Surgery for Stage 4 Lung Cancer: 112 Real Stories

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 ALK Lung Cancer: Ruchira's Survivor Story

Patient Info: Ruchira, Female | Stage IV

Biomarkers: ALK-positive

Metastatic Site: Not reported

Although the disease progressed to Stage IV after lobectomy, ALK testing led to lorlatinib; she reported no evidence of disease after 3 months and continued daily targeted therapy.

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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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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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Lung cancer treated with nivolumab: rare kidney inflammation as a side effect

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

Metastatic Site: lung; pleura; lymph nodes

He remained dependent on maintenance hemodialysis after the kidney injury and died from advanced lung cancer 10 months later.

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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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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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Stage IVB EGFR-mutated lung adenocarcinoma with brain metastases: complete response and pathologic complete response

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

Biomarkers: Lung adenocarcinoma with EGFR L858R, PD-L1 TPS 95%

Metastatic Site: brain

Brain metastases achieved complete response on imaging, and surgery after systemic therapy showed pathologic complete response, ypT0N0M0 with 0/13 lymph nodes involved.

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Stage IVA EGFR-mutant lung adenocarcinoma: response to triple targeted therapy and surgery

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

Biomarkers: Initial EGFR exon 19 deletion; acquired BRAF V600E mutation in progressive lesion while EGFR exon 19 deletion persisted

Metastatic Site: pleura, pulmonary metastases; mediastinal and left…

As of May 2025, she continued osimertinib, dabrafenib, and trametinib after segmentectomy/lymphadenectomy, with 1% viable residual tumor in resected lung lesions, complete nodal pathologic response, and no disease progression.

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ALK-fusion lung adenocarcinoma with pleural progression: alectinib toxicity and switch to lorlatinib

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

Biomarkers: EML4::ALK fusion positive

Metastatic Site: pleura

After pleural progression, disease was stable on ALK-targeted therapy; lorlatinib was tolerated after alectinib-related hemolysis and bradycardia resolved.

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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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Metastatic lung adenocarcinoma with brain and iliac bone response to chemoimmunotherapy

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

Biomarkers: PD-L1-negative; no EGFR, ALK, ROS1, RET, KRAS, BRAF, MET, HER2, or NTRK alteration detected; TP53 mutation found.

Metastatic Site: left iliac bone, brain

Brain metastases achieved complete remission without cranial irradiation, and lung, bone, and brain lesions remained stable at last follow-up, with PFS of 35 months and OS exceeding 40 months.

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Recurrent lung adenocarcinoma with bevacizumab-associated glomerular microangiopathy

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

Biomarkers: No tumor molecular biomarkers reported. Kidney biopsy and complement/immune deposits supported bevacizumab-related kidney microangiopathy.

Metastatic Site: pleura

He was living with recurrent metastatic lung adenocarcinoma after pleural spread and had persistent renal dysfunction and severe proteinuria from bevacizumab-associated glomerular microangiopathy despite stopping bevacizumab.

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Stage IVA lung adenosquamous carcinoma: complete response after paclitaxel, nedaplatin, and tislelizumab

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

Biomarkers: Adenosquamous lung cancer markers; PD-L1 TPS 18%; KRAS, BRAF, PIK3CA, FLT1 mutation; TMB 3.7

Metastatic Site: pleura/chest wall, cervical lymph nodes, axillary…

As of March 30, 2025, he maintained complete response with normal tumor markers, no radiologic evidence of progression or recurrence, and progression-free survival of 46.5 months after paclitaxel/nedaplatin/tislelizumab followed by maintenance tislelizumab.

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Stage I Pleomorphic Lung Cancer Recurring With Bone Metastasis Within Five Months

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

Biomarkers: PD-L1 high; no detected driver mutation

Metastatic Site: bone

PET-CT in December 2024 showed a partial response. As of February 2025, he remained on sintilimab and bevacizumab maintenance with about 9 months of progression-free survival after recurrence treatment.

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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.

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How We Got Here: 6 Young Lung Cancer Patients & Their Paths To Surgery- Part 1

Patient Info: Leah Phillips, Female | Stage IV

Biomarkers: EGFR exon 19 deletion

Metastatic Site: bone (pelvis; spine; ribs)

As of April 2025, Leah was living with Stage IV EGFR exon 19 deletion lung cancer while continuing Tagrisso after SBRT and right middle lobe lobectomy.

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Stage 4 SMARCA4-deficient lung cancer: ongoing treatment response

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

Biomarkers: SMARCA4-deficient lung cancer with BRG-1 loss, CK/CK7 positive, Ki-67 >40%. CEA

Metastatic Site: sigmoid colon, left adrenal gland

After colon metastasis surgery, continued radiotherapy, and later gemcitabine/nedaplatin/bevacizumab/camrelizumab for adrenal metastasis, the cancer showed a favorable response with no further recurrence or new metastasis reported.

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Metastatic lung adenocarcinoma: complete remission on nivolumab complicated by immune-mediated diabetes

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

Biomarkers: Lung tumor: EGFR wild type, ALK rearrangement not detected. Immune-mediated diabetes: islet/GAD antibodies negative and C-peptide undetectable.

Metastatic Site: brain (cerebellum and occipital lobe); liver

As of March 2025, serial CT and MRI scans through October 2023 showed no evidence of oncologic disease after nivolumab, while immune-mediated diabetes was controlled with basal-bolus insulin.

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Stage IV KRAS Lung Cancer: Rosemary's Patient Story

Patient Info: Rosemary Conway, female, 60s | Stage IV

Biomarkers: KRAS mutation

After 14 months on daraxonracib in a clinical trial, Rosemary’s Stage IV lung cancer had stopped growing and she had returned to walking and lifting weights.

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EML4-ALK lung cancer: complete remission on alectinib for 4 years

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

Biomarkers: EML4-ALK fusion

Metastatic Site: brain

Alectinib produced complete remission for nearly 4 years; after grade 3 colitis/ulcers, she switched to ceritinib and maintained stable tumor control without recurrent intestinal ulcers or colitis.

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EGFR-Mutant Lung Adenocarcinoma That Transformed to Small Cell Lung Cancer

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

Biomarkers: EGFR exon 19 deletion; acquired EGFR T790M mutation

Metastatic Site: liver

The cancer progressed after transformation to small cell lung cancer, and she died 49 months after the original diagnosis.

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EGFR-Mutant Lung Adenocarcinoma That Transformed to Small Cell Lung Cancer

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

Biomarkers: EGFR exon 19 deletion

Metastatic Site: brain, adrenal gland, liver, thyroid

The cancer progressed after small-cell transformation with adrenal, thyroid, liver and brain involvement, and she died 52.7 months after the original diagnosis from disease progression and organ failure.

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