Targeted Therapy for Stage 4 Lung Cancer: 213 Real Stories

Hormone Problems During Nivolumab Treatment for Advanced Lung Cancer

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

Biomarkers: EGFR/ALK/ROS1/BRAF wild type

Metastatic Site: abdominal wall|brain

She was living with Stage IVA lung cancer after about 1 year of nivolumab. Thyroid levels normalized after levothyroxine adjustment, and continued endocrine monitoring was planned for treatment-related pituitary dysfunction.

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Stage IV ALK Lung Adenocarcinoma: Amanda's Survivor Story

Patient Info: Amanda Nerstad, Under 40 | Stage IV

Biomarkers: ALK-positive

She achieved a complete metabolic response on alectinib and had shown no evidence of disease since November 2017 while continuing treatment.

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EGFR-Mutated Stage IV Lung Adenocarcinoma With Painful Finger Lesions During Osimertinib

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

Biomarkers: EGFR-mutated; EGFR T790M-positive at relapse

She remained on active osimertinib treatment; the finger lesions persisted but were controlled with colloidal oatmeal.

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Stage IV EGFR Lung Cancer: Molly's Patient Story

Patient Info: Molly Golbon, Female, Under 40 | Stage IV

Biomarkers: EGFR mutation

Metastatic Site: Left hip; right shoulder; brain

Molly had a strong early response to Tarceva for Stage IV EGFR-mutated lung cancer, with about 50% tumor shrinkage after 2 months and metastatic disease described as almost undetectable; no later remission/NED status is provided in this record.

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Autoimmune hemolytic anemia after 39 cycles of nivolumab for metastatic lung cancer

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

Metastatic Site: liver, bone

While nivolumab remained on hold, his lung cancer was stable on imaging and clinically, and hemoglobin had recovered to 14.6 g/dL about 4 months after high-dose prednisone and rituximab began.

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Finding Happiness Despite Stage IV Lung Cancer

Patient Info: Anonymized, 50s | Stage IV

More than a year after diagnosis, she remained in treatment for Stage IV lung cancer, with some therapies losing effectiveness as the cancer developed resistance.

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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.

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Stage IV ERBB2-Mutated Lung Adenocarcinoma Responding to HER2-Targeted Therapy

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

Biomarkers: ERBB2 exon 20 insertion

Metastatic Site: bilateral lungs

Afatinib showed a response after 1 month, but insurance denial required a return to trastuzumab-based treatment.

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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.

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Stage IV ERBB2-Mutated Lung Adenocarcinoma With Brain Metastases and Multiple Targeted Therapies

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

Biomarkers: ERBB2 exon 20 insertion, exact sequence not specified. ERBB2 copy-number gain was identified during progression on afatinib.

Metastatic Site: brain, adrenal gland, liver

The final documented afatinib plus bevacizumab rechallenge produced a mixed response followed by liver progression after 3 months.

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Advanced metastatic lung cancer with bone metastases, pneumonia, and worsening pain

Patient Info: Anonymized, Male | Stage IV

Metastatic Site: Bone

By March 2017, he described worsening metastatic lung cancer with bone lesions, recent pneumonia, severe pain, and concern that AZD9291 might no longer be effective.

Afatinib Controlled EGFR-Mutant Metastatic Lung Cancer After Erlotinib Caused Pneumonitis

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

Biomarkers: EGFR-mutant

Metastatic Site: contralateral lung, pleura

At the last follow-up, she remained on afatinib with stable metastatic lung cancer almost 3 years after diagnosis and no recurrence of the pneumonitis.

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Metastatic lung cancer controlled on AZD9291 clinical trial with tracheal narrowing under review

Patient Info: Anonymized, Male | Stage IV

Metastatic Site: Metastasis mentioned; site not specified in this entry

On 20 November 2016, the patient’s tumor and metastasis appeared controlled on AZD9291 and the disease was not considered progressive, though tracheal narrowing required closer review and earlier follow-up.

Metastatic lung cancer on AZD9291 with a left iliac bone lesion

Patient Info: Anonymized, Male | Stage IV

Metastatic Site: Bone: left iliac bone

On 18 September 2016, the patient was living with lung cancer on AZD9291 after MRI confirmed a solitary left iliac bone lesion suspicious for metastasis, with radiotherapy deferred and the next CT planned for November.

Lung Adenocarcinoma Metastatic to the Breast With Inflammatory Breast-Like Symptoms

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

Biomarkers: EGFR positive. Breast metastasis: TTF-1 positive

Metastatic Site: right breast

A PET scan after breast radiation showed no metabolically active cancer, but she died 2 months after the breast metastasis was diagnosed.

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Lung cancer on AZD9291 with tumor shrinkage and new suspected iliac bone metastasis

Patient Info: Anonymized, Male | Stage IV

Metastatic Site: Bone: left sacroiliac/iliac region

On 28 August 2016, AZD9291 had reduced the lung mass and stabilized nodes, but CT also showed a new suspected left iliac/sacroiliac bone metastasis requiring MRI workup.

EGFR exon 19 lung adenocarcinoma with bone and brain metastases: brain lesions resolved on gefitinib

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

Biomarkers: EGFR exon 19 deletion

Metastatic Site: lumbar spine, pelvic bone, brain (left occipital lobe,…

As of March 2014, asymptomatic brain metastases had regressed after 1 month of gefitinib and were no longer discernible after another 3 months, while lumbar vertebral disease was treated with radiotherapy.

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EGFR L858R-mutant Stage IV lung adenocarcinoma managed after gefitinib-induced lung injury

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

Biomarkers: EGFR L858R mutation

Metastatic Site: liver, bone, hilar lymph nodes, mediastinal lymph…

Gefitinib produced early tumor shrinkage but was stopped for interstitial lung disease; subsequent carboplatin, pemetrexed, and bevacizumab produced a good response, while variceal bleeding was controlled with endoscopic treatment.

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Stage IV lung squamous cell carcinoma with liver metastasis treated with chemotherapy and 90Y radioembolization

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

Metastatic Site: liver

After treatment for liver metastasis, PET CT 2 months after 90Y radioembolization showed complete tumor response without residual tumor, and she was alive without active disease.

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Stage IV lung adenocarcinoma: partial responses to cisplatin-docetaxel and erlotinib, complicated by fistula

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

Biomarkers: Tumor genomic biomarkers not reported. EGFR testing result not reported; erlotinib was used as second-line therapy.

Metastatic Site: contralateral lung, pleura

Metastatic lung adenocarcinoma had partial response to chemotherapy and persistent partial response on erlotinib; after erlotinib was stopped for enterocutaneous fistula, she was alive and well without evidence of lung-cancer progression.

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Stage IV NSCLC with choroidal metastasis responding to intravitreal bevacizumab

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

Metastatic Site: choroid of right eye

The right-eye choroidal metastasis showed complete local response after intravitreal bevacizumab, with pain resolution, vision improvement to 20/20, and no residual ocular tumor detected 10 months after treatment began.

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