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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Lung adenocarcinoma first detected through an adrenal metastasis

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

Biomarkers: No driver mutations identified.

Metastatic Site: left adrenal gland

After resection of the adrenal metastasis, postoperative imaging showed further thoracic uptake and he began palliative chemotherapy for metastatic lung adenocarcinoma without identified driver mutations.

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Likely lung carcinoma presenting as bilateral adrenal metastases

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

Metastatic Site: bilateral adrenal glands

Three months after bilateral adrenalectomy, he remained under regular oncology surveillance, was receiving steroid replacement, and had not required adjuvant chemotherapy.

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A regressed choroidal metastasis during EGFR-targeted lung cancer treatment

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

Biomarkers: EGFR exon 19 deletion.

Metastatic Site: liver; bone; central nervous system; right choroid

The right choroidal metastasis appeared inactive and regressed during systemic treatment, visual acuity remained 20/20, and no local eye treatment was required.

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

Patient Info: Saila Hanninen, Under 40 | Stage IV

Biomarkers: EGFR mutation

After progression on earlier EGFR-directed treatment and other therapies, Saila began chemotherapy and her cancer was stable at the time of the story.

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Lung adenocarcinoma first presented through skin and haemorrhagic brain metastases

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

Biomarkers: TTF-1-positive; CK7-positive; CEA-positive; PD-L1 10%; EGFR-negative; ALK-negative; ROS1-negative; BRAF-negative

Metastatic Site: skin|brain

Her condition declined rapidly after brain radiation, systemic therapy could not be started, and she died from metastatic lung cancer within 6 weeks of presentation.

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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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Long response to afatinib in EGFR-mutated lung cancer

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

Biomarkers: EGFR L861Q mutation; EGFR G719X mutation

Metastatic Site: multiple bilateral ribs

CT at 30 months showed no recurrence, and he remained well 32 months after starting afatinib.

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

Patient Info: Tomma Hargraves, Female | Stage IV

Metastatic Site: brain

After a later brain and lymph-node relapse was brought under control, Tomma had no further cancer treatment and remained active in survivorship advocacy. She died on September 7, 2023.

Tomma Hargraves: Choosing to Help Other Patients after Surviving Lung Cancer

Patient Info: Tomma Hargraves | Stage IV

Metastatic Site: brain

After treatment and a later recurrence, Tomma went many years without further cancer treatment and became a patient navigator and advocate. She died on September 7, 2023.

Surgery for an isolated splenic metastasis from lung adenocarcinoma

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

Metastatic Site: spleen

Nine months after removal of the isolated splenic metastasis, follow-up showed no local or disseminated recurrence and she remained under regular lung-cancer surveillance.

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More than 10 years living with relapsing extensive-stage small cell lung cancer

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

Biomarkers: Chromogranin-positive.

Metastatic Site: pleura; pancreas; left kidney and perinephric region

After five treatment lines and several metastatic relapses over more than 10 years, his latest irinotecan and carboplatin course produced another partial response and he was doing well at the last follow-up.

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Late-onset mania revealed advanced small cell lung cancer

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

Biomarkers: ACTH-producing tumor with ACTH 776 pg/mL and morning cortisol 206.8 micrograms/dL.

Metastatic Site: right lung; liver

He died a few months after diagnosis from aspiration pneumonia and multiorgan failure in the setting of rapidly deteriorating stage IV small cell lung cancer.

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Osimertinib rechallenge after severe pneumonitis in Stage IV lung cancer

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

Biomarkers: EGFR exon 19 deletion; acquired EGFR T790M mutation

Metastatic Site: pleura, liver, bone, leptomeninges

She initially regained a significant response after osimertinib rechallenge without recurrent pneumonitis, but developed progressive leptomeningeal disease after 11 months.

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Stage IV EGFR-mutated lung cancer responding to osimertinib despite new lung opacities

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

Biomarkers: EGFR L858R mutation; EGFR T790M mutation

Metastatic Site: bilateral lungs

Over the following year on osimertinib, imaging showed an excellent tumour response with gradual improvement of the lung opacities and sustained clinical improvement.

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Erlotinib-related uveitis during treatment for stage IV EGFR-mutated lung cancer

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

Biomarkers: EGFR L858R mutation-positive.

A partial response to erlotinib was maintained at six months, while the uveitis resolved and did not recur after treatment resumed at a lower dose.

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A uterine mass revealed a rare metastasis from lung adenocarcinoma

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

Biomarkers: CK7-positive; TTF-1-positive; CK20-negative; PAX8-negative; GATA3-negative.

Metastatic Site: uterus within a leiomyoma

Twelve months after removal of the uterine metastasis, she remained well with normal surveillance imaging and no concern for recurrent disease.

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