What happened, in summary

Shirley was 34 when a cough and severe back pain were first treated as possible long COVID or pneumonia. Two bronchoscopies did not give answers. A wedge resection was then done to obtain tissue, and pathology showed adenocarcinoma. PET and MRI scans did not show cancer elsewhere in the body, but the disease involved the right lung, mediastinum, and pleura, and she was diagnosed with Stage IV lung cancer.

The mass was about 8 cm and was pressing on the vena cava and esophagus, so treatment started before all testing was complete. Shirley had 3 cycles of chemotherapy and began chest radiation during the second cycle. Before a planned fourth cycle and immunotherapy, pathology found an ALK mutation. Chemotherapy and immunotherapy were stopped, and she started oral ALK-targeted pills in August 2021.

Those pills controlled most disease for almost 3 years. In 2023, she began coughing blood from a smaller progressing tumor and needed cautery procedures, followed by pulsed-field ablation. In 2024, the larger mass started progressing, and a biopsy did not yield useful results. Shirley joined a phase 2 ALK clinical trial on July 29, 2024. As of December 2024, she was taking 1 pill daily, had minimal side effects, and scans showed stable disease.