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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ERBB2-Mutated Metastatic Lung Adenocarcinoma With Leptomeningeal Progression

Patient Info: Anonymized, male

Biomarkers: ERBB2 A775_G776 insYVMA mutation with amplification

The final treatment produced a mixed systemic response, but leptomeningeal disease developed.

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ERBB2-Mutated Metastatic Lung Adenocarcinoma With Treatment Intolerance and Progression

Patient Info: Anonymized, male

Biomarkers: ERBB2 A775_G776 insYVMA mutation

After poorly tolerated earlier regimens with stable disease, he developed symptomatic progression during 1 month of afatinib.

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ERBB2-Mutated Metastatic Lung Adenocarcinoma Progressing Through Multiple Therapies

Patient Info: Anonymized, female

Biomarkers: ERBB2 mutation

The cancer progressed during afatinib, nivolumab and a later paclitaxel rechallenge.

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ERBB2-Mutated Metastatic Lung Adenocarcinoma With Progression Across Multiple Regimens

Patient Info: Anonymized, male

Biomarkers: ERBB2 V777delinsVGSP mutation

After a brief period of stable disease on cisplatin plus docetaxel, the cancer progressed through erlotinib, gemcitabine and afatinib.

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ERBB2-Mutated Metastatic Lung Adenocarcinoma With Limited Disease Control Across Multiple Therapies

Patient Info: Anonymized, female

Biomarkers: ERBB2 V776delinsVC mutation

After temporary stable disease when bevacizumab was added to chemotherapy, the cancer progressed on trastuzumab plus paclitaxel and then erlotinib.

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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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BRCA1 Non-Small Cell Lung Cancer: Nadine's Survivor Story

Patient Info: Nadine Beech, Female, Under 40

Biomarkers: Germline BRCA1 mutation for hereditary breast/ovarian cancer risk; lung cancer biomarker not reported

As of November 2016, Nadine was cancer-free after right bilobectomy for recurrent non-small cell lung cancer, following 19 years of lung cancer management that included left lower lobectomy, surveillance, Tarceva, and risk-reducing surgery for germline BRCA1.

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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.

Living with lung cancer: AZD9291 toxicity check, pain control, and social isolation story

Patient Info: Anonymized, Male

On 9 October 2016, the patient was living with lung cancer on AZD9291, had a reassuring toxicity check, and was managing ongoing physical pain and social isolation while waiting 6 weeks for the next CT.

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-mutated lung cancer on AZD9291 clinical trial with improved symptoms

Patient Info: Anonymized, Male

Biomarkers: EGFR mutation

On 20 July 2016, the patient was on AZD9291 through a clinical trial, toxicity checks were reassuring, symptoms felt improved, and the next CT was planned for late August.

Lung cancer progression with T790M-positive tissue result and AZD9291 trial start

Patient Info: Anonymized, Male | Stage Metastatic/Advanced

Biomarkers: resistance detected in tissue biopsy

On 5 June 2016, CT showed lung tumor progression after afatinib, but a tissue T790M result allowed entry into an AZD9291 clinical trial and treatment had just started.

Lung adenocarcinoma with squamous-cell component on afatinib while awaiting June CT

Patient Info: Anonymized, Male

Biomarkers: resistance no longer detected in later liquid biopsies; squamous-cell component described in bronchial biopsy pathology

On 8 May 2016, the patient was continuing afatinib/Giotrif for lung cancer with adenocarcinoma and squamous-cell features, waiting for a June CT to judge response after about 5 months of treatment.

T790M-negative lung cancer on afatinib after AZD9291 trial ineligibility

Patient Info: Anonymized, Male

Biomarkers: T790M-negative blood test; EGFR/TKI treatment context

On 21 April 2016, the patient was not eligible for the AZD9291 trial because the blood sample was T790M-negative, so he continued afatinib/Giotrif while weighing future options and advance-care preferences.

Lung cancer progression on afatinib with T790M testing for AZD9291 trial eligibility

Patient Info: Anonymized, Male | Stage Metastatic/Advanced

Biomarkers: resistance testing pending

On 14 April 2016, CT showed the right upper-lobe lung tumor had grown despite afatinib/Giotrif, prompting T790M testing and discussion of AZD9291 trial eligibility or radiotherapy.

Lung cancer on afatinib with liquid-biopsy monitoring and CT pending

Patient Info: Anonymized, Male

Biomarkers: Liquid biopsy drawn for resistance monitoring; specific result pending

On 20 March 2016, the patient was continuing afatinib/Giotrif, had blood drawn for liquid-biopsy resistance monitoring, and was waiting for a new CT appointment.

Lung cancer on afatinib after liquid biopsy showed T790M resistance no longer detected

Patient Info: Anonymized, Male

Biomarkers: resistance to erlotinib no longer detected in latest liquid-biopsy blood sample

On 21 February 2016, the patient was continuing afatinib/Giotrif after liquid-biopsy monitoring no longer detected T790M resistance, while managing diarrhea, nausea, mucositis, and skin/eye irritation.