Irinotecan: 37 Real Stories

Extensive-stage small cell lung cancer: multi-line treatment complicated by glucocorticoid-refractory immune-related cystitis

Patient Info: Anonymized, Male, 50s

Biomarkers: No molecular biomarkers reported for SCLC. Bladder biopsy during cystitis showed mostly CD3/CD8-positive T-cell inflammation.

As of December 2025, the cancer had progressed through multiple systemic lines, new brain metastasis had appeared, and care had shifted to palliative symptomatic treatment; immune-related cystitis had resolved after prednisone plus mycophenolate mofetil.

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Stage IV rectal mucinous adenocarcinoma with pancreatic metastasis: response to chemotherapy and staged surgery

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

Biomarkers: CA 19-9 93.4 U/mL; CEA 3.4 ng/mL; pancreatic lesion biopsy consistent with colorectal origin

Metastatic Site: pancreas

As of May 2026, he had good clinical progress during 5 months of follow-up after staged treatment, including chemoradiation, FOLFOX, abdominoperineal resection, FOLFIRINOX, and Whipple resection of the pancreatic metastasis.

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Stage IV Colorectal Cancer: Helen's Survivor Story

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

Metastatic Site: Liver; pelvis

No active tumors / no evidence of disease after liver-directed treatment, liver surgery/ablation, colon resection, and hysterectomy, though she personally described herself as living with cancer and still planned cleanup treatment.

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My STAGE 4 Colon Cancer was Revealed by a Routine Blood Test! (NO SYMPTOMS!)

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

Metastatic Site: Liver; lungs

Stage IV colon cancer with liver and lung metastases responded strongly to FOLFIRINOX-based chemotherapy, with tumor reduction over 70%, no detectable lung cancer on testing, and ongoing maintenance chemotherapy for remaining liver disease.

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Kidney complication after switching colorectal cancer chemotherapy regimens

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

Metastatic Site: liver

The cancer had worsening liver metastases when FTD/TPI began. After treatment was stopped, steroid therapy resolved edema within 1 month and proteinuria returned to baseline 2.5 months after admission; the later cancer course was not established.

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Stage IV transverse colon cancer with NTRK fusion: entrectinib response followed by fatal PTTM

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

Biomarkers: RAS/BRAF wild type, low TMB. CEA and CA19-9 were elevated before entrectinib and fell with response.

Metastatic Site: peritoneum, greater omentum, pleura,…

He died 7 weeks after hospitalization from pulmonary tumor thrombotic microangiopathy causing severe pulmonary hypertension and right-heart failure, despite biochemical and ascites response to entrectinib.

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Limited-stage small-cell lung cancer: complete response after salvage chemoradiation and continued serplulimab

Patient Info: Anonymized, Male, 40s

Biomarkers: PD-L1 CPS 1

As of May 13, 2025, after salvage chemoradiation, irinotecan, and continued serplulimab for isolated supraclavicular nodal recurrence, he remained in complete response with no radiologic recurrence or metastasis on brain MRI and CT of the neck, chest, and abdomen.

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Metastatic NSCLC with ATM mutations: 28-month response to olaparib before progression

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

Biomarkers: cfDNA showed ATM and ATM mutations. Common NSCLC drivers were negative; initial tumor markers were negative.

Metastatic Site: liver, left pubic bone, bilateral pulmonary nodules,…

After 28 months of remission and improved quality of life on olaparib, June 2024 PET-CT showed progression with a new 1.2 cm hypermetabolic left lower-lobe pulmonary nodule; olaparib was still being continued at the October 2024 clinic visit.

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Extensive-stage small cell lung cancer with brain and adrenal progression after prolonged disease control

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

Biomarkers: Small-cell lung cancer markers included CD56, CgA and TTF-1; Ki-67 was 80%.

Metastatic Site: brain, right adrenal gland, left adrenal gland

After 31 months of stability on second-line anlotinib with palliative chemoradiotherapy, disease progressed in July 2024 with new brain lesions and adrenal progression; the patient declined additional systemic options and continued anlotinib.

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Metastatic colon cancer: soft-tissue and adrenal metastases responding to FOLFIRI plus bevacizumab

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

Biomarkers: KRAS codon 146 mutation; BRAF wild type. CK20 and Ki-67 supported colorectal metastasis; CEA/CA19-9 were elevated.

Metastatic Site: lungs; left arm/biceps soft tissue; right…

As of May 2025, metastatic colon cancer involving soft tissue, muscle, lung history, and right adrenal gland had regressed after 12 months of FOLFIRI plus bevacizumab, and the patient was alive 1 year after chemotherapy completion.

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Extended-stage small cell lung cancer with breast metastasis: complete response after pembrolizumab

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

Biomarkers: TMB-high, microsatellite stable; TP53/PTEN mutations, and SOX2/PIK3CA/FGF12 amplifications.

Metastatic Site: breast

As of March 2025, she had maintained complete response for more than 18 months on pembrolizumab monotherapy after prior cisplatin/irinotecan response.

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Etoposide Desensitization After Cardiac Arrest in Metastatic Small Cell Lung Cancer

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

Metastatic Site: brain

After later tumor progression and further systemic treatment, she died in September 2021 from multifactorial progressive leukoencephalopathy, meningopyoventriculitis, and brain atrophy.

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EGFR-Mutant Lung Adenocarcinoma That Transformed to Small Cell Lung Cancer

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

Biomarkers: EGFR exon 19 deletion

Metastatic Site: brain, adrenal gland, liver, thyroid

The cancer progressed after small-cell transformation with adrenal, thyroid, liver and brain involvement, and she died 52.7 months after the original diagnosis from disease progression and organ failure.

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ALK-Fusion Small Cell Lung Cancer Responding to ALK-Targeted Therapy

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

Biomarkers: EML4-ALK fusion

Metastatic Site: brain

After several earlier treatments stopped controlling the cancer, ALK-targeted iruplinalkib produced a partial response and was still controlling disease after more than 8 months.

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Stage IV small-cell esophageal cancer: initial complete response before brain, lung, liver, and adrenal progression

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

Biomarkers: pancytokeratin and CD56; PD-L1 TPS 5%; later lung lesion Ki-67 80%.

Metastatic Site: abdominal lymph nodes, brain, lung, liver, right…

After an extended initial complete response, she developed progressive metastatic disease involving brain, lung, liver, and right adrenal gland; whole-brain radiation and lurbinectedin were started, but septic shock and acute hypoxic respiratory failure with ARDS led to comfort care.

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Stage IV cecum cancer with liver and ovarian metastases: ramucirumab-related nephrotic syndrome and glomerular microangiopathy

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

Biomarkers: Cancer biomarkers were not reported. Kidney injury workup showed severe protein leakage and biopsy-proven glomerular microangiopathy.

Metastatic Site: liver, right ovary

The liver metastasis shrank after XELOX plus bevacizumab and metastatic liver/ovarian sites were resected, but ramucirumab-based second-line therapy was stopped after nephrotic syndrome and severe glomerular microangiopathy; blood pressure and proteinuria improved with telmisartan.

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Small Cell Lung Cancer With Paraneoplastic Cushing Syndrome Treated With Immunochemotherapy

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

Biomarkers: PD-L1 negative; low tumor mutation burden; microsatellite stable

Metastatic Site: liver, abdominal wall, left ilium

He lived 20 months after diagnosis. After repeated treatment responses and later progression, he died in September 2023 from respiratory and cardiac failure during a severe infection following treatment-related myelosuppression.

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My Stage 4 Colorectal Cancer Story: How I Never Lost Hope

Patient Info: Jason Randall, Male | Stage IV

Metastatic Site: Liver; lungs; bone/sacrum

As of June 2023, Jason had a negative Signatera test, CT scans showing 9 months with no evidence of disease, and about 2.5 years off chemotherapy after Stage IV colorectal cancer treatment and lung ablation.

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Continuing 5-FU After Severe Chest Pain During Metastatic Colon Cancer Treatment

Patient Info: Anonymized, Female | Stage IV

Pretreatment with diltiazem allowed her to complete a 48-hour 5-FU infusion without recurrent chest pain, abnormal heart rhythm or loss of heart function.

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Stage IV gastric cancer with a TP53 blood finding traced to clonal hematopoiesis

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

Metastatic Site: distant lymph nodes

At age 57, 3 years 4 months after his Stage IV diagnosis, he remained alive after multiple lines of treatment; progression had occurred before his later-line regimens.

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Stage IV KRAS Colorectal Cancer: Kris's Patient Story

Patient Info: Kris Sokolowski, Male, 40s | Stage IV

Biomarkers: KRAS mutation

Metastatic Site: Liver; sternum; spine; lymph nodes; omentum/abdominal…

As of May 2022, Kris was living with Stage IV KRAS G13D-mutant colorectal cancer. Most tumors had been stable or shrinking, but abdominal/omental disease continued to grow despite additional full-strength chemotherapy, so clinical-trial and immunotherapy options were being explored.

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HER2-positive metastatic gastric cancer responding to trastuzumab deruxtecan rechallenge

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

Biomarkers: HER2-positive

Metastatic Site: liver

After trastuzumab deruxtecan was restarted, his symptoms improved after the first cycle and imaging showed tumor shrinkage after 3 cycles. He was still receiving treatment without progression at the latest follow-up.

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Kidney Injury During Nivolumab Treatment for Stage IV Gastric Cancer

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

Kidney function and proteinuria improved after nivolumab was stopped, but the gastric cancer progressed. Restarted nivolumab was ineffective, and treatment was changed to irinotecan.

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Severe headache during chemotherapy for small-cell lung cancer

Patient Info: Anonymized, Male, 50s

After the regimen change, he completed five chemotherapy cycles, remained free of severe headache, and had improvement in chest pain, cough, and breathing.

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