Immunotherapy for Stage 4 Lung Cancer: 146 Real Stories

Stage 4 lung adenocarcinoma with RET fusion responding to pralsetinib

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

Biomarkers: RET fusion

Metastatic Site: pleura

As of March 2025, he had recovered from grade 3 Pneumocystis jirovecii pneumonia, restarted pralsetinib, and had no progressive disease or recurrence of adverse events over 13 months.

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Stage 4 lung cancer: managing pembrolizumab-induced myasthenia gravis

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

Biomarkers: Anti-acetylcholine receptor antibody elevated; TSH elevated during immune-related adverse event workup; cancer biomarkers not reported

At 9 months after the immune-related myasthenia gravis presentation, lung cancer remained in complete response while she continued low-dose prednisolone, pyridostigmine, levothyroxine, and nighttime NIV.

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Stage 4 small cell lung cancer with paraneoplastic neurological syndrome

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

Biomarkers: Paraneoplastic antibody panel positive for anti-Hu, anti-AMPH, anti-Ri

Metastatic Site: left axillary lymph nodes

Over 2 years of follow-up, CT showed stable complete response, tumor markers stayed normal, no new metastases appeared, and neurological symptoms did not worsen.

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Fatal Multiorgan Failure After Pembrolizumab-Based Treatment for Metastatic Lung Cancer

Patient Info: Anonymized, female | Stage IV

She died less than 12 hours after hospital presentation with rapidly progressive multiorgan failure one week after the first pembrolizumab-based treatment cycle; immune-related toxicity was strongly suspected, although the rapid decline limited full evaluation.

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ALK-Fusion Small Cell Lung Cancer Responding to ALK-Targeted Therapy

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

Biomarkers: EML4-ALK fusion

Metastatic Site: brain

After several earlier treatments stopped controlling the cancer, ALK-targeted iruplinalkib produced a partial response and was still controlling disease after more than 8 months.

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

Patient Info: Eugenia Horan, Female, 40s | Stage IV

Eugenia became Stage IV while critically ill in the ICU and was later told hospice might be appropriate, but she started Keytruda on August 29, 2019 and was alive 5 years later. As of February 2025, she described that treatment as the medicine that saved her.

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Metastatic Lung Adenocarcinoma With a Serious Immune-Therapy Pituitary Complication

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

Biomarkers: No detected EGFR, ALK, ROS1, RET, MET or HER2 alterations

Metastatic Site: brain, meninges, skull, bone, pituitary

The cancer had progressed to extensive brain, skull and bone involvement after several treatments. Steroid treatment improved the severe thirst, high urine output and other symptoms from immune-related hypophysitis.

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Stage IV Squamous Lung Cancer Complicated by an Esophageal-Mediastinal Fistula

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

Metastatic Site: brain, bone

Four months after the fistula was treated conservatively, imaging showed the fistula had resolved and the lung tumor and metastatic hilar nodes had decreased despite no additional antitumor treatment during that interval.

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Stage IVA pulmonary squamous cell carcinoma with nasal and bone metastases: response after paclitaxel, carboplatin, and tislelizumab

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

Biomarkers: PD-L1 15%

Metastatic Site: nasal region/skin; bone (left acromion)

The lung tumor and nasal metastasis regressed after paclitaxel/carboplatin plus tislelizumab, symptoms improved, no immune-related pneumonitis/colitis/hepatitis occurred, and progression-free survival exceeded 12 months.

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Lung Adenocarcinoma That Transformed to Small Cell Cancer After Recurrence

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

Biomarkers: PD-L1 1%-24%; no druggable driver alteration identified

Metastatic Site: brain, liver

After treatment for the small-cell-transformed recurrence, the liver metastases showed sustained regression and progression-free survival had reached 13 months by September 2024.

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MET Y1003N-Mutant Lung Adenocarcinoma Responding to Tepotinib

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

Biomarkers: MET mutation

Metastatic Site: bone

Tepotinib produced an 8-month response after many earlier treatments, but the cancer later recurred and she died about 3 years after treatment began.

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Stage 4 lung cancer: complete response to chemoimmunotherapy and surgery

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

Biomarkers: EGFR exon 20 duplication with PD-L1 TPS 70%; P40/CK5/6 positive squamous markers; Ki-67 60%.

Metastatic Site: right adrenal gland; possible adjacent…

As of May 7, 2024, CT follow-up showed no evidence of disease after chemoimmunotherapy, conversion surgery with pathologic complete response, and pembrolizumab maintenance.

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Stage IV lung cancer: brain metastasis complete response after chemoimmunotherapy

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

Biomarkers: KRAS-mutated; BRG-1 partial loss; PD-L1 TPS 5%; CPS 20

Metastatic Site: brain (right cerebellar hemisphere)

The right cerebellar brain metastasis completely resolved and chest CT showed only postsurgical changes after carrelizumab plus paclitaxel/carboplatin; immune-mediated adrenal insufficiency improved with systemic glucocorticoids.

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Small Cell Lung Cancer With Paraneoplastic Cushing Syndrome Treated With Immunochemotherapy

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

Biomarkers: PD-L1 negative; low tumor mutation burden; microsatellite stable

Metastatic Site: liver, abdominal wall, left ilium

He lived 20 months after diagnosis. After repeated treatment responses and later progression, he died in September 2023 from respiratory and cardiac failure during a severe infection following treatment-related myelosuppression.

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Stage IV lung adenocarcinoma: ROS1 fusion detected after immunotherapy resistance and partial response to entrectinib

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

Biomarkers: Initial lung adenocarcinoma markers supported lung origin; PD-L1 <1%, no target found at first. Later testing found CD74-ROS1 fusion.

Metastatic Site: brain, bilateral lung lesions

As of December 2024, repeat imaging after entrectinib showed partial response in lung disease and regression of brain metastases, with the patient stable and willing to continue treatment.

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Stage IV lung adenocarcinoma: clinical complete remission with pembrolizumab

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

Biomarkers: No EGFR/ALK/BRAF driver alteration; PD-L1 <1%; high TMB in tissue and blood; immune-cell markers reported.

Metastatic Site: bilateral lungs, mediastinal lymph nodes, right hilar…

Clinical complete remission by RECIST while receiving pembrolizumab monotherapy for driver-negative, PD-L1-negative, high-TMB Stage IV lung adenocarcinoma.

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Stage IV Lung Cancer: Natalie's Patient Story

Patient Info: Natalie, Female | Stage IV

Metastatic Site: lungs, lymph nodes

As of December 2024, Natalie had restarted chemotherapy after progression, and the current chemotherapy had stopped growth for the moment while she continued transplant evaluation.

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Stage IV Lung Adenocarcinoma With Delayed Pembrolizumab-Related Pneumonitis

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

Metastatic Site: contralateral lung

After brachytherapy and continued pembrolizumab, imaging 1 year later showed a smaller right hilar lesion with otherwise stable disease. She later recovered from delayed pembrolizumab-related pneumonitis after immunotherapy had been stopped.

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Lung Adenocarcinoma With Immune-Related Abdominal Inflammation and Later Bone Progression

Patient Info: Anonymized, male | Stage IV

Biomarkers: PD-L1 30%; KRAS G13X mutation; EGFR/ALK/ROS1 negative

Metastatic Site: bone

After several periods of response or stability, lymph-node progression recurred and bone progression was documented in July 2024. Another treatment line was being planned.

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

Patient Info: Samantha, Female | Stage IV

Biomarkers: HER2 mutation

Metastatic Site: Lungs/pleural fluid; liver

As of November 2024, Samantha reported a 55% reduction across the board on chemotherapy plus immunotherapy, few side effects, improved energy, and enough function to hike, work, and feel more like herself.

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Stage 4 small-cell lung cancer: ongoing response to immunotherapy

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

Biomarkers: PD-L1-negative

Metastatic Site: liver, bone, brain

Extensive-stage small-cell lung cancer had complete response in the primary lung, liver, bone, and treated brain lesions, with partial response in hilar/mediastinal nodes; after about 20 months of serplulimab-based first-line therapy, the patient had no deterioration, no immunotherapy-related adverse effects, and high quality of life.

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Stage IV Non-Small Cell Lung Cancer: Ashley's Survivor Story

Patient Info: Ashley Vasallo, Female, Under 40 | Stage IV

Biomarkers: No actionable driver biomarker identified; rare fusion reported

Metastatic Site: spine, hip/bone, chest cavity

As of October 2024, Ashley reported clear labs and scans after radiation for small chest-cavity and hip lesions, with scans planned every 3 months.

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Stage IV Lung Cancer: Florence's Patient Story

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

Metastatic Site: Brain

As of the September 2024 article update, Florence was living with metastatic lung cancer, traveling every 3 weeks for immunotherapy in a clinical trial, and reported less fatigue, more energy, and a return to sports and social life.

Stage 4 lung LCNEC: major response to chemotherapy plus immunotherapy

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

Biomarkers: Large-cell neuroendocrine lung cancer markers were positive. PD-L1 was negative

Metastatic Site: left adrenal gland

By July 2024, PET-CT showed complete metabolic response of the adrenal metastasis, no visible adrenal disease, no pulmonary recurrence, and no distant metastasis after immunochemotherapy, lobectomy, adjuvant therapy, and serplulimab maintenance.

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