Immunotherapy and surgery for lung adenocarcinoma with two brain metastases

Patient Info: Anonymized, Female, 50s

Biomarkers: PD-L1 100%; no actionable mutations on next-generation sequencing.

After brain surgery, radiation, 11 cycles of pembrolizumab, and lung surgery, she was off treatment and under observation in remission.

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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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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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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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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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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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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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Lung cancer response to pembrolizumab complicated by severe kidney injury

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

The lung tumor had decreased after 5 pembrolizumab courses and had not progressed again by hospital discharge. The kidney complication required temporary dialysis but resolved, with creatinine 0.91 mg/dL at 8-month follow-up.

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Pleomorphic lung cancer responding to pembrolizumab plus chemotherapy

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

Biomarkers: PD-L1 tumor proportion score >75%; EGFR negative; ROS1 negative; ALK fusion negative

Metastatic Site: right 8th rib, left adrenal gland

