Targeted Therapy for Stage 4 Lung Cancer: 213 Real Stories

Metastatic NSCLC with ATM mutations: 28-month response to olaparib before progression

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

Biomarkers: cfDNA showed ATM and ATM mutations. Common NSCLC drivers were negative; initial tumor markers were negative.

Metastatic Site: liver, left pubic bone, bilateral pulmonary nodules,…

After 28 months of remission and improved quality of life on olaparib, June 2024 PET-CT showed progression with a new 1.2 cm hypermetabolic left lower-lobe pulmonary nodule; olaparib was still being continued at the October 2024 clinic visit.

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Stage IV Large-Cell Neuroendocrine Lung Cancer Controlled for Nearly Four Years With Multiple Treatments

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

Biomarkers: PD-L1 high initially; no actionable driver mutation; later PD-L1 5%

Metastatic Site: liver, bones

After several partial responses across multiple treatment lines, she entered hospice and died on December 13, 2024, after an overall survival of 47 months.

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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 Lung Adenocarcinoma With KRAS Mutation Responding to Immunotherapy and Anti-Angiogenic Treatment

Patient Info: Anonymized, male | Stage IV

Biomarkers: KRAS mutation; MET amplification

Metastatic Site: pleura

By the December 2023 follow-up, the pleural effusion had disappeared, the primary lung tumor had not progressed, and he was described as symptom-free and in good health on maintenance 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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Stage IV EGFR Lung Cancer: Natasha's Patient Story

Patient Info: Natasha, Female | Stage IV

Biomarkers: EGFR-positive

Metastatic Site: brain

Natasha had Stage IV EGFR-positive lung cancer with brain metastases. Tagrisso/osimertinib was her main treatment, but a new brain metastasis later appeared and was treated with Gamma Knife. As of May 2025, she was awaiting follow-up MRI while continuing care.

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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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Metastatic SMARCA4-Deficient Lung Cancer Controlled for More Than Two Years With Tislelizumab and Fruquintinib

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

Biomarkers: PD-L1 8%; no target-sensitive mutation identified

Metastatic Site: left adrenal gland, cervical lymph nodes

After radiotherapy reduced the cervical-node metastasis, imaging on April 26, 2024 showed stable disease. He ended trial treatment after 2 years and continued regular follow-up.

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Stage 4 ALK-rearranged lung cancer: complete response with alectinib and SBRT

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

Biomarkers: Initial tumor: EML4-ALK fusion, EGFR wild type. Later tumor: EGFR L858R/T790M and TP53 L194R, without ALK rearrangement.

Metastatic Site: pleura, lymph nodes

As of March 2025, the original ALK-rearranged metastatic disease had responded to alectinib, the separate EGFR-mutant right upper-lobe lesion had responded to SBRT, and PET-CT showed no hypermetabolic lung lesion.

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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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Stage IV ROS1 Lung Adenocarcinoma: Luna's Patient Story

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

Biomarkers: ROS1 rearrangement; EGFR negative; ALK negative

Metastatic Site: liver; bones

Luna had Stage IV ROS1-positive lung adenocarcinoma with liver and bone metastases. After progression on initial chemotherapy, crizotinib led to tumor shrinkage and controlled her cancer for almost 12 years as of March 2025.

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

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

Biomarkers: EGFR-positive; exon 19 mentioned

Metastatic Site: brain; bones — ribs, femur/hip, clavicle

Jeff has Stage IV EGFR-positive non-small cell lung cancer with brain and bone metastases. Biomarker testing changed the plan from radiation/chemotherapy toward Tagrisso targeted therapy. As of March 2025, he was living with metastatic lung cancer and emphasizing hope and self-advocacy.

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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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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 IV ALK Lung Cancer: Sydney's Patient Story

Patient Info: Sydney Barned, Female, Under 40 | Stage IV

Biomarkers: ALK-rearranged

Metastatic Site: brain

Living with Stage IV ALK-positive lung cancer. She had about 5.5 years of disease control on her first targeted therapy, then developed 3 brain metastases in September 2022 and switched to another targeted therapy. As of February 2025, she was working full-time and continuing treatment.

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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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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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Advanced Non-Small Cell Lung Cancer With ERBB2 and TP53 Mutations

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

Biomarkers: ERBB2 exon 20 Y772-A775dup mutation; TP53 mutation; PD-L1 TPS 0%

Metastatic Site: liver, bone, both lungs

Imaging after treatment showed stable disease, and he remained in good condition while continuing maintenance pemetrexed and bevacizumab.

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ALK-Fusion Small Cell Lung Cancer Responding to ALK-Targeted Therapy

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

Biomarkers: EML4-ALK fusion

Metastatic Site: brain

After several earlier treatments stopped controlling the cancer, ALK-targeted iruplinalkib produced a partial response and was still controlling disease after more than 8 months.

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Metastatic Lung Adenocarcinoma With a Serious Immune-Therapy Pituitary Complication

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

Biomarkers: No detected EGFR, ALK, ROS1, RET, MET or HER2 alterations

Metastatic Site: brain, meninges, skull, bone, pituitary

The cancer had progressed to extensive brain, skull and bone involvement after several treatments. Steroid treatment improved the severe thirst, high urine output and other symptoms from immune-related hypophysitis.

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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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