Immunotherapy for Stage 4 Lung Cancer: 146 Real Stories

Stage IV Lung Cancer: Steve's Patient Story

Patient Info: Steve Castellaw, 70+ | Stage IV

Metastatic Site: right pelvis, L1 and L2 vertebrae, skull

After about 2 years on sotorasib, Steve had a large reduction in tumor size and his latest scans continued to look good while he returned to golf, exercise, and normal daily life.

Pleomorphic Lung Cancer Progressed Despite Pembrolizumab

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

Biomarkers: EGFR-negative; ALK-negative; ROS1-negative; PD-L1 TPS 80%-90%.

Metastatic Site: small intestine; pleura; abdominal subcutaneous tissue

The cancer did not respond to pembrolizumab, and he died four months after immunotherapy began.

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Pembrolizumab Controlled Metastatic Pleomorphic Lung Cancer After Chemotherapy Failed

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

Biomarkers: EGFR-negative; ALK-negative; ROS1-negative; BRAF-negative; PD-L1 TPS 60%-70%; BRCA2, and TP53 mutations; tumor mutation burden 42 mutations/Mb; no actionable alteration.

Metastatic Site: right adrenal gland; left adrenal gland; bone

Tumor diameter had decreased at 11 months, and pembrolizumab remained ongoing at 12 months.

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A painful scalp metastasis from sarcomatoid lung cancer

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

Biomarkers: No targetable mutations identified; CAM5.2-positive; p63-positive; CD10-positive; vimentin-positive.

Metastatic Site: chest wall and rib; liver; right gluteal region; scalp…

Her disease progressed with a further liver lesion and additional metastatic complications, and systemic treatment was stopped because of severe immune-related toxicity and the absence of targetable mutations.

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Stage IV Mucinous Lung Cancer Treated With Afatinib and Surgery

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

Biomarkers: CD74-NRG1 fusion; ALK/ROS1/EGFR/BRAF/KRAS/MET/HER2 wild type; PD-L1 initially not expressed and later 0%-20%

Metastatic Site: bilateral lungs|bone|right adrenal gland

She was alive and receiving treatment after bone and right-adrenal progression at the latest follow-up.

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Stage IV Lung Cancer: Oswald's Patient Story

Patient Info: Oswald Peterson, Male | Stage IV

Metastatic Site: Lymph nodes; Spine

As of December 2020, Oswald described dramatic recovery after immunotherapy for Stage IV lung cancer, returning to the gym, travel, and normal activities; the source did not explicitly report NED or a maintenance schedule.

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Advanced Lung Cancer With Extreme White Blood Cell Counts and Poor Circulation

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

Biomarkers: PD-L1 70%

Metastatic Site: contralateral lung|bone (left iliac)

After a mixed but mildly improved response to three pembrolizumab cycles, she developed severe paraneoplastic leukocytosis, arterial ischaemia, and acute respiratory failure and died after choosing comfort measures.

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Metastatic Lung Cancer Responded Completely After a Change in Immunotherapy

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

Biomarkers: TTF-1-positive; napsin-positive; PD-L1 0%; high tumour mutational burden; no actionable mutations

Metastatic Site: bone (left iliac bone, acetabulum and thoracic…

After progression on nivolumab, atezolizumab produced a complete response by the 6-month scan; after 35 cycles, the response remained sustained, he was alive and well, and no immune-related adverse effects were documented.

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Lung cancer response to pembrolizumab complicated by severe kidney injury

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

The lung tumor had decreased after 5 pembrolizumab courses and had not progressed again by hospital discharge. The kidney complication required temporary dialysis but resolved, with creatinine 0.91 mg/dL at 8-month follow-up.

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Pleomorphic lung cancer responding to pembrolizumab plus chemotherapy

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

Biomarkers: PD-L1 tumor proportion score >75%; EGFR negative; ROS1 negative; ALK fusion negative

Metastatic Site: right 8th rib, left adrenal gland

His general condition improved as the tumors shrank, and he remained well 7 months after diagnosis with maintenance pembrolizumab planned.

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Nivolumab-related adrenal failure during treatment for metastatic lung cancer

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

Metastatic Site: brain (left cerebellum)

Her confusion, gastrointestinal symptoms, and hyponatremia improved after glucocorticoid and mineralocorticoid replacement, and she was discharged on ongoing hormone replacement.

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

Patient Info: Donna Fernandez, Female, 50s | Stage IV

While receiving nivolumab on a Phase III trial, Donna’s tumors remained present but stopped growing, and she was able to return to an active daily life.

Long-Term Nivolumab Response With Thyroid and Adrenal Side Effects

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

Nivolumab remained ongoing at course 82, tumor burden had fallen to one-fifth of baseline, and no disease progression was documented.

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Nivolumab-Related Myocarditis and Heart Block in Metastatic Lung Cancer

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

Metastatic Site: left adrenal gland

He stabilized after high-dose steroids and pacemaker implantation after nivolumab was permanently stopped.

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Hormone Problems During Nivolumab Treatment for Advanced Lung Cancer

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

Biomarkers: EGFR/ALK/ROS1/BRAF wild type

Metastatic Site: abdominal wall|brain

She was living with Stage IVA lung cancer after about 1 year of nivolumab. Thyroid levels normalized after levothyroxine adjustment, and continued endocrine monitoring was planned for treatment-related pituitary dysfunction.

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Durable brain and leptomeningeal response to pembrolizumab in Stage IV lung cancer

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

Biomarkers: PD-L1 high positive; EGFR negative; BRAF negative; KRAS negative; ROS1 negative; ALK negative

Metastatic Site: right adrenal gland, left sixth rib, brain,…

After 29 pembrolizumab cycles over 20 months, imaging showed no leptomeningeal disease, resolution of 3 brain lesions and marked reduction of the dominant frontal lesion; she remained neurologically intact and radiographically stable.

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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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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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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 adenocarcinoma causing sudden hearing loss and vertigo

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

Metastatic Site: bone|liver|brain|internal auditory meatus

About 10 months after the metastatic diagnosis, she developed new left-sided deafness, vertigo and facial weakness associated with metastatic involvement of the internal auditory meatus.

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Stage IV Squamous Lung Cancer Resected After Response to Checkpoint Immunotherapy

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

After complete resection, he was alive, disease free and off treatment at postoperative follow-up.

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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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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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