Immunotherapy for Stage 4 Lung Cancer: 146 Real Stories

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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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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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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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 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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Stage IV Lung Adenocarcinoma Presenting as Persistent Chest Pain and Rib Metastasis

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

Biomarkers: TP53 mutation; PD-L1 30%; no sensitive driver mutation identified

Metastatic Site: bone

After delayed diagnosis of Stage IV lung adenocarcinoma with a painful rib metastasis, he began systemic immunotherapy and local treatment for the painful bone lesion.

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Metastatic SMARCA4-Deficient Lung Cancer Controlled for More Than Two Years With Tislelizumab and Fruquintinib

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

Biomarkers: PD-L1 8%; no target-sensitive mutation identified

Metastatic Site: left adrenal gland, cervical lymph nodes

After radiotherapy reduced the cervical-node metastasis, imaging on April 26, 2024 showed stable disease. He ended trial treatment after 2 years and continued regular follow-up.

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Metastatic lung squamous cell carcinoma: no recurrence after chemoimmunotherapy and pembrolizumab maintenance

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

Biomarkers: EGFR exon 19 deletion; PD-L1 TPS 95%; TTF-1-negative; p40-positive

Metastatic Site: mediastinal lymph nodes; bilateral lung nodules

As of April 2025, PET/CT 3 years after treatment initiation showed no sign of recurrence after carboplatin, nab-paclitaxel, pembrolizumab, and 2 years of pembrolizumab monotherapy.

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Stage IV squamous lung cancer: partial response complicated by pulmonary artery pseudoaneurysm

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

Metastatic Site: distant sites not specified (M1c1)

As of April 2025, tumor imaging showed partial remission/significant reduction, and the pulmonary artery pseudoaneurysm was successfully embolized with no recurrent hemoptysis over 6 months.

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Metastatic lung adenocarcinoma: pembrolizumab response complicated by pulmonary arterial hypertension

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

Biomarkers: CK7-positive; TTF-1-positive; p40 focally positive; high tumor mutational burden; no targetable mutations identified

Metastatic Site: right axillary lymph node; right hilar lymph nodes;…

As of April 2025, the patient was tolerating single-agent pemetrexed without evidence of lung cancer progression, while pulmonary arterial hypertension symptoms had improved on riociguat and macitentan.

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Small-Cell Lung Cancer With Later Brain and Other Metastases in a Woman With COPD

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

Metastatic Site: central nervous system

Her neurologic condition progressively worsened after immune-related encephalitis and extensive metastatic progression. She died from sepsis 8 months after the lung-cancer diagnosis.

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Stage 4 SMARCA4-deficient lung cancer: ongoing treatment response

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

Biomarkers: SMARCA4-deficient lung cancer with BRG-1 loss, CK/CK7 positive, Ki-67 >40%. CEA

Metastatic Site: sigmoid colon, left adrenal gland

After colon metastasis surgery, continued radiotherapy, and later gemcitabine/nedaplatin/bevacizumab/camrelizumab for adrenal metastasis, the cancer showed a favorable response with no further recurrence or new metastasis reported.

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Severe Autoimmune Hemolytic Anemia After Pembrolizumab for Metastatic Lung Cancer

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

Biomarkers: PD-L1 70%

Metastatic Site: left adrenal gland, subdiaphragmatic region

He recovered clinically from the acute hemolytic anemia after intravenous immunoglobulin, high-dose steroids, and blood transfusions, then continued outpatient oncology follow-up.

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Metastatic lung adenocarcinoma: complete remission on nivolumab complicated by immune-mediated diabetes

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

Biomarkers: Lung tumor: EGFR wild type, ALK rearrangement not detected. Immune-mediated diabetes: islet/GAD antibodies negative and C-peptide undetectable.

Metastatic Site: brain (cerebellum and occipital lobe); liver

As of March 2025, serial CT and MRI scans through October 2023 showed no evidence of oncologic disease after nivolumab, while immune-mediated diabetes was controlled with basal-bolus insulin.

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Extended-stage small cell lung cancer with breast metastasis: complete response after pembrolizumab

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

Biomarkers: TMB-high, microsatellite stable; TP53/PTEN mutations, and SOX2/PIK3CA/FGF12 amplifications.

Metastatic Site: breast

As of March 2025, she had maintained complete response for more than 18 months on pembrolizumab monotherapy after prior cisplatin/irinotecan response.

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EGFR-Mutant Lung Adenocarcinoma That Transformed to Small Cell Lung Cancer

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

Biomarkers: EGFR exon 19 deletion; acquired EGFR T790M mutation

Metastatic Site: liver

The cancer progressed after transformation to small cell lung cancer, and she died 49 months after the original diagnosis.

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EGFR-Mutant Lung Adenocarcinoma That Transformed to Small Cell Lung Cancer

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

Biomarkers: EGFR exon 19 deletion

Metastatic Site: brain, adrenal gland, liver, thyroid

The cancer progressed after small-cell transformation with adrenal, thyroid, liver and brain involvement, and she died 52.7 months after the original diagnosis from disease progression and organ failure.

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HER2 exon 20 metastatic lung adenocarcinoma with pathologic complete response after chemoimmunotherapy and surgery

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

Biomarkers: HER2 exon 20 insertion lung adenocarcinoma with TP53 mutation, PD-L1 TPS 50%, and low TMB.

Metastatic Site: contralateral lung

Right lower lobectomy with radical lymphadenectomy in November 2023 showed pathologic complete response, and no additional therapy was offered after surgery.

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