What happened, in summary

A 57-year-old woman developed a persistent dry cough and low-grade fever in 2022. Imaging showed a right upper-lung mass, enlarged chest lymph nodes, and lesions suspicious for distant spread. Biopsy identified a poorly differentiated pulmonary mucoepidermoid carcinoma, and the cancer was classified as Stage IV. She first received 4 cycles of albumin paclitaxel plus nedaplatin together with bevacizumab and immunotherapy. Follow-up imaging showed progression, including enlarging liver lesions, and her general condition worsened enough that further chemotherapy was difficult. A biopsy of a liver lesion then identified an EML4-ALK fusion. She switched to oral ALK-targeted therapy. Over the next 6 months, her cough and fever improved, her appetite returned, and she gained about 20 pounds. Follow-up CT scans showed substantial shrinkage of the lung and metastatic disease. By December 2023, treatment was continuing and the response remained partial rather than complete.