Radiation for Stage 4 Lung Cancer: 150 Real Stories

EGFR-mutated Stage IV lung cancer with later brain progression

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

Biomarkers: EGFR exon 19 deletion; acquired EGFR C797S mutation; acquired ROS1 rearrangement

Metastatic Site: brain|bone

She died about 20 months after diagnosis after brain progression and a severe postoperative stroke.

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Stage IV ALK Lung Cancer: Jake's Patient Story

Patient Info: Jake, Male, Under 40 | Stage IV

Biomarkers: ALK-positive mutation

Metastatic Site: brain; lung; ankle bone

As of May 2026, Jake was 28 and had lived more than 13 years with Stage IV ALK-positive lung cancer, with ongoing treatment history including targeted therapy, surgeries, radiation, clinical-trial therapy, and recent chemotherapy.

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More than 5 years of disease control with maintenance chemotherapy for Stage IV lung cancer

Patient Info: Anonymized, Male | Stage IV

Biomarkers: KRAS mutation; TP53 mutation

Metastatic Site: brain

After more than 60 months of follow-up and prolonged maintenance chemotherapy, the latest assessment found no evidence of current tumor progression.

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Stage IV EGFR Lung Cancer: Kelsey's Patient Story

Patient Info: Kelsey, Female, Under 40 | Stage IV

Biomarkers: EGFR mutation; later ALK mutation after progression

Metastatic Site: Bone — pelvis and spine/L5

Living with Stage IV lung cancer on a clinical trial after progression, with current treatment described as working and quality of life improved.

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

Patient Info: Natalie, Female, Under 40 | Stage IV

Metastatic Site: Spine

Natalie was living with Stage IV NSCLC after a double lung transplant gave her new lung function, but cancer later appeared in the spine and required renewed chemotherapy and radiation.

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

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

Biomarkers: EGFR mutation; MET amplification resistance mutation; MET overexpression

Metastatic Site: Brain

Maggie initially reached no evidence of disease on EGFR-targeted therapy, but later had repeated progression, including MET-amplification resistance and MET overexpression, requiring SBRT, a clinical trial, chemotherapy, and later-line targeted treatment.

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

Patient Info: Clara, Female, Under 40 | Stage IV

Biomarkers: ALK-positive / ALK-rearranged after repeat Tempus testing

Metastatic Site: Pelvis; spleen

As of February 2026, ALK-targeted therapy had improved Clara’s symptoms enough that she no longer needed a walker or cane, and upcoming scans would determine whether pelvic tumor surgery remained an option.

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Stage IV ROS1 Lung Cancer: Phil's Patient Story

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

Biomarkers: ROS1 mutation

Metastatic Site: Lymph nodes; other lung

Phil was living with incurable Stage IV ROS1-positive lung cancer. After initial chemotherapy, a ROS1-targeted pill worked for about 2 years, and he later continued on a Mass General clinical-trial treatment with follow-up every 3 months.

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Stage IV Small Cell Lung Cancer: Jennifer's Survivor Story

Patient Info: Jennifer Robertson, Female, 40s | Stage IV

Metastatic Site: Collar bones; shoulder blades; femur; pancreas;…

As of February 2026, Jennifer had shown no evidence of disease since August 2025 after tarlatamab-dlle and whole-brain radiation, while continuing tarlatamab infusions every other Monday and scans every 3 months.

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EGFR-mutant lung adenocarcinoma with acquired ROS1 rearrangement after EGFR-TKI resistance

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

Biomarkers: EGFR exon 19 deletion; acquired EGFR T790M; acquired EZR exon10-ROS1 exon34 rearrangement

Metastatic Site: bone (distal femur); contralateral lung;…

After fourth-line crizotinib for acquired EZR-ROS1 rearrangement, response evaluation on August 27, 2025 showed partial response, and September 2025 bone scan showed stable bone lesions.

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Stage 4 lung cancer: never-smoker with complete remission

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

Biomarkers: EGFR20ins mutation; TP53 p.Q192 mutation; PD-L1 TPS 0%; CPS 0%

Metastatic Site: bilateral lungs, mediastinal lymph nodes, bilateral…

The patient had a durable response to high-dose furmonertinib, later developed a right cerebellar metastasis treated with stereotactic radiation, and continued to benefit from furmonertinib as of April 2025 with 27 months of progression-free survival reported.

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Lynch-associated lung and colorectal cancers responded to immunotherapy

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

Biomarkers: dMMR/MSI-H pattern with MLH1/PMS2 loss and germline MLH1 mutation; KRAS and PTEN mutations; PD-L1 TPS 15%.

