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.

PubMed CentralRead more →

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.

PubMed CentralRead more →

Long-term erlotinib treatment alongside worsening kidney vasculitis

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

Metastatic Site: bone

Bone metastases showed osteosclerotic change after erlotinib began, and the drug continued because he was benefiting from treatment despite worsening renal vasculitis.

PubMed CentralRead more →

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

Patient Info: Abby Kanarek, Female, 60s | Stage IV

Biomarkers: PD-L1 90%

Metastatic Site: Brain

As of November 2021, Abby was in remission 2 years after only 4 Keytruda infusions, with the lung cancer eliminated and ongoing surveillance by a multidisciplinary City of Hope team.

City of HopeRead more →

Pleomorphic Lung Cancer Progressed Despite Pembrolizumab

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

Biomarkers: EGFR-negative; ALK-negative; ROS1-negative; PD-L1 TPS 80%-90%.

Metastatic Site: small intestine; pleura; abdominal subcutaneous tissue

The cancer did not respond to pembrolizumab, and he died four months after immunotherapy began.

PubMed CentralRead more →

Pembrolizumab Controlled Metastatic Pleomorphic Lung Cancer After Chemotherapy Failed

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

Biomarkers: EGFR-negative; ALK-negative; ROS1-negative; BRAF-negative; PD-L1 TPS 60%-70%; BRCA2, and TP53 mutations; tumor mutation burden 42 mutations/Mb; no actionable alteration.

Metastatic Site: right adrenal gland; left adrenal gland; bone

Tumor diameter had decreased at 11 months, and pembrolizumab remained ongoing at 12 months.

PubMed CentralRead more →

A painful scalp metastasis from sarcomatoid lung cancer

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

Biomarkers: No targetable mutations identified; CAM5.2-positive; p63-positive; CD10-positive; vimentin-positive.

Metastatic Site: chest wall and rib; liver; right gluteal region; scalp…

Her disease progressed with a further liver lesion and additional metastatic complications, and systemic treatment was stopped because of severe immune-related toxicity and the absence of targetable mutations.

PubMed CentralRead more →

Lung adenocarcinoma first detected through an adrenal metastasis

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

Biomarkers: No driver mutations identified.

Metastatic Site: left adrenal gland

After resection of the adrenal metastasis, postoperative imaging showed further thoracic uptake and he began palliative chemotherapy for metastatic lung adenocarcinoma without identified driver mutations.

PubMed CentralRead more →

Likely lung carcinoma presenting as bilateral adrenal metastases

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

Metastatic Site: bilateral adrenal glands

Three months after bilateral adrenalectomy, he remained under regular oncology surveillance, was receiving steroid replacement, and had not required adjuvant chemotherapy.

PubMed CentralRead more →

Stage IV Mucinous Lung Cancer Treated With Afatinib and Surgery

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

Biomarkers: CD74-NRG1 fusion; ALK/ROS1/EGFR/BRAF/KRAS/MET/HER2 wild type; PD-L1 initially not expressed and later 0%-20%

Metastatic Site: bilateral lungs|bone|right adrenal gland

She was alive and receiving treatment after bone and right-adrenal progression at the latest follow-up.

PubMed CentralRead more →

Surgery for an isolated splenic metastasis from lung adenocarcinoma

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

Metastatic Site: spleen

Nine months after removal of the isolated splenic metastasis, follow-up showed no local or disseminated recurrence and she remained under regular lung-cancer surveillance.

PubMed CentralRead more →

A uterine mass revealed a rare metastasis from lung adenocarcinoma

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

Biomarkers: CK7-positive; TTF-1-positive; CK20-negative; PAX8-negative; GATA3-negative.

Metastatic Site: uterus within a leiomyoma

Twelve months after removal of the uterine metastasis, she remained well with normal surveillance imaging and no concern for recurrent disease.

PubMed CentralRead more →

Nivolumab-related adrenal failure during treatment for metastatic lung cancer

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

Metastatic Site: brain (left cerebellum)

Her confusion, gastrointestinal symptoms, and hyponatremia improved after glucocorticoid and mineralocorticoid replacement, and she was discharged on ongoing hormone replacement.

