What happened, in summary

A 52-year-old woman and former 90-pack-year smoker presented with metastatic poorly differentiated non-small cell lung cancer involving the right upper lobe and left adrenal gland. She received combined anti-PD-1 and CTLA-4 immunotherapy and had a marked radiographic response. The treatment continued for 16 months before it was stopped because the team considered that she had achieved the maximum clinical benefit. During therapy she developed autoimmune pancreatic dysfunction, but no pulmonary toxicity. She then underwent laparoscopic removal of the left adrenal gland. Five weeks after stopping immunotherapy, she also underwent a robot-assisted right upper-lobe wedge resection with mediastinal lymph-node dissection. Her postoperative recovery was rapid, and she was discharged on postoperative day 2. Final lung pathology showed no residual viable cancer. At postoperative follow-up, she remained alive, disease free and off treatment after complete resection.