Metastatic Site: right paraspinal metastatic lesion from lung…

After starting iparomlimab plus tuvonralimab, pleural and pelvic disease improved, intestinal wall involvement decreased further after 5 cycles, the paraspinal lung metastasis remained stable, tumor markers stayed normal, and treatment continued.

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

Patient Info: Jennifer, Female | Stage IV

Biomarkers: EGFR genomic mutation

Metastatic Site: Not reported

Jennifer is alive more than 5.5 years after a Stage IV adenocarcinoma diagnosis, continuing EGFR-targeted treatment and living with ongoing side effects and surveillance needs.

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Stage IV METex14 lung adenocarcinoma: responding well to capmatinib and SBRT

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

Biomarkers: MET exon 14 skipping mutation; PD-L1 >80%. EGFR/RAS/MEK wild type; lung-origin markers present.

Metastatic Site: brain; bone (thoracic/lumbar vertebrae, right iliac…

At 24 months after diagnosis, he was alive, asymptomatic, and continuing capmatinib with no evidence of progression and excellent tolerance.

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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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Extensive-stage small-cell lung cancer with bone metastases: stable response after durvalumab rechallenge

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

Metastatic Site: bone (axial skeleton and skull)

As of November 2025, the patient continued durvalumab with no recurrent gastritis symptoms, continued response to treatment, and no evidence of disease progression on regular CT and bone-scan surveillance.

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Stage IV NSCLC with brain and leptomeningeal metastases responding to radiotherapy, camrelizumab, GM-CSF, and chemotherapy

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

Biomarkers: Lung cancer markers supported adenocarcinoma. PD-L1 negative; no common lung driver found; TMB high; MSI not detected.

Metastatic Site: brain, leptomeningeal disease, left supraclavicular…

As of March 2025, leptomeningeal metastases had complete response, brain lesions had further regression, the lung lesion had decreased from 76 mm to 21 mm, and overall disease remained in partial response with 69 months of progression-free survival since radiotherapy.

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Stage IV Pulmonary Lymphoepithelioma-Like Cancer With Pseudoprogression After Immunotherapy and Radiation

Patient Info: Anonymized, female, Under 40 | Stage IV

Biomarkers: EBER positive; no EGFR, ROS1, RAS/RAF or PIK3CA mutations/fusions detected

Through May 2025, follow-up showed no clear evidence of cancer recurrence or metastasis, with progression-free survival exceeding 70 months.

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Stage IVB SMARCA4-deficient NSCLC with brain metastasis: stable disease after surgery, radiation, chemotherapy, immunotherapy, and bevacizumab

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

Biomarkers: SMARCA4/BRG-1 loss with TP53 and other mutations; TMB high; PD-L1 <1%; MSI-H not detected.

Metastatic Site: brain

As of October 2025, the patient had stable disease, no brain recurrence, a controlled left lower-lobe lung lesion, and manageable treatment toxicity while continuing bevacizumab plus pemetrexed maintenance.

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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 ROS1 Non-Small Cell Lung Cancer: Drea's Patient Story

Patient Info: Drea, Female, Under 40 | Stage IV

Biomarkers: ROS1-positive

Metastatic Site: bilateral lungs; spine; pelvis; brain

Drea had about 3 years of good response and quality of life on her first ROS1 TKI; after new lesions appeared, a second TKI was keeping disease under control with manageable symptoms.

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Stage IVA lung adenocarcinoma: fatal hemoptysis from pulmonary artery pseudoaneurysm after chemoradiotherapy

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

Biomarkers: CEA 62 ng/mL; CA19-9 and neuron-specific enolase within normal limits; no molecular biomarkers reported

Metastatic Site: bone (11th thoracic vertebra)

The patient died from airway obstruction after massive hemoptysis caused by rupture of a pulmonary artery pseudoaneurysm that developed at the tumor-invaded pulmonary artery site after chemoradiotherapy.

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EGFR L858R lung adenocarcinoma presenting as rectal and peritoneal metastases

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

Biomarkers: Rectal/peritoneal tumors supported lung origin. Key result: EGFR L858R with TP53 mutations; no other actionable lung alteration reported.

Metastatic Site: rectum; peritoneum; omentum; mesentery; colonic wall

After transverse colostomy and confirmation of EGFR L858R-mutant lung adenocarcinoma metastasis, aumolertinib led to clinical stabilization; palliative radiotherapy was later given to the rectal lesion, but long-term follow-up was not yet available.

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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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