PubMed CentralRead more →

Nivolumab-Related Myocarditis and Heart Block in Metastatic Lung Cancer

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

Metastatic Site: left adrenal gland

He stabilized after high-dose steroids and pacemaker implantation after nivolumab was permanently stopped.

PubMed CentralRead more →

Osimertinib Improved Spinal Cord Metastases in Long-Standing Lung Cancer

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

Biomarkers: Initial surgical specimen: no detected EGFR mutation and ALK-negative. Later pleural-fluid tumor: acquired EGFR T790M mutation with no other detected EGFR mutation.

Metastatic Site: cervical and mediastinal lymph nodes; bone; brain;…

Osimertinib improved neurologic function and kept the lung cancer stable for 14 months; he later died from bacterial pneumonia.

PubMed CentralRead more →

Metastatic Lung Adenocarcinoma Complicated by Severe Nivolumab Pneumonitis

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

Biomarkers: Microsatellite stable; low tumor mutation burden; PD-L1 70%

His severe nivolumab-related pneumonitis improved after infliximab.

PubMed CentralRead more →

Lung cancer presenting with brain and leptomeningeal spread

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

Biomarkers: PD-L1 100%; EGFR negative; ALK rearrangement negative

Metastatic Site: brain, leptomeninges

His condition deteriorated within weeks of radiotherapy. He was readmitted with pneumonia and an acute right frontal brain haemorrhage and died within 1 week; metastatic lung adenocarcinoma was recorded as the cause of death.

PubMed CentralRead more →

Metastatic lung cancer causing recurrent small-bowel intussusception

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

Biomarkers: EGFR mutation; exon 19 deletion in metastatic bowel lesions

Metastatic Site: small bowel

She recovered satisfactorily after bowel surgery, and care shifted to palliation with long-term nutritional support planned.

PubMed CentralRead more →

Stage IV Squamous Lung Cancer Resected After Response to Checkpoint Immunotherapy

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

After complete resection, he was alive, disease free and off treatment at postoperative follow-up.

PubMed CentralRead more →

Oligometastatic Lung Cancer With Brain Spread, Surgery and Later Recurrence

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

Metastatic Site: brain

After 15 months off treatment he developed mediastinal nodal and distant metastases and was alive with disease on platinum-based chemotherapy 25 months after surgery.

PubMed CentralRead more →

ERBB2-Mutated Stage III Lung Cancer With Liver Recurrence and Multiple Lines of Therapy

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

Biomarkers: ERBB2 exon 20 insertion

Metastatic Site: liver

After 6 months of disease control on vinorelbine plus trastuzumab, the cancer progressed in all sites and she chose hospice care.

PubMed CentralRead more →

Stage IV ERBB2-Mutated Lung Cancer With Extensive Bone Metastases

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

Biomarkers: ERBB2 exon 20 insertion. A PIK3CA mutation was later detected at progression and considered a possible resistance mechanism.

Metastatic Site: bone

After progression on pemetrexed following several earlier treatment lines, she transitioned to hospice care.

PubMed CentralRead more →

Lung Cancer Immunotherapy Caused New Type 1 Diabetes

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

Biomarkers: No ALK, ROS1, KRAS or EGFR alteration was detected; CK7-positive; TTF-1-negative; PAX-negative; CK20-negative

Metastatic Site: Pleura

After 4 combination-treatment cycles, the right-lung nodules had decreased markedly and nearly resolved. He continued maintenance pembrolizumab every 3 weeks and remained on insulin with stable glucose control.

PubMed CentralRead more →

Stage IV Lung Cancer: Bill's Patient Story

Patient Info: Bill Smith, Male | Stage IV

Biomarkers: Genomic testing performed; specific result not reported

Metastatic Site: Brain; liver; bone/humerus

As of October 2016, Bill was receiving immunotherapy every 2 weeks, all tumors had shrunk, chemotherapy had stopped and he reported markedly improved quality of life while living with Stage IV lung cancer.

Cleveland ClinicRead more →