Surgery for Stage 4 Lung Cancer: 112 Real Stories

HER2 exon 20 metastatic lung adenocarcinoma with pathologic complete response after chemoimmunotherapy and surgery

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

Biomarkers: HER2 exon 20 insertion lung adenocarcinoma with TP53 mutation, PD-L1 TPS 50%, and low TMB.

Metastatic Site: contralateral lung

Right lower lobectomy with radical lymphadenectomy in November 2023 showed pathologic complete response, and no additional therapy was offered after surgery.

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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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Stage 4 RET-rearranged lung cancer: complete pathologic response to pralsetinib

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

Biomarkers: KIF5B-RET rearrangement; TP53 missense mutation; PD-L1-negative; CK7-positive; TTF-1-positive; Ki-67 70%

Metastatic Site: pleura, mediastinal lymph nodes, hilar lymph nodes

After pralsetinib response and surgery, pathology showed no residual viable tumor in the lung primary, pleural nodules, or sampled lymph nodes; she continued adjuvant pralsetinib.

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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.

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Lung Adenocarcinoma With Rare Skin Metastasis to the Neck

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

Metastatic Site: neck skin

The lung cancer later spread to the neck skin, and he died during the following year after stopping further treatment.

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Metastatic lung adenocarcinoma with cervical spine involvement: surgery after cord compression

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

Metastatic Site: cervical spine

Cervical spine metastatic disease caused acute spinal cord compression requiring emergency decompression and reoperation; neurologic function improved partially, but he was discharged with substantial residual disability.

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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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ALK-Positive Metastatic Lung Cancer Responding to Lorlatinib During Hemodialysis

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

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

Metastatic Site: brain

After about 1 year of lorlatinib, imaging was almost compatible with a complete response, brain MRI showed no active lesions, and she continued treatment with manageable high cholesterol as the main reported side effect.

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Lung Adenocarcinoma That Transformed to Small Cell Cancer After Recurrence

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

Biomarkers: PD-L1 1%-24%; no druggable driver alteration identified

Metastatic Site: brain, liver

After treatment for the small-cell-transformed recurrence, the liver metastases showed sustained regression and progression-free survival had reached 13 months by September 2024.

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EGFR-Mutant Lung Cancer With Pleomorphic Transformation Treated With Local Surgery

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

Biomarkers: EGFR L858R mutation; PD-L1 less than 1% initially and greater than 75% after transformation

Metastatic Site: brain

Nine months after surgery for isolated progression, no recurrence had been seen and she remained on osimertinib.

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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 cancer: brain metastasis complete response after chemoimmunotherapy

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

Biomarkers: KRAS-mutated; BRG-1 partial loss; PD-L1 TPS 5%; CPS 20

Metastatic Site: brain (right cerebellar hemisphere)

The right cerebellar brain metastasis completely resolved and chest CT showed only postsurgical changes after carrelizumab plus paclitaxel/carboplatin; immune-mediated adrenal insufficiency improved with systemic glucocorticoids.

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Doctors Assured Me It Wasn’t Cancer!

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

Biomarkers: ALK-rearranged

Metastatic Site: mediastinum, pleura

Shirley was living with Stage IV ALK-positive lung cancer on a phase 2 ALK clinical trial; scans remained stable after 2 scan sets, but the large mass persisted.

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Small Cell Lung Cancer With Paraneoplastic Cushing Syndrome Treated With Immunochemotherapy

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

Biomarkers: PD-L1 negative; low tumor mutation burden; microsatellite stable

Metastatic Site: liver, abdominal wall, left ilium

He lived 20 months after diagnosis. After repeated treatment responses and later progression, he died in September 2023 from respiratory and cardiac failure during a severe infection following treatment-related myelosuppression.

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Stage IV EGFR Lung Cancer: Leah's Patient Story

Patient Info: Leah Phillips, Female, 40s | Stage IV

Biomarkers: EGFR mutation

Metastatic Site: Not reported

As of December 2024, Leah was recovering well a few weeks after right-middle-lobe lobectomy, but remained a Stage IV EGFR-mutated lung cancer patient needing ongoing treatment and follow-up.

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

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

Biomarkers: EGFR exon 19 deletion

Metastatic Site: brain, bone, left lung, kidney

As of November 2024, Filipe was living with ongoing Stage IV EGFR exon 19-mutated lung cancer after initial response to osimertinib, later progression and current amivantamab plus chemotherapy.

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Stage IV Non-Small Cell Lung Cancer: Ashley's Survivor Story

Patient Info: Ashley Vasallo, Female, Under 40 | Stage IV

Biomarkers: No actionable driver biomarker identified; rare fusion reported

Metastatic Site: spine, hip/bone, chest cavity

As of October 2024, Ashley reported clear labs and scans after radiation for small chest-cavity and hip lesions, with scans planned every 3 months.

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Stage I Lung Adenocarcinoma With Later Kidney Metastases Responding to Osimertinib

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

Biomarkers: EGFR L858R mutation; RB1 mutation; MAP3K1 mutation; PD-L1 negative

Metastatic Site: kidneys, peritoneal lymph nodes

Osimertinib produced a partial response within 6 weeks after metastatic recurrence in the kidneys. She remained alive and continued targeted treatment.

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Stage IV Lung Cancer: Florence's Patient Story

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

Metastatic Site: Brain

As of the September 2024 article update, Florence was living with metastatic lung cancer, traveling every 3 weeks for immunotherapy in a clinical trial, and reported less fatigue, more energy, and a return to sports and social life.

Stage 4 lung LCNEC: major response to chemotherapy plus immunotherapy

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

Biomarkers: Large-cell neuroendocrine lung cancer markers were positive. PD-L1 was negative

Metastatic Site: left adrenal gland

By July 2024, PET-CT showed complete metabolic response of the adrenal metastasis, no visible adrenal disease, no pulmonary recurrence, and no distant metastasis after immunochemotherapy, lobectomy, adjuvant therapy, and serplulimab maintenance.

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Stage 4 lung cancer: complete resection after splenectomy

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

Biomarkers: TTF-1-positive; Synaptophysin-positive; CD56-positive

Metastatic Site: spleen

No evidence of recurrence 1 year after open splenectomy/partial diaphragm resection and later R0 resection of the primary lung tumor for Stage IVB lung cancer with splenic metastasis; systemic therapy was refused.

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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 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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