Immunotherapy and surgery for adenosquamous lung cancer with brain metastases

Patient Info: Anonymized, Female, 70+

Biomarkers: PD-L1 positive; no actionable mutations on next-generation sequencing.

After chemotherapy, 19 cycles of pembrolizumab, and right middle lobectomy, she was off immunotherapy and under observation in remission.

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Chemotherapy, immunotherapy, and surgery for lung cancer that spread to the foot

Patient Info: Anonymized, Female, 70+

Biomarkers: PD-L1 20%; no actionable mutations on next-generation sequencing.

She had a significant response after four cycles of chemotherapy and pembrolizumab, and the resected lung nodule contained fibrosis and scar without carcinoma; further systemic treatment and radiation were under consideration.

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Lung Cancer Metastases to Both Kidneys Causing Kidney Failure

Patient Info: Anonymized, Male, 50s | Stage Metastatic/Advanced

Biomarkers: PD-L1 highly expressed

Metastatic Site: brain|bilateral kidneys|lungs

The cancer progressed in both kidneys and lungs despite treatment, causing dialysis-dependent kidney failure. He later developed severe respiratory illness and died 5 days after readmission.

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Pleomorphic Lung Cancer Progressed Despite Pembrolizumab

Patient Info: Anonymized, Male, 70+ | Stage IV

Biomarkers: EGFR-negative; ALK-negative; ROS1-negative; PD-L1 TPS 80%-90%.

Metastatic Site: small intestine; pleura; abdominal subcutaneous tissue

The cancer did not respond to pembrolizumab, and he died four months after immunotherapy began.

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Strong Response to Pembrolizumab-Based Therapy for Pleomorphic Lung Cancer

Patient Info: Anonymized, Male, 60s | Stage III

Biomarkers: EGFR-negative; ALK-negative; ROS1-negative; PD-L1 TPS 90%-100%.

A marked response followed four combination cycles, and maintenance pembrolizumab remained ongoing seven months after treatment began.

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Pembrolizumab Controlled Metastatic Pleomorphic Lung Cancer After Chemotherapy Failed

Patient Info: Anonymized, Male, 40s | Stage IV

Biomarkers: EGFR-negative; ALK-negative; ROS1-negative; BRAF-negative; PD-L1 TPS 60%-70%; BRCA2, and TP53 mutations; tumor mutation burden 42 mutations/Mb; no actionable alteration.

Metastatic Site: right adrenal gland; left adrenal gland; bone

Tumor diameter had decreased at 11 months, and pembrolizumab remained ongoing at 12 months.

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Non-Small Cell Lung Cancer: Rachel's Survivor Story

Patient Info: Rachel Chua Bradley, Female, 50s

As of April 2021, Rachel had completed treatment for recurrent non-small cell lung cancer, was not on maintenance cancer medication, and returned to MD Anderson every 6 months for checkups.

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A painful scalp metastasis from sarcomatoid lung cancer

Patient Info: Anonymized, Female, 50s | Stage IV

Biomarkers: No targetable mutations identified; CAM5.2-positive; p63-positive; CD10-positive; vimentin-positive.

Metastatic Site: chest wall and rib; liver; right gluteal region; scalp…

Her disease progressed with a further liver lesion and additional metastatic complications, and systemic treatment was stopped because of severe immune-related toxicity and the absence of targetable mutations.

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Lung cancer remission after pembrolizumab despite severe inflammatory arthritis

Patient Info: Anonymized, Male, 50s | Stage Metastatic/Advanced

Biomarkers: PD-L1-positive.

Metastatic Site: brain (temporal and parietal lobes)

The lung adenocarcinoma remained in complete remission 28 months after diagnosis, while the treatment-related arthritis also reached sustained remission and he returned to work and exercise.

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Extensive-stage small cell lung cancer with acquired haemophilia

Patient Info: Anonymized, Female, 60s

Biomarkers: Synaptophysin weakly positive; Ki-67 greater than 90%.

Her small cell lung cancer remained stable on imaging one month before her death, which followed aseptic meningitis after intravenous immunoglobulin treatment for autoimmune myasthenia gravis.

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Colon Cancer With an MLH1 Deletion and Lynch Syndrome

Patient Info: Anonymized, Male, Under 40 | Stage III

Biomarkers: dMMR with loss of MLH1 and PMS2. Familial MLH1 c.1057_1060delGCTG frameshift deletion identified; its clinical significance had not previously been reported.

The colon cancer progressed rapidly despite postoperative and second-line therapy, and he died from multiple organ failure one week after pembrolizumab was started.

