Chemotherapy for Stage 4 Lung Cancer: 217 Real Stories

Long-term erlotinib treatment alongside worsening kidney vasculitis

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

Metastatic Site: bone

Bone metastases showed osteosclerotic change after erlotinib began, and the drug continued because he was benefiting from treatment despite worsening renal vasculitis.

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Stage IV Lung Cancer: Steve's Patient Story

Patient Info: Steve Castellaw, 70+ | Stage IV

Metastatic Site: right pelvis, L1 and L2 vertebrae, skull

After about 2 years on sotorasib, Steve had a large reduction in tumor size and his latest scans continued to look good while he returned to golf, exercise, and normal daily life.

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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Lung adenocarcinoma first detected through an adrenal metastasis

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

Biomarkers: No driver mutations identified.

Metastatic Site: left adrenal gland

After resection of the adrenal metastasis, postoperative imaging showed further thoracic uptake and he began palliative chemotherapy for metastatic lung adenocarcinoma without identified driver 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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Stage IV Mucinous Lung Cancer Treated With Afatinib and Surgery

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

Biomarkers: CD74-NRG1 fusion; ALK/ROS1/EGFR/BRAF/KRAS/MET/HER2 wild type; PD-L1 initially not expressed and later 0%-20%

Metastatic Site: bilateral lungs|bone|right adrenal gland

She was alive and receiving treatment after bone and right-adrenal progression at the latest follow-up.

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

Patient Info: Saila Hanninen, Under 40 | Stage IV

Biomarkers: EGFR mutation

After progression on earlier EGFR-directed treatment and other therapies, Saila began chemotherapy and her cancer was stable at the time of the story.

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

Patient Info: Tomma Hargraves, Female | Stage IV

Metastatic Site: brain

After a later brain and lymph-node relapse was brought under control, Tomma had no further cancer treatment and remained active in survivorship advocacy. She died on September 7, 2023.

Tomma Hargraves: Choosing to Help Other Patients after Surviving Lung Cancer

Patient Info: Tomma Hargraves | Stage IV

Metastatic Site: brain

After treatment and a later recurrence, Tomma went many years without further cancer treatment and became a patient navigator and advocate. She died on September 7, 2023.

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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Late-onset mania revealed advanced small cell lung cancer

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

Biomarkers: ACTH-producing tumor with ACTH 776 pg/mL and morning cortisol 206.8 micrograms/dL.

Metastatic Site: right lung; liver

He died a few months after diagnosis from aspiration pneumonia and multiorgan failure in the setting of rapidly deteriorating stage IV small cell lung cancer.

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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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Stage IV RET Non-Small Cell Lung Cancer: Sara's Patient Story

Patient Info: Sara Whitlock, Female, 40s | Stage IV

Biomarkers: RET fusion-positive NSCLC

Metastatic Site: Brain; abdomen; bowel

As of November 2019, Sara had Stage IV RET fusion-positive NSCLC with a long-term response and no signs of cancer while taking selpercatinib/LOXO-292 on a clinical trial, with ongoing monthly follow-up.

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

Patient Info: James “Rocky” Lagno, Male | Stage IV

Biomarkers: ALK-positive

Metastatic Site: brain

After starting ceritinib through compassionate use, Rocky reported stable disease from the middle of 2013 with quality of life close to his pre-diagnosis level, while recognizing that he was not in remission or cancer-free.

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

Patient Info: Donna Fernandez, Female, 50s | Stage IV

While receiving nivolumab on a Phase III trial, Donna’s tumors remained present but stopped growing, and she was able to return to an active daily life.

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

Patient Info: Ginger Tam, Female | Stage IV

Biomarkers: EGFR mutation

Ginger lived for more than 5 years with metastatic lung cancer while receiving multiple research-driven treatments. She died on February 10, 2018.

Long-Term Nivolumab Response With Thyroid and Adrenal Side Effects

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

Nivolumab remained ongoing at course 82, tumor burden had fallen to one-fifth of baseline, and no disease progression was documented.

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Nivolumab-Related Myocarditis and Heart Block in Metastatic Lung Cancer

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

Metastatic Site: left adrenal gland

He stabilized after high-dose steroids and pacemaker implantation after nivolumab was permanently stopped.

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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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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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