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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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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Graves disease during nivolumab treatment for HER2-positive metastatic gastric cancer

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

Biomarkers: HER2-positive

Metastatic Site: liver, brain

After progression through several treatment lines and development of brain metastasis, he died 4 months after evaluation for nivolumab-associated Graves disease, more than 1.5 years after his Stage IV gastric-cancer diagnosis.

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Metastatic Lung Cancer Responded Completely After a Change in Immunotherapy

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

Biomarkers: TTF-1-positive; napsin-positive; PD-L1 0%; high tumour mutational burden; no actionable mutations

Metastatic Site: bone (left iliac bone, acetabulum and thoracic…

After progression on nivolumab, atezolizumab produced a complete response by the 6-month scan; after 35 cycles, the response remained sustained, he was alive and well, and no immune-related adverse effects were documented.

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Nivolumab-related IgA kidney disease during treatment for Stage IV gastric cancer

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

The gastric tumor regrew while nivolumab was withheld. Kidney function improved with steroids, but recurrent pneumonia and poor performance status prevented immunotherapy from restarting.

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Multifocal stage IIIA lung adenocarcinoma responding to nivolumab

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

Biomarkers: CK7-positive; TTF-1-positive; napsin-A-positive; PD-L1 85% positive.

The biopsied lung nodule nearly resolved after four nivolumab cycles, and the remaining pulmonary nodules were stable at 24 months.

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Clival skull-base metastasis during treatment for Stage IV gastric cancer

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

Biomarkers: HER2-negative

Metastatic Site: peritoneum, cervical lymph nodes, pelvic bone, lungs,…

At publication he was alive on fourth-line treatment, with no disease progression for 6 months after the clival metastasis was treated and with sustained improvement in his cranial-nerve symptoms.

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Nivolumab-related adrenal failure during treatment for metastatic lung cancer

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

Metastatic Site: brain (left cerebellum)

Her confusion, gastrointestinal symptoms, and hyponatremia improved after glucocorticoid and mineralocorticoid replacement, and she was discharged on ongoing hormone replacement.

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Stage IV Non-Small Cell Lung Cancer: Donna's Patient Story

Patient Info: Donna Fernandez, Female, 50s | Stage IV

While receiving nivolumab on a Phase III trial, Donna’s tumors remained present but stopped growing, and she was able to return to an active daily life.

Long-Term Nivolumab Response With Thyroid and Adrenal Side Effects

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

Nivolumab remained ongoing at course 82, tumor burden had fallen to one-fifth of baseline, and no disease progression was documented.

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Nivolumab-Related Myocarditis and Heart Block in Metastatic Lung Cancer

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

Metastatic Site: left adrenal gland

He stabilized after high-dose steroids and pacemaker implantation after nivolumab was permanently stopped.

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Stage IV gastric cancer complicated by paraneoplastic dermatomyositis during nivolumab treatment

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

Metastatic Site: liver, lung, abdominal cavity

He died from rapidly worsening gastric cancer 142 days after the first nivolumab dose, roughly 14 months after his April 2017 diagnosis.

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Hormone Problems During Nivolumab Treatment for Advanced Lung Cancer

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

Biomarkers: EGFR/ALK/ROS1/BRAF wild type

Metastatic Site: abdominal wall|brain

She was living with Stage IVA lung cancer after about 1 year of nivolumab. Thyroid levels normalized after levothyroxine adjustment, and continued endocrine monitoring was planned for treatment-related pituitary dysfunction.

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Metastatic Lung Adenocarcinoma Complicated by Severe Nivolumab Pneumonitis

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

Biomarkers: Microsatellite stable; low tumor mutation burden; PD-L1 70%

His severe nivolumab-related pneumonitis improved after infliximab.

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Delayed Adrenal Insufficiency After Nivolumab for Stage IV Lung Cancer

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

Biomarkers: EGFR unmutated; ALK unmutated; ROS1 unmutated

His weakness, fatigue, weight loss, and orthostatic hypotension resolved after hormone replacement, and he returned home independently.

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Autoimmune hemolytic anemia after 39 cycles of nivolumab for metastatic lung cancer

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

Metastatic Site: liver, bone

While nivolumab remained on hold, his lung cancer was stable on imaging and clinically, and hemoglobin had recovered to 14.6 g/dL about 4 months after high-dose prednisone and rituximab began.

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Metastatic lung adenocarcinoma causing sudden hearing loss and vertigo

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

Metastatic Site: bone|liver|brain|internal auditory meatus

About 10 months after the metastatic diagnosis, she developed new left-sided deafness, vertigo and facial weakness associated with metastatic involvement of the internal auditory meatus.

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Stage IV ERBB2-Mutated Lung Adenocarcinoma With Brain Metastases and Multiple Targeted Therapies

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

Biomarkers: ERBB2 exon 20 insertion, exact sequence not specified. ERBB2 copy-number gain was identified during progression on afatinib.

Metastatic Site: brain, adrenal gland, liver

The final documented afatinib plus bevacizumab rechallenge produced a mixed response followed by liver progression after 3 months.

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ERBB2-Mutated Metastatic Lung Adenocarcinoma With Leptomeningeal Progression

Patient Info: Anonymized, male

Biomarkers: ERBB2 A775_G776 insYVMA mutation with amplification

The final treatment produced a mixed systemic response, but leptomeningeal disease developed.

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ERBB2-Mutated Metastatic Lung Adenocarcinoma Progressing Through Multiple Therapies

Patient Info: Anonymized, female

Biomarkers: ERBB2 mutation

The cancer progressed during afatinib, nivolumab and a later paclitaxel rechallenge.

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Lung cancer on AZD9291 with tumor shrinkage and new suspected iliac bone metastasis

Patient Info: Anonymized, Male | Stage IV

Metastatic Site: Bone: left sacroiliac/iliac region

On 28 August 2016, AZD9291 had reduced the lung mass and stabilized nodes, but CT also showed a new suspected left iliac/sacroiliac bone metastasis requiring MRI workup.

Lung cancer progression on Tarceva with urgent T790M resistance testing planned

Patient Info: Anonymized, Male | Stage Metastatic/Advanced

Biomarkers: resistance suspected; bronchoscopy planned to test for it

As of January 2016, CT showed clear progression while he was taking Tarceva/erlotinib, so urgent bronchoscopy was planned to look for T790M resistance and guide the next treatment option.

EGFR-mutated NSCLC on Tarceva with CT follow-up pending and future resistance options discussed

Patient Info: Anonymized, Male

Biomarkers: EGFR mutation; T790M resistance discussed as a possible future resistance mechanism

As of December 2015, he was on Tarceva/erlotinib for EGFR-mutated NSCLC, had new cough/chest pain/fatigue, and was waiting for a control CT to clarify whether the tumor remained controlled.

Lung cancer on Tarceva with stable symptoms during summer follow-up

Patient Info: Anonymized, Male

As of July 2015, he was continuing Tarceva, felt strong overall, had no major cancer symptoms, and was waiting until October for the next CT while assuming the tumor remained stable.