Chemotherapy for Stage 4 Lung Cancer: 217 Real Stories

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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Stage IV EGFR Lung Cancer: Emily's Patient Story

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

Biomarkers: EGFR mutation

Metastatic Site: Right lung; right 8th rib; sacrum; pancreas; brain

Emily had Stage IV EGFR-mutated lung cancer treated with daily targeted therapy, 4 rounds of chemotherapy, and later radiation. As of September 2025, she felt well and described being almost/basically in remission, but her cancer remained treatable rather than curable and she continued daily targeted therapy.

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Stage IV HER2-Positive Non-Small Cell Lung Cancer: Lauren's Patient Story

Patient Info: Lauren, Female, Under 40 | Stage IV

Biomarkers: HER2 mutation

Metastatic Site: Bones/ribs/shoulder; liver

As of September 2025, after about 4 months of targeted therapy, Lauren reported better quality of life, resolved bone pain, improved liver pain, improved liver enzymes, and manageable infusion-week side effects.

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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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Metastatic lung adenocarcinoma presenting with central diabetes insipidus

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

Biomarkers: Weak TTF-1-positive; weak Napsin A-positive; weak p63-positive; CK5/6-negative; molecular testing not performed because of financial constraints

Metastatic Site: brain lesions, cervical spine bone lesions

He died shortly after the second cycle of platinum-based chemotherapy for metastatic lung adenocarcinoma that presented with central diabetes insipidus and brain/bone lesions.

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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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Stage IV lung adenocarcinoma with Aspergillus-associated empyema: disease control after chemotherapy and antifungal therapy

Patient Info: Anonymized, Male | Stage IV

Biomarkers: Pathogenic NF1 mutation; CEA elevated in pleural fluid; Aspergillus fumigatus cultured from bronchoalveolar lavage fluid

Metastatic Site: pleural disease/effusion (M1a)

After 6 cycles of pemetrexed/cisplatin and 6 months of antifungal therapy for Aspergillus-associated empyema, 12-month follow-up showed disease stability without recurrence.

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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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Stage IV Lung Cancer: Clara's Patient Story

Patient Info: Clara, Female, Under 40 | Stage IV

Biomarkers: Biomarker found but specific mutation not stated

Metastatic Site: Bone and joints; brain; liver/other organs

Clara was living with Stage IV metastatic lung cancer involving bone/joints, brain, and other organs. As of August 2025, she had received brain radiation and first-line chemotherapy plus immunotherapy, with ongoing lifelong immunotherapy planned.

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Recurrent lung adenocarcinoma with bevacizumab-associated glomerular microangiopathy

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

Biomarkers: No tumor molecular biomarkers reported. Kidney biopsy and complement/immune deposits supported bevacizumab-related kidney microangiopathy.

Metastatic Site: pleura

He was living with recurrent metastatic lung adenocarcinoma after pleural spread and had persistent renal dysfunction and severe proteinuria from bevacizumab-associated glomerular microangiopathy despite stopping bevacizumab.

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Stage IV Small Cell Lung Cancer: Kristen's Patient Story

Patient Info: Kristen, Female | Stage IV

Metastatic Site: liver, abdominal wall, bone

Kristen had metastatic small cell lung cancer with liver, abdominal wall, and bone involvement. As of July 2025, she had completed chemotherapy, had organ-tumor shrinkage, had immunotherapy on hold because of shortness of breath, and was planning bone-directed treatment and possible immunotherapy restart.

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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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Stage IV small-cell lung cancer: complete response after chemotherapy, radiotherapy, and immunotherapy

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

Biomarkers: especially at recurrence. PD-L1 was not reported.

Metastatic Site: liver; right hilar and mediastinal lymph nodes

As of January 2, 2024, she was alive with overall survival exceeding 95 months and complete response after treatment for recurrent small-cell lung cancer.

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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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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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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 Large-Cell Neuroendocrine Lung Cancer Controlled for Nearly Four Years With Multiple Treatments

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

Biomarkers: PD-L1 high initially; no actionable driver mutation; later PD-L1 5%

Metastatic Site: liver, bones

After several partial responses across multiple treatment lines, she entered hospice and died on December 13, 2024, after an overall survival of 47 months.

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Stage IVA lung adenosquamous carcinoma: complete response after paclitaxel, nedaplatin, and tislelizumab

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

Biomarkers: Adenosquamous lung cancer markers; PD-L1 TPS 18%; KRAS, BRAF, PIK3CA, FLT1 mutation; TMB 3.7

Metastatic Site: pleura/chest wall, cervical lymph nodes, axillary…

As of March 30, 2025, he maintained complete response with normal tumor markers, no radiologic evidence of progression or recurrence, and progression-free survival of 46.5 months after paclitaxel/nedaplatin/tislelizumab followed by maintenance tislelizumab.

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Stage IV EGFR Non-Small Cell Lung Cancer: Jenny's Patient Story

Patient Info: Jenny Apple, Female | Stage IV

Biomarkers: EGFR exon 20 mutation

Metastatic Site: brain

Jenny Apple had nonsmoking lung adenocarcinoma with an EGFR exon 20 mutation. Her cancer was first found at Stage IIIA / near IIIB and later progressed to Stage IV with brain metastases. She died before the June 2025 story from her husband Kyle.

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Stage I Pleomorphic Lung Cancer Recurring With Bone Metastasis Within Five Months

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

Biomarkers: PD-L1 high; no detected driver mutation

Metastatic Site: bone

PET-CT in December 2024 showed a partial response. As of February 2025, he remained on sintilimab and bevacizumab maintenance with about 9 months of progression-free survival after recurrence treatment.

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Stage IV Lung Adenocarcinoma With KRAS Mutation Responding to Immunotherapy and Anti-Angiogenic Treatment

Patient Info: Anonymized, male | Stage IV

Biomarkers: KRAS mutation; MET amplification

Metastatic Site: pleura

By the December 2023 follow-up, the pleural effusion had disappeared, the primary lung tumor had not progressed, and he was described as symptom-free and in good health on maintenance treatment.

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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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Small-cell lung cancer: complete response complicated by radiation bronchial injury and adrenal recurrence

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

Metastatic Site: left adrenal gland

As of May 2025, the initial lung and mediastinal disease had achieved complete response, but the patient developed severe radiation-related bronchial injury and later left adrenal metastasis requiring renewed systemic chemotherapy.

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