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NRG1-Fusion Lung Cancer With a 24-Month Response to Afatinib

Patient Info: Anonymized, Female, 50s | Stage Metastatic/Advanced

Biomarkers: NRG1 fusion; KRAS/EGFR/ALK/ROS1/ERBB2 alterations not detected

Metastatic Site: left lung

Her cancer progressed during atezolizumab, and she died in May 2019.

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Metastatic NRG1-Fusion Lung Cancer Responding to Long-Term Afatinib

Patient Info: Anonymized, Female, 60s | Stage Metastatic/Advanced

Biomarkers: CD74-NRG1 fusion

Metastatic Site: lungs

As of February 2020, she remained on afatinib 30 mg daily with an ongoing partial response after 27 months.

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Recurrent NRG1-Fusion Lung Cancer After Surgery and Immunotherapy

Patient Info: Anonymized, Male, 60s | Stage Metastatic/Advanced

Biomarkers: SDC4-NRG1 fusion

He chose no further treatment after rapid progression on afatinib and died shortly afterward in hospice.

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Stage IV Mucinous Lung Cancer Treated With Afatinib and Surgery

Patient Info: Anonymized, Female, 40s | Stage IV

Biomarkers: CD74-NRG1 fusion; ALK/ROS1/EGFR/BRAF/KRAS/MET/HER2 wild type; PD-L1 initially not expressed and later 0%-20%

Metastatic Site: bilateral lungs|bone|right adrenal gland

She was alive and receiving treatment after bone and right-adrenal progression at the latest follow-up.

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Stage IV Breast Cancer: Stephanie's Patient Story

Patient Info: Stephanie, female, 40s | Stage IV

Metastatic Site: liver

Her doctor declared the cancer in remission, and she remains on immunotherapy to keep the disease under control.

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Stage IV Lung Cancer: Oswald's Patient Story

Patient Info: Oswald Peterson, Male | Stage IV

Metastatic Site: Lymph nodes; Spine

As of December 2020, Oswald described dramatic recovery after immunotherapy for Stage IV lung cancer, returning to the gym, travel, and normal activities; the source did not explicitly report NED or a maintenance schedule.

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Blood Vessel Inflammation After Durvalumab Treatment for Stage III Lung Cancer

Patient Info: Anonymized, Female, 70+ | Stage III

The lung cancer had responded well to chemoradiation and durvalumab, while treatment-related pneumonitis and vasculitis improved with corticosteroids and withdrawal or completion of durvalumab.

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Sjögren syndrome during nivolumab treatment for HER2-positive metastatic gastric cancer

Patient Info: Anonymized, male, 60s | Stage IV

Biomarkers: HER2-positive

Metastatic Site: liver, lungs, adrenal gland

One year after nivolumab was stopped, the shrinkage of lung metastases was maintained and the adrenal metastasis remained unchanged, although severe dry-mouth symptoms from treatment-related Sjögren syndrome persisted.

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Advanced Lung Cancer With Extreme White Blood Cell Counts and Poor Circulation

Patient Info: Anonymized, Female, 60s | Stage IV

Biomarkers: PD-L1 70%

Metastatic Site: contralateral lung|bone (left iliac)

After a mixed but mildly improved response to three pembrolizumab cycles, she developed severe paraneoplastic leukocytosis, arterial ischaemia, and acute respiratory failure and died after choosing comfort measures.

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Left Lung Adenocarcinoma With Complete Response to Pembrolizumab

Patient Info: Anonymized, Male, 70+

Biomarkers: PD-L1 tumor proportion score 100%; no driver gene mutation detected

The left adenocarcinoma had a complete response to pembrolizumab. He nevertheless died on March 8, 2018, as the separate right-sided small cell lung cancer progressed.

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Right Small Cell Lung Cancer Progressing During Pembrolizumab

Patient Info: Anonymized, Male, 70+ | Stage Metastatic/Advanced

Metastatic Site: pleura|liver

The right small cell lung cancer progressed with malignant pleural effusion and liver metastases. His condition declined rapidly, and he died on March 8, 2018.

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Stage III Ovarian Cancer: Jackie's Survivor Story

Patient Info: Jackie Page, Female, 50s | Stage III

In remission with no sign of recurrent disease at the September 2020 publication, while continuing treatment on the clinical trial.

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MSI-High Gastric Cancer With a Complete Response to Preoperative Nivolumab

Patient Info: Anonymized, Female, 60s

Biomarkers: MSI-high; PD-L1 expression in more than 1% of tumor cells; HER2 negative

Surgery found a complete pathologic response with no residual tumor cells and no cancer in 12 lymph nodes. At the time of reporting, she had no complaints and had returned to normal activities.

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