BRCA2-Mutated Metastatic Lung Adenocarcinoma Controlled for 30 Months With Olaparib

This lung cancer diagnosis at a glance

Stage at diagnosis
Stage IV
Subtype
Adenocarcinoma
Biomarkers
PD-L1-negative; BRCA2 mutation; ATM mutation; EGFR-negative; ALK-negative
Sex
female
Spread to
brain
Treatment
radiation, chemotherapy, immunotherapy, surgery and targeted therapy
Outcome
Stable Disease

Treatment course, step by step

  1. Received stereotactic radiation to 3 brain metastases.
  2. Received 4 cycles of pembrolizumab, carboplatin and pemetrexed followed by maintenance pembrolizumab plus pemetrexed.
  3. Received radiation to the residual right-upper-lung mass.
  4. Underwent surgery for a new cerebellar metastasis and stereotactic radiation to another cerebellar lesion.
  5. Started olaparib in November 2020 after BRCA2 and ATM mutations were identified.

What happened, in summary

A 65-year-old woman was diagnosed in August 2019 with lung adenocarcinoma that had already spread to the brain. She received stereotactic radiation to three brain metastases, followed by 4 cycles of pembrolizumab, carboplatin and pemetrexed and then maintenance pembrolizumab with pemetrexed. She also received focused radiation to a residual right-upper-lung mass.

When new cerebellar metastases developed, the larger lesion was removed surgically and another was treated with stereotactic radiation. Pathology confirmed that the brain lesion came from the lung adenocarcinoma. Molecular testing of the lung tumor identified BRCA2 and ATM mutations, with no EGFR or ALK alteration, and olaparib was started in November 2020.

The lung cancer remained controlled for about 30 months on olaparib. In February 2023, PET imaging was still overall stable apart from a newly detected breast lesion. Biopsy showed that the breast lesion was a separate triple-negative breast primary rather than progression of the lung cancer, allowing olaparib to be continued for the metastatic lung disease.

Where this story comes from

This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full

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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. Read the full disclaimer

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