Long-term lung cancer control after immunotherapy-related diabetes
This lung cancer diagnosis at a glance
- Stage at diagnosis
- Stage IV
- Subtype
- Adenocarcinoma
- Biomarkers
- PD-L1 80%; EGFR, ALK, ROS1 and BRAF negative
- Sex
- Male
- Spread to
- brain|liver
- Treatment
- surgery, chemotherapy, radiation and immunotherapy
- Outcome
- Living With Cancer
Treatment course, step by step
- He had surgery to remove the right upper lobe of his lung.
- He then completed 4 cycles of chemotherapy followed by radiation.
- After the cancer spread to the brain and liver, he received focused brain radiation and pembrolizumab.
- Pembrolizumab was permanently stopped after 10 cycles when he developed severe diabetes.
- A new brain lesion in 2025 was treated with focused radiation.
What happened, in summary
A 72-year-old man was diagnosed with Stage III lung adenocarcinoma in 2018 after a persistent cough. He had surgery to remove the right upper lobe of his lung, followed by 4 cycles of chemotherapy and radiation. Testing showed high PD-L1 expression at 80%, while several common driver alterations were negative.
In May 2020, scans showed that the cancer had spread to the brain and liver, making it Stage IV. The brain lesion was treated with focused radiation, and pembrolizumab immunotherapy started several months later. Within about 10 weeks, both the brain and liver disease showed a sustained partial response.
After 10 cycles of pembrolizumab, he developed severe high blood sugar and was diagnosed with immunotherapy-related diabetes. He required insulin and remained permanently insulin-dependent. Because of his age and the risk of further metabolic complications, pembrolizumab was stopped.
The cancer remained controlled for several years without further systemic treatment. In December 2025, a new brain lesion appeared and was treated with focused radiation. He remained clinically stable under oncology and endocrinology follow-up.
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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Collections this story belongs to
- Stage 4 Lung Cancer 384 stories
- Chemotherapy for Stage 4 Lung Cancer 217 stories
- Chemotherapy for Lung Cancer 386 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