Chemotherapy for Stage 4 Lung Cancer: 217 Real Stories

Metastatic Lung Adenocarcinoma Complicated by Severe Nivolumab Pneumonitis

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

Biomarkers: Microsatellite stable; low tumor mutation burden; PD-L1 70%

His severe nivolumab-related pneumonitis improved after infliximab.

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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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Delayed Adrenal Insufficiency After Nivolumab for Stage IV Lung Cancer

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

Biomarkers: EGFR unmutated; ALK unmutated; ROS1 unmutated

His weakness, fatigue, weight loss, and orthostatic hypotension resolved after hormone replacement, and he returned home independently.

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EGFR-Mutated Stage IV Lung Adenocarcinoma With Painful Finger Lesions During Osimertinib

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

Biomarkers: EGFR-mutated; EGFR T790M-positive at relapse

She remained on active osimertinib treatment; the finger lesions persisted but were controlled with colloidal oatmeal.

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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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Metastatic lung cancer causing recurrent small-bowel intussusception

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

Biomarkers: EGFR mutation; exon 19 deletion in metastatic bowel lesions

Metastatic Site: small bowel

She recovered satisfactorily after bowel surgery, and care shifted to palliation with long-term nutritional support planned.

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Oligometastatic Lung Cancer With Brain Spread, Surgery and Later Recurrence

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

Metastatic Site: brain

After 15 months off treatment he developed mediastinal nodal and distant metastases and was alive with disease on platinum-based chemotherapy 25 months after surgery.

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Finding Happiness Despite Stage IV Lung Cancer

Patient Info: Anonymized, 50s | Stage IV

More than a year after diagnosis, she remained in treatment for Stage IV lung cancer, with some therapies losing effectiveness as the cancer developed resistance.

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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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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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Lung Cancer Immunotherapy Caused New Type 1 Diabetes

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

Biomarkers: No ALK, ROS1, KRAS or EGFR alteration was detected; CK7-positive; TTF-1-negative; PAX-negative; CK20-negative

Metastatic Site: Pleura

After 4 combination-treatment cycles, the right-lung nodules had decreased markedly and nearly resolved. He continued maintenance pembrolizumab every 3 weeks and remained on insulin with stable glucose control.

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Stage IV Lung Cancer: Bill's Patient Story

Patient Info: Bill Smith, Male | Stage IV

Biomarkers: Genomic testing performed; specific result not reported

Metastatic Site: Brain; liver; bone/humerus

As of October 2016, Bill was receiving immunotherapy every 2 weeks, all tumors had shrunk, chemotherapy had stopped and he reported markedly improved quality of life while living with Stage IV lung cancer.

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Lung Adenocarcinoma Metastatic to the Breast With Inflammatory Breast-Like Symptoms

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

Biomarkers: EGFR positive. Breast metastasis: TTF-1 positive

Metastatic Site: right breast

A PET scan after breast radiation showed no metabolically active cancer, but she died 2 months after the breast metastasis was diagnosed.

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Stage IV NSCLC: near-complete response despite severe docetaxel-induced diarrhea

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

As of October 2013, he had completed 6 cycles of weekly docetaxel-cisplatin with dose reduction and supportive care, resulting in a near-complete response.

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Stage IIIA squamous lung cancer with later kidney and paraaortic lymph node metastases

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

Biomarkers: Squamous lung cancer markers supported the diagnosis; TTF-1, CK7 and CK20 were not seen; Ki-67 >10%.

Metastatic Site: left renal parenchyma, paraaortic lymph nodes

After surgery, 4 cycles of cisplatin plus vinblastine, and mediastinal radiotherapy, she had a 10-month disease-free interval before biopsy-confirmed metastatic squamous lung carcinoma appeared in the left kidney with paraaortic lymph node enlargement.

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EGFR L858R-mutant Stage IV lung adenocarcinoma managed after gefitinib-induced lung injury

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

Biomarkers: EGFR L858R mutation

Metastatic Site: liver, bone, hilar lymph nodes, mediastinal lymph…

Gefitinib produced early tumor shrinkage but was stopped for interstitial lung disease; subsequent carboplatin, pemetrexed, and bevacizumab produced a good response, while variceal bleeding was controlled with endoscopic treatment.

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Stage IV EBV-positive lymphoepithelioma-like lung cancer with brain metastasis

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

Biomarkers: EBV-positive by in-situ hybridization

Metastatic Site: brain, retroperitoneal/posterior mediastinal soft…

Remained well and disease-free 6 months after resection of the retroperitoneal/posterior mediastinal metastasis and 8 years after initial presentation.

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Stage IV lung squamous cell carcinoma with liver metastasis treated with chemotherapy and 90Y radioembolization

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

Metastatic Site: liver

After treatment for liver metastasis, PET CT 2 months after 90Y radioembolization showed complete tumor response without residual tumor, and she was alive without active disease.

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Stage IV large-cell lung cancer with adrenal metastasis: no recurrence after R0 surgery

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

Biomarkers: Marker profile supported large-cell lung carcinoma: CK7/CEA/Ber-EP4 positive, with neuroendocrine and prostate markers negative.

Metastatic Site: left adrenal gland

Six months after combined lung and adrenal surgery with R0 resection, he had no evidence of recurrence.

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Stage IV lung adenocarcinoma with brain metastasis: partial remission after pemetrexed/cisplatin and AOSD-like paraneoplastic syndrome

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

Biomarkers: No tumor molecular biomarkers reported. AOSD-like syndrome had high ferritin, inflammation markers, and RF/ANA negative.

Metastatic Site: brain

As of November 2011, pemetrexed/cisplatin produced partial remission of Stage IV lung adenocarcinoma and controlled the AOSD-like paraneoplastic syndrome without recurrent fever, rash, or arthralgia.

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Stage IV lung adenocarcinoma: partial responses to cisplatin-docetaxel and erlotinib, complicated by fistula

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

Biomarkers: Tumor genomic biomarkers not reported. EGFR testing result not reported; erlotinib was used as second-line therapy.

Metastatic Site: contralateral lung, pleura

Metastatic lung adenocarcinoma had partial response to chemotherapy and persistent partial response on erlotinib; after erlotinib was stopped for enterocutaneous fistula, she was alive and well without evidence of lung-cancer progression.

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Stage IV NSCLC with choroidal metastasis responding to intravitreal bevacizumab

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

Metastatic Site: choroid of right eye

The right-eye choroidal metastasis showed complete local response after intravitreal bevacizumab, with pain resolution, vision improvement to 20/20, and no residual ocular tumor detected 10 months after treatment began.

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