Pembrolizumab for Stage 4 Lung Cancer: 59 Real Stories

Stage IV Lung Cancer: Joanne's Patient Story

Patient Info: Joanne Sabol, Female, 60s | Stage IV

Metastatic Site: abdomen

More than 2 years after starting pembrolizumab for recurrent Stage IV lung cancer, Joanne had an 81% tumor reduction and continued to feel well while remaining on treatment.

Memorial Sloan KetteringRead more →

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

Patient Info: Amy, Female | Stage IV

Metastatic Site: Neck lymph node; bones — hips, femurs, foot; adrenal…

Living 5 years after Stage IV squamous NSCLC diagnosis, after Keytruda did not work and treatment included bone radiation, SBRT to the lung nodule, and adrenal cryoablation.

Lung Cancer Research FoundationRead more →

Stage IV Lung Adenocarcinoma Discovered After Cancer Cells Were Found in a Stroke Clot

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

Biomarkers: PD-L1 high; no actionable driver alteration

Metastatic Site: brain

New frontal brain metastases developed during treatment, and he died 51 days after the stroke that led to discovery of his lung cancer.

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Long-term lung cancer control after immunotherapy-related diabetes

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

Biomarkers: PD-L1 80%; EGFR, ALK, ROS1 and BRAF negative

Metastatic Site: brain|liver

After years of disease control off pembrolizumab, a new brain lesion appeared in December 2025 and was treated with focused radiation. He remained clinically stable under oncology follow-up.

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Long-term lung cancer response complicated by immune-related lung inflammation

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

Biomarkers: KRAS mutation; PD-L1 90%

Metastatic Site: pleura|lungs|peritoneum|bone|brain

By October 2025, the lung inflammation had resolved and she remained in systemic and intracranial remission.

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Complete response to pembrolizumab despite treatment-related lung inflammation

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

Biomarkers: PD-L1 70%

Metastatic Site: pleura|bone

By November 2025, serial imaging continued to show a complete response without disease progression.

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Stage IVA EGFR-mutant lung adenocarcinoma: clonal evolution, chemoimmunotherapy response, osimertinib rechallenge, and death after progression

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

Biomarkers: Markers changed over time: started with EGFR L747S/L858R; later MET-amplified, PD-L1 TPS 80%, high TMB clone; later EGFR reappeared.

Metastatic Site: pleura, peritoneal nodule, retroperitoneal lymph nodes

The patient died on 30 April 2025 after progression through multiple lines and infection related to treatment-associated myelosuppression.

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Stage IV squamous NSCLC: durable pembrolizumab response followed by invasive aspergillosis, marrow failure, and death

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

Biomarkers: PD-L1 20%

Metastatic Site: bilateral lungs

After durable partial response to pembrolizumab-based therapy, he developed severe pulmonary infection, invasive pulmonary aspergillosis, progressive AA-like bone marrow failure with severe cytopenias, declined further treatment, and died at home in early 2025.

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Stage IV squamous lung cancer with steroid-refractory immune-related gastritis after pembrolizumab

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

Biomarkers: Gastric biopsy during immune gastritis showed CD8-positive lymphocyte inflammation, no cancer

After about 2 years of carboplatin, pemetrexed, and pembrolizumab, lung cancer treatment was stopped because of tumor growth; the later immune-related gastritis improved after escalation to infliximab, while the cancer course remained a setback/progression story.

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MET exon 14 skipping lung adenocarcinoma: sequential MET-TKI toxicity and ongoing chemotherapy

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

Biomarkers: MET exon 14 skipping mutation; EGFR negative; ALK negative; ROS1 negative; PD-L1 tumor proportion score 10%

Metastatic Site: pleura

The cancer recurred with pleural dissemination after surgery and adjuvant UFT. Sequential MET inhibitors and systemic therapies provided periods of disease control but were limited by ILD and non-ILD toxicities; at the report, he remained on carboplatin, pemetrexed, and bevacizumab.

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KRAS G12C Stage IV lung adenocarcinoma with synchronous urothelial carcinoma and durable response

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

Biomarkers: Lung adenocarcinoma: KRAS ; PD-L1 TPS 5%. Urothelial carcinoma: GATA3-positive; CK7-positive; TTF1-negative.

Metastatic Site: homolateral pulmonary metastases and N2 lymph nodes…

After enfortumab vedotin, the urothelial carcinoma reached complete radiologic response and the lung cancer remained partially responding/stable; treatment was stopped after 16 months, and PET 2 months later showed complete metabolic response.

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Stage IV squamous lung cancer: complete response followed by fatal bone marrow metastasis

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

Biomarkers: with PD-L1 95%. SCC antigen/CYFRA rose at relapse.

Metastatic Site: bone (spine, bilateral humerus, bilateral femur); bone…

As of December 2025, he had died of aspiration pneumonia 1 month after admission for biopsy-confirmed bone marrow metastasis from squamous lung cancer, despite a prior complete response to chemoimmunotherapy and pembrolizumab maintenance.

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Stage IV NSCLC with brain metastasis and organic psychosis: improvement with blonanserin patch

Patient Info: Anonymized, Male | Stage IV

Metastatic Site: brain, bone

As of December 2025, he was living with Stage IV NSCLC and brain metastases; severe organic psychosis linked to brain metastasis improved with blonanserin transdermal patch, allowing discharge on hospital day 53.

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Synchronous primary squamous lung cancers: long disease control after multimodal therapy, then Stage IVA lung recurrence

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

Biomarkers: Squamous lung cancers with PD-L1 20% and no driver mutation detected; P40/P63 markers supported squamous type.

Metastatic Site: bilateral lung metastases at recurrence

As of November 2025, the patient had achieved 72 months of progression-free survival and remained alive at 75 months, but had developed Stage IVA recurrent pulmonary squamous cell carcinoma with bilateral lung metastases and had restarted systemic therapy.

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Stage IV lung adenocarcinoma with paraneoplastic nephrotic syndrome during pembrolizumab therapy

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

Biomarkers: PD-L1 tumor proportion score >50% by Roche SP263 assay; KRAS exon 3 mutation; NGS/FISH did not identify targets for first-line targeted therapy

Metastatic Site: brain, bone

Pembrolizumab produced partial response and improved nephrotic-syndrome parameters, but bone metastases progressed in September 2022 and the right upper-lobe target lesion progressed 2 months later, leading to carboplatin plus pemetrexed.

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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 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.

City of HopeRead more →

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.

PubMed CentralRead more →

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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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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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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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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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.

PubMed CentralRead more →