Stage 4 lung cancer stable on durvalumab immunotherapy

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

Metastatic Site: brain, pancreas, liver

Stage IV small cell lung cancer remained stable after durvalumab, platinum chemotherapy, radiation, and 1 year of durvalumab monotherapy; severe right sternoclavicular joint arthritis resolved after infliximab, and immunotherapy was suspended for 1 year.

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Stage IV small cell lung cancer with metastases involving bone and both eye muscles

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

Metastatic Site: bone; bilateral extraocular muscles (orbits)

He died 5 months after presenting with bilateral orbital involvement while receiving palliative treatment for Stage IV small cell lung cancer.

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Stage IV lung adenocarcinoma complicated by visceral leishmaniasis during chemotherapy

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

Biomarkers: EGFR wild-type; ALK negative; ROS negative; PD-L1 negative

Imaging showed progression while maintenance pemetrexed was temporarily interrupted; pemetrexed was then restarted during treatment for visceral leishmaniasis.

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ALK-positive lung adenocarcinoma complicated by crizotinib-associated kidney and liver cysts

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

Biomarkers: ALK fusion

Metastatic Site: bone

After switching from crizotinib to alectinib, the lung cancer and hilar lymph nodes remained stable at the latest follow-up described.

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Rare non-small cell lung cancer with TTF-1 and p40 coexpression and later bone recurrence

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

Biomarkers: PD-L1 TPS 60%; ALK negative; ROS1 negative

Metastatic Site: lumbar vertebrae

The cancer recurred in the lumbar vertebrae about 4 months after surgery, and he died from cancer 9 months after the operation.

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SMARCA4-deficient undifferentiated lung cancer with pleural disease and later spinal metastasis

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

Biomarkers: BRCA1 p.S1796 variant; TP53 p.; tumor mutational burden 12.6

Metastatic Site: spine

After chemotherapy and one cycle of nivolumab, a new 4.5 cm spinal metastasis caused cord compression and required surgery; further outpatient treatment was planned.

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Stage IV BRAF-mutated lung adenocarcinoma responding to second-line chemo-immunotherapy

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

Biomarkers: BRAF exon 15 p.T599dup; PD-L1 5%

Metastatic Site: pleura, pericardium

After progression on BRAF/MEK-targeted therapy, second-line chemo-immunotherapy produced a partial response that was still ongoing after about 1 year of second-line treatment.

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EGFR L858R/S768I lung adenocarcinoma with more than 5 years of survival after targeted therapy

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

Biomarkers: EGFR L858R and S768I compound mutation

Metastatic Site: bone, brain

He died on August 15, 2022, about 5 years and 4 months after his April 2017 presentation; afatinib had provided more than 3 years of disease control before later bone and brain progression.

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Stage IV ALK Lung Adenocarcinoma: Keegan's Survivor Story

Patient Info: Keegan Murphy, Male, 40s | Stage IV

Biomarkers: ALK fusion mutation

Metastatic Site: Lungs; lymph nodes; ribs/bone; abdomen

As of March 2024, Keegan had gone from Stage IV ALK-positive lung adenocarcinoma with tumors in the lungs, lymph nodes, ribs, and abdomen to no evidence of disease after alectinib and surgery.

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Stage IV lung adenocarcinoma presenting as a painful thigh metastasis

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

Metastatic Site: right thigh soft tissue/muscle, bilateral iliac bones…

After 9 months of therapy, the lung lesion had a partial response and the painful thigh mass had markedly decreased, although she remained unable to walk.

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ALK-positive lung adenocarcinoma with a large brain metastasis responding to brigatinib

Patient Info: Anonymized, female | Stage IV

Biomarkers: ALK-positive

Metastatic Site: brain

The approximately 70 mm brain metastasis shrank dramatically within 2 to 5 weeks of brigatinib, allowing transition back to outpatient care.

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Stage IV lung adenocarcinoma complicated by immunotherapy-related perimyocarditis

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

Biomarkers: EGFR-negative; ALK-negative; ROS1-negative; PD-L1 <1%

She died from cancer progression 3 months after recovering from immunotherapy-related perimyocarditis.

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Stage IV enteric-type lung adenocarcinoma with EGFR mutations and MSI-high disease

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

Biomarkers: EGFR exon 19 deletion; acquired EGFR T790M; MSI-high; high tumor mutation burden; MLH1 mutation; pMMR; PD-L1-negative

Metastatic Site: lung, pleura

The cancer progressed through multiple targeted, chemotherapy, and immunotherapy regimens. He died about 30 months after the initial diagnosis.

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Stage IV Lung Cancer: Deborah's Patient Story

Patient Info: Deborah Persinger, Female, 70+ | Stage IV

Metastatic Site: Brain

As of January 2024, Deborah was living actively 13 years after lung cancer diagnosis, with recurrent brain metastases managed through repeated Gamma Knife radiosurgery and ongoing MRI surveillance.

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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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Stage IV lung adenocarcinoma followed without treatment after chemotherapy and pembrolizumab caused kidney injury

Patient Info: Anonymized, female | Stage IV

Metastatic Site: liver, pleura

After stopping antitumor drugs, follow-up imaging and tumor markers showed no evidence suggesting cancer recurrence.

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First reported case of a severe immune reaction (cytokine release syndrome) from tislelizumab

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

Metastatic Site: pleura (malignant pleural effusion)

The cytokine release syndrome initially improved with high-dose steroids, but he developed severe ventilator-associated pneumonia during the steroid taper and died.

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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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MET-mutated lung cancer: testing savolitinib before surgery

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

Biomarkers: MET exon 14 skipping, TP53 and BRAF mutations; PD-L1 expression 5%

Metastatic Site: pleura; mediastinal lymph node

Savolitinib produced a partial radiological response, but surgery confirmed persistent pleural and mediastinal nodal metastases with ypStage IVA disease. He recovered and continued adjuvant savolitinib.

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Lung cancer recurrence in the thyroid, initially mistaken for thyroid cancer

Patient Info: Anonymized, Male | Stage IV

Biomarkers: EGFR exon 19 deletion; TTF-1-positive; Napsin A-positive; PAX8-negative; thyroglobulin staining limited to tumour cells adjacent to normal thyroid tissue

Metastatic Site: thyroid; cervical lymph nodes

After starting osimertinib for EGFR exon 19-deleted recurrent lung adenocarcinoma, he was disease free 5 months after thyroid surgery.

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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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