Carboplatin for Stage 4 Lung Cancer: 104 Real Stories

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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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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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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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 Lung Cancer Reached Remission After Severe Nerve Damage and Neck Surgery

Patient Info: Anonymized, Female | Stage IV

Metastatic Site: left cervical lymph nodes

Considered in complete remission after cervical lymph-node surgery, with no clinical or radiological progression 24 months after systemic treatment; alive and back at work 3 years after diagnosis.

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

Patient Info: Shyreece, Female | Stage IV

Biomarkers: ALK rearrangement / ALK-positive

Metastatic Site: Brain

As of March 2022, Shyreece was a long-term Stage IV ALK-positive lung cancer survivor with later brain metastases, ongoing treatment decisions, and advocacy focused on biomarker testing, trials, and disparities in Black lung cancer care.

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Pembrolizumab Controlled Metastatic Pleomorphic Lung Cancer After Chemotherapy Failed

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

Biomarkers: EGFR-negative; ALK-negative; ROS1-negative; BRAF-negative; PD-L1 TPS 60%-70%; BRCA2, and TP53 mutations; tumor mutation burden 42 mutations/Mb; no actionable alteration.

Metastatic Site: right adrenal gland; left adrenal gland; bone

Tumor diameter had decreased at 11 months, and pembrolizumab remained ongoing at 12 months.

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A painful scalp metastasis from sarcomatoid lung cancer

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

Biomarkers: No targetable mutations identified; CAM5.2-positive; p63-positive; CD10-positive; vimentin-positive.

Metastatic Site: chest wall and rib; liver; right gluteal region; scalp…

Her disease progressed with a further liver lesion and additional metastatic complications, and systemic treatment was stopped because of severe immune-related toxicity and the absence of targetable mutations.

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A regressed choroidal metastasis during EGFR-targeted lung cancer treatment

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

Biomarkers: EGFR exon 19 deletion.

Metastatic Site: liver; bone; central nervous system; right choroid

The right choroidal metastasis appeared inactive and regressed during systemic treatment, visual acuity remained 20/20, and no local eye treatment was required.

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Metastatic Lung Cancer Responded Completely After a Change in Immunotherapy

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

Biomarkers: TTF-1-positive; napsin-positive; PD-L1 0%; high tumour mutational burden; no actionable mutations

Metastatic Site: bone (left iliac bone, acetabulum and thoracic…

After progression on nivolumab, atezolizumab produced a complete response by the 6-month scan; after 35 cycles, the response remained sustained, he was alive and well, and no immune-related adverse effects were documented.

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Pleomorphic lung cancer responding to pembrolizumab plus chemotherapy

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

Biomarkers: PD-L1 tumor proportion score >75%; EGFR negative; ROS1 negative; ALK fusion negative

Metastatic Site: right 8th rib, left adrenal gland

His general condition improved as the tumors shrank, and he remained well 7 months after diagnosis with maintenance pembrolizumab planned.

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More than 10 years living with relapsing extensive-stage small cell lung cancer

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

Biomarkers: Chromogranin-positive.

Metastatic Site: pleura; pancreas; left kidney and perinephric region

After five treatment lines and several metastatic relapses over more than 10 years, his latest irinotecan and carboplatin course produced another partial response and he was doing well at the last follow-up.

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Osimertinib rechallenge after severe pneumonitis in Stage IV lung cancer

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

Biomarkers: EGFR exon 19 deletion; acquired EGFR T790M mutation

Metastatic Site: pleura, liver, bone, leptomeninges

She initially regained a significant response after osimertinib rechallenge without recurrent pneumonitis, but developed progressive leptomeningeal disease after 11 months.

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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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Rapidly Progressive Stage IV Lung Adenocarcinoma With a Miliary Imaging Pattern

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

Biomarkers: TTF-1-positive; p40-negative; chromogranin-negative; synaptophysin-negative; EGFR-negative; ALK-negative; ROS1-negative; PD-L1 expression 5%–10%.

The cancer progressed rapidly, and he died approximately four months after diagnosis while being transported to inpatient hospice.

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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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Durable brain and leptomeningeal response to pembrolizumab in Stage IV lung cancer

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

Biomarkers: PD-L1 high positive; EGFR negative; BRAF negative; KRAS negative; ROS1 negative; ALK negative

Metastatic Site: right adrenal gland, left sixth rib, brain,…

After 29 pembrolizumab cycles over 20 months, imaging showed no leptomeningeal disease, resolution of 3 brain lesions and marked reduction of the dominant frontal lesion; she remained neurologically intact and radiographically stable.

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Stage IV Small Cell Lung Cancer Causing Severe Cushing Syndrome

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

Biomarkers: Ectopic ACTH secretion with markedly elevated ACTH and cortisol

Metastatic Site: liver|bones

The cancer and hormone syndrome progressed after an initial response, and he died after cardiopulmonary arrest 1 year after diagnosis.

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Small cell lung cancer presenting with spontaneous tumor lysis syndrome

Patient Info: Anonymized, Male | Stage IV

Metastatic Site: liver

He developed rapidly worsening encephalopathy, gastrointestinal bleeding, cyanosis and mottling and died before planned chemotherapy could be started.

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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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Stage IV ERBB2-Mutated Lung Adenocarcinoma Responding to HER2-Targeted Therapy

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

Biomarkers: ERBB2 exon 20 insertion

Metastatic Site: bilateral lungs

Afatinib showed a response after 1 month, but insurance denial required a return to trastuzumab-based treatment.

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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 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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