Pembrolizumab for Stage 4 Lung Cancer: 59 Real Stories

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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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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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 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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Primary Lung Cancer That Spread to Both Breasts and the Adrenal Gland

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

Biomarkers: PD-L1 negative; EGFR, ALK, ROS1, RET, MET exon 14, NTRK and BRAF wild type

Metastatic Site: both breasts, subcutaneous tissue, adrenal gland

After the lung origin was established, she was in good general condition and asymptomatic while first-line systemic therapy was being planned.

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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 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 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 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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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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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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