died the following month.

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EGFR-Mutant Lung Adenocarcinoma That Transformed to Small Cell Lung Cancer

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

Biomarkers: EGFR exon 19 deletion; acquired EGFR T790M mutation

Metastatic Site: liver

The cancer progressed after transformation to small cell lung cancer, and she died 49 months after the original diagnosis.

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Stage 4 lung cancer: managing pembrolizumab-induced myasthenia gravis

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

Biomarkers: Anti-acetylcholine receptor antibody elevated; TSH elevated during immune-related adverse event workup; cancer biomarkers not reported

At 9 months after the immune-related myasthenia gravis presentation, lung cancer remained in complete response while she continued low-dose prednisolone, pyridostigmine, levothyroxine, and nighttime NIV.

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Stage 4 lung adenocarcinoma with RET fusion responding to pralsetinib

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

Biomarkers: RET fusion

Metastatic Site: pleura

As of March 2025, he had recovered from grade 3 Pneumocystis jirovecii pneumonia, restarted pralsetinib, and had no progressive disease or recurrence of adverse events over 13 months.

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