Carboplatin for Stage 4 Lung Cancer: 104 Real Stories

Stage 4 small cell lung cancer with paraneoplastic neurological syndrome

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

Biomarkers: Paraneoplastic antibody panel positive for anti-Hu, anti-AMPH, anti-Ri

Metastatic Site: left axillary lymph nodes

Over 2 years of follow-up, CT showed stable complete response, tumor markers stayed normal, no new metastases appeared, and neurological symptoms did not worsen.

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Fatal Multiorgan Failure After Pembrolizumab-Based Treatment for Metastatic Lung Cancer

Patient Info: Anonymized, female | Stage IV

She died less than 12 hours after hospital presentation with rapidly progressive multiorgan failure one week after the first pembrolizumab-based treatment cycle; immune-related toxicity was strongly suspected, although the rapid decline limited full evaluation.

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Lung Adenocarcinoma With Rare Skin Metastasis to the Neck

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

Metastatic Site: neck skin

The lung cancer later spread to the neck skin, and he died during the following year after stopping further treatment.

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Advanced Non-Small Cell Lung Cancer With ERBB2 and TP53 Mutations

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

Biomarkers: ERBB2 exon 20 Y772-A775dup mutation; TP53 mutation; PD-L1 TPS 0%

Metastatic Site: liver, bone, both lungs

Imaging after treatment showed stable disease, and he remained in good condition while continuing maintenance pemetrexed and bevacizumab.

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Metastatic Lung Adenocarcinoma With a Serious Immune-Therapy Pituitary Complication

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

Biomarkers: No detected EGFR, ALK, ROS1, RET, MET or HER2 alterations

Metastatic Site: brain, meninges, skull, bone, pituitary

The cancer had progressed to extensive brain, skull and bone involvement after several treatments. Steroid treatment improved the severe thirst, high urine output and other symptoms from immune-related hypophysitis.

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Stage IV Squamous Lung Cancer Complicated by an Esophageal-Mediastinal Fistula

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

Metastatic Site: brain, bone

Four months after the fistula was treated conservatively, imaging showed the fistula had resolved and the lung tumor and metastatic hilar nodes had decreased despite no additional antitumor treatment during that interval.

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Small Cell Lung Cancer With Rapidly Progressive Paraneoplastic Neuropathy

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

Metastatic Site: adrenal glands

Despite a partial tumor response, severe ascending motor and sensory neuropathy progressed to respiratory compromise. He chose supportive care and died 3 weeks after the neurologic symptoms began.

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Stage IVA pulmonary squamous cell carcinoma with nasal and bone metastases: response after paclitaxel, carboplatin, and tislelizumab

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

Biomarkers: PD-L1 15%

Metastatic Site: nasal region/skin; bone (left acromion)

The lung tumor and nasal metastasis regressed after paclitaxel/carboplatin plus tislelizumab, symptoms improved, no immune-related pneumonitis/colitis/hepatitis occurred, and progression-free survival exceeded 12 months.

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Stage 4 lung cancer: complete response to chemoimmunotherapy and surgery

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

Biomarkers: EGFR exon 20 duplication with PD-L1 TPS 70%; P40/CK5/6 positive squamous markers; Ki-67 60%.

Metastatic Site: right adrenal gland; possible adjacent…

As of May 7, 2024, CT follow-up showed no evidence of disease after chemoimmunotherapy, conversion surgery with pathologic complete response, and pembrolizumab maintenance.

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Stage IV lung cancer: brain metastasis complete response after chemoimmunotherapy

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

Biomarkers: KRAS-mutated; BRG-1 partial loss; PD-L1 TPS 5%; CPS 20

Metastatic Site: brain (right cerebellar hemisphere)

The right cerebellar brain metastasis completely resolved and chest CT showed only postsurgical changes after carrelizumab plus paclitaxel/carboplatin; immune-mediated adrenal insufficiency improved with systemic glucocorticoids.

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Stage IV lung adenocarcinoma: ROS1 fusion detected after immunotherapy resistance and partial response to entrectinib

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

Biomarkers: Initial lung adenocarcinoma markers supported lung origin; PD-L1 <1%, no target found at first. Later testing found CD74-ROS1 fusion.

Metastatic Site: brain, bilateral lung lesions

As of December 2024, repeat imaging after entrectinib showed partial response in lung disease and regression of brain metastases, with the patient stable and willing to continue treatment.

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Stage IV Lung Cancer: Natalie's Patient Story

Patient Info: Natalie, Female | Stage IV

Metastatic Site: lungs, lymph nodes

As of December 2024, Natalie had restarted chemotherapy after progression, and the current chemotherapy had stopped growth for the moment while she continued transplant evaluation.

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Lung Adenocarcinoma With Immune-Related Abdominal Inflammation and Later Bone Progression

Patient Info: Anonymized, male | Stage IV

Biomarkers: PD-L1 30%; KRAS G13X mutation; EGFR/ALK/ROS1 negative

Metastatic Site: bone

After several periods of response or stability, lymph-node progression recurred and bone progression was documented in July 2024. Another treatment line was being planned.

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Stage 4 small-cell lung cancer: ongoing response to immunotherapy

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

Biomarkers: PD-L1-negative

Metastatic Site: liver, bone, brain

Extensive-stage small-cell lung cancer had complete response in the primary lung, liver, bone, and treated brain lesions, with partial response in hilar/mediastinal nodes; after about 20 months of serplulimab-based first-line therapy, the patient had no deterioration, no immunotherapy-related adverse effects, and high quality of life.

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Metastatic Lung Cancer With Morphine-Induced Fever During Palliative Radiation

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

Metastatic Site: brain, bone

She remained on dacomitinib while receiving radiation for painful metastatic disease in 2022. After morphine was identified as the cause of recurrent fever and stopped, her symptoms resolved and she was discharged in satisfactory condition.

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Stage 4 lung cancer: stable disease on immunotherapy combination

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

Biomarkers: TP53, and MSH2 mutations; PD-L1 locally positive; Ki-67 20%; ALK negative. Markers otherwise supported lung cancer.

Metastatic Site: left atrium, right adrenal gland, skull; hilar and…

Stage IVB NSCLC remained clinically stable during carboplatin, pemetrexed, and tislelizumab, but treatment was stopped because of financial and psychological burden; later cancer status was not reported.

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Primary Lung Cancer That Spread to Both Breasts and the Adrenal Gland

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

Biomarkers: PD-L1 negative; EGFR, ALK, ROS1, RET, MET exon 14, NTRK and BRAF wild type

Metastatic Site: both breasts, subcutaneous tissue, adrenal gland

After the lung origin was established, she was in good general condition and asymptomatic while first-line systemic therapy was being planned.

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Stage 4 small cell lung cancer: response to carboplatin, etoposide, and atezolizumab

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

Biomarkers: CD56-positive; synaptophysin-positive

Metastatic Site: right hilar/mediastinal disease, left adrenal gland,…

Extensive-stage small-cell lung cancer presenting with chronic intestinal pseudo-obstruction improved after 3 cycles of carboplatin, etoposide, and atezolizumab, with PET response and symptomatic improvement; longer-term durability was not reported.

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Stage 4 lung cancer: immunotherapy plus particle therapy halts progression

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

Biomarkers: PD-L1 90%; high tumor mutational burden; PIK3CA ; TP53 mutation; MET mutation

Metastatic Site: left proximal femur

Stage IV oligometastatic NSCLC had good CT response to carboplatin, pemetrexed, and pembrolizumab, then no disease progression 6 months after PULSAR radiotherapy plus pembrolizumab; grade 2 pneumonitis improved with prednisone.

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Stage 4 lung cancer: complete response to chemo-immunotherapy combo

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

Metastatic Site: right hilar lymph nodes, mediastinal lymph nodes

Stage IVA lung squamous cell carcinoma achieved complete response at 12 months. Pembrolizumab was stopped after immune-related RS3PE and likely colitis; 8 months after glucocorticoid initiation, there was no relapse of lung cancer or RS3PE.

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Stage IV Non-Small Cell Lung Cancer: Lenny's Survivor Story

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

Biomarkers: PD-L1 expression positive

Metastatic Site: right femur; brain/cerebellum

As of July 2024, Lenny described himself as NED/no evidence of disease after surgery, CyberKnife radiation, chemotherapy, and Keytruda-based immunotherapy.

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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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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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