EGFR-mutated Stage IV lung cancer with later brain progression
This lung cancer diagnosis at a glance
- Stage at diagnosis
- Stage IV
- Subtype
- Adenocarcinoma
- Biomarkers
- EGFR exon 19 deletion; acquired EGFR C797S mutation; acquired ROS1 rearrangement
- Sex
- Female
- Spread to
- brain|bone
- Treatment
- targeted therapy, radiation, surgery and supportive care
- Outcome
- In Memory
Treatment course, step by step
- She started osimertinib and received palliative radiation to painful bone metastases.
- After brain progression at 19 months, a brain metastasis was surgically removed.
- Following a major postoperative stroke, she declined further systemic treatment and transitioned to palliative care.
What happened, in summary
A 68-year-old woman who had never smoked developed progressive weakness in her left arm. Brain imaging showed multiple metastases, while chest imaging found a lung mass with extensive bone involvement. A biopsy confirmed Stage IV lung adenocarcinoma with an EGFR exon 19 deletion.
She started osimertinib and received palliative radiation to symptomatic bone metastases. For about 17 months, imaging showed durable control of both the cancer in the body and the brain.
At 19 months, she developed new weakness on the right side, and brain imaging showed progression of multiple metastases. Surgeons removed a left frontoparietal brain lesion. Molecular testing of that metastasis showed the original EGFR mutation along with acquired EGFR C797S and ROS1 changes associated with treatment resistance.
Two days after surgery, she suffered an ischemic stroke with bleeding and required emergency neurosurgery. Her condition remained very poor. She and her family decided against further systemic cancer treatment, and care shifted to comfort-focused support. She died approximately 20 months after her lung-cancer diagnosis.
Where this story comes from
This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full
How we source and attribute stories Accuracy and limitations
Collections this story belongs to
- Stage 4 Lung Cancer 384 stories
- Stage 4 EGFR Mutation Lung Cancer 74 stories
- EGFR Mutation Lung Cancer 112 stories
- Osimertinib for EGFR Mutation Lung Cancer 56 stories
- Osimertinib for Lung Cancer 65 stories
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