What happened, in summary

Allison was an active 45-year-old mother of 2 when back pain that seemed muscular turned into a much larger warning sign. A CT report mentioned possible metastatic lesions in her spine. More testing followed, including chest imaging, MRI, brain imaging, PET scan, biopsy, and next-generation sequencing. By mid-June, she knew she had Stage IV lung adenocarcinoma with an ALK-positive fusion. The cancer involved extensive bone sites, including the spine, femur, ribs, and later shoulder, and about 3 small brain lesions. Because of the ALK result, she did not start chemotherapy. Her first treatment was an oral targeted therapy pill. She began at full dose but developed a severe rash, stopped briefly, and then tapered back up. A femur tumor raised concern for fracture, so she had 5 radiation treatments to that area. She also received quarterly bone-strengthening infusions. After about 1.5 years, a shoulder lesion became painful and started growing. A blood biopsy showed 2 new ALK resistance mutations, so her team radiated the shoulder and switched her in January to a second-line, fourth-generation targeted therapy. The response was strong: brain lesions cleared within 3 months, most PET activity resolved, and the primary lung tumor shrank to about 1.5 cm. As of August 2025, Allison was responding well while managing side effects from ongoing targeted therapy.