Stage IV ALK Lung Adenocarcinoma: Allison's Patient Story
This lung cancer diagnosis at a glance
- Stage at diagnosis
- Stage IV
- Subtype
- Adenocarcinoma
- Biomarkers
- ALK-positive fusion; later ALK resistance mutations reported
- Sex
- Female
- Spread to
- Bone (spine, femur, ribs, shoulder); brain
- Treatment
- targeted therapy, radiation and bone modifying agent
- Outcome
- Responding Well
Treatment course, step by step
- Workup used CT scans, MRI/brain scan, PET scan, biopsy, and next-generation sequencing
- Diagnosis was Stage IV ALK-positive lung adenocarcinoma with extensive bone spread and about 3 small brain lesions
- Started an oral targeted therapy pill at full dose, then paused and slowly restarted after a full-body rash
- Received 5 radiation treatments to the femur because of fracture risk
- Also received bone-strengthening infusions every 3 months
- After about 1.5 years, a shoulder bone lesion became painful and grew; blood biopsy showed 2 new ALK resistance mutations
- Shoulder radiation was given and treatment switched in January to a newer targeted therapy
- Brain lesions cleared within 3 months of targeted therapy, and later scans showed almost no activity except the healing shoulder site
- Specific drug names were not stated.
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.
Where this story comes from
This is a lay summary of an account first published by The Patient Story. Read the original in full
These are lay summaries of published cancer stories, for information only. No two cancers behave the same way, and nothing here predicts your own diagnosis or replaces advice from your oncology team.