Immunotherapy for Stage 4 Lung Cancer: 146 Real Stories

Stage 4 lung cancer: stable disease on immunotherapy combination

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

Biomarkers: TP53, and MSH2 mutations; PD-L1 locally positive; Ki-67 20%; ALK negative. Markers otherwise supported lung cancer.

Metastatic Site: left atrium, right adrenal gland, skull; hilar and…

Stage IVB NSCLC remained clinically stable during carboplatin, pemetrexed, and tislelizumab, but treatment was stopped because of financial and psychological burden; later cancer status was not reported.

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Stage 4 small-cell lung cancer: complete response on durvalumab

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

Metastatic Site: pericardial effusion; left supraclavicular lymph node

As of July 2024, she had clinical complete response after chemoimmunotherapy and chest radiation, improving immune-related bone changes, and ongoing durvalumab maintenance every 4 weeks.

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Stage 4 small cell lung cancer: response to carboplatin, etoposide, and atezolizumab

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

Biomarkers: CD56-positive; synaptophysin-positive

Metastatic Site: right hilar/mediastinal disease, left adrenal gland,…

Extensive-stage small-cell lung cancer presenting with chronic intestinal pseudo-obstruction improved after 3 cycles of carboplatin, etoposide, and atezolizumab, with PET response and symptomatic improvement; longer-term durability was not reported.

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Stage 4 lung cancer: immunotherapy plus particle therapy halts progression

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

Biomarkers: PD-L1 90%; high tumor mutational burden; PIK3CA ; TP53 mutation; MET mutation

Metastatic Site: left proximal femur

Stage IV oligometastatic NSCLC had good CT response to carboplatin, pemetrexed, and pembrolizumab, then no disease progression 6 months after PULSAR radiotherapy plus pembrolizumab; grade 2 pneumonitis improved with prednisone.

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Stage IV PD-L1-negative lung adenocarcinoma: complete response with nivolumab and ipilimumab

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

Biomarkers: PD-L1-negative; no targetable molecular alterations on DNA/RNA next-generation sequencing; TP53 alteration reported at 66%

Metastatic Site: left pleural effusion; right adrenal gland;…

As of February 2024, she remained on maintenance nivolumab and ipilimumab after 14 cycles, without significant toxicity and with persistent complete response of Stage IV PD-L1-negative lung adenocarcinoma.

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Stage 4 lung cancer: complete response to chemo-immunotherapy combo

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

Metastatic Site: right hilar lymph nodes, mediastinal lymph nodes

Stage IVA lung squamous cell carcinoma achieved complete response at 12 months. Pembrolizumab was stopped after immune-related RS3PE and likely colitis; 8 months after glucocorticoid initiation, there was no relapse of lung cancer or RS3PE.

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

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

Biomarkers: PD-L1 expression positive

Metastatic Site: right femur; brain/cerebellum

As of July 2024, Lenny described himself as NED/no evidence of disease after surgery, CyberKnife radiation, chemotherapy, and Keytruda-based immunotherapy.

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Stage IVA lung adenocarcinoma with solitary brain metastasis: pCR after brain surgery, chemoradiation, immunotherapy, and lobectomy

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

Biomarkers: PD-L1 75%; negative for driver gene mutations and translocations

Metastatic Site: brain

As of May 2024, he had no recurrence after brain metastasis resection and radiation, carboplatin/pemetrexed/atezolizumab, robot-assisted right upper lobectomy with pathologic complete response, and 13 cycles of maintenance atezolizumab.

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Stage 4 lung adenocarcinoma: complete response on immunotherapy combination

Patient Info: Anonymized, Male | Stage IV

Biomarkers: No targetable mutation found. Tissue showed TP53/ARID1A; liquid biopsy added KEAP1, and SMARCA4. PD-L1 not evaluable.

Metastatic Site: bilateral lung nodules, left adrenal gland

As of May 2024, metastatic lung adenocarcinoma had a complete radiologic response lasting more than 14 months on pembrolizumab maintenance, and a new PET-avid lung nodule was benign inflammation rather than cancer.

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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 4 lung adenocarcinoma: brain surgery followed by immunotherapy response

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

Biomarkers: PD-L1-positive; EGFR wild-type/no mutation; ALK rearrangement not detected; TTF-1-positive; Napsin A-positive

Metastatic Site: brain

As of March 2024, after 31 cycles of zimberelimab, the lung lesion had shown partial response, brain metastasis had not recurred, and the patient had 24-month progression-free and intracranial recurrence-free survival with normal quality of life.

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

Patient Info: Tim Monds, Male, 50s | Stage IV

Biomarkers: High PD-L1 expression

Metastatic Site: Other lung lobes / lung nodules

As of March 2024, Tim Monds was identified as a Stage IV lung cancer survivor involved in discussion of the PaCES early palliative-care project and broader lung cancer advocacy.

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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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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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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Living with Stage 4 Lung Cancer (Plus Radiation & My Follow Up!) | Amy’s Story (3 of 3)

Patient Info: Amy, Female | Stage IV

Biomarkers: MET amplification

Metastatic Site: Bone/femur and hips; adrenal gland

As of July 2022, Amy was 3.5 years after Stage IV squamous cell lung cancer diagnosis, not NED but stable for about 3 years on Crizotinib with ongoing imaging and local treatment to lung/adrenal sites.

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Stage IV MET Lung Squamous Cell Carcinoma: Amy's Patient Story

Patient Info: Amy, Female | Stage IV

Biomarkers: MET amplification

Metastatic Site: Bone/femur; lymph nodes; shoulder; adrenal glands;…

As of July 2022, Amy had a rapid and strong response to Crizotinib after MET amplification was found, with pain and lumps improving within about 2 weeks after Keytruda had failed.

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

Patient Info: Amy, Female | Stage IV

Biomarkers: MET amplification identified later in the series; not known at initial treatment decision

As of July 2022, this first Amy segment covered diagnosis, second opinion, and the initial Keytruda-versus-clinical-trial decision before MET amplification was known; later response is addressed in the following series segments.

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

Patient Info: Abby Kanarek, Female, 60s | Stage IV

Biomarkers: PD-L1 90%

Metastatic Site: Brain

As of November 2021, Abby was in remission 2 years after only 4 Keytruda infusions, with the lung cancer eliminated and ongoing surveillance by a multidisciplinary City of Hope team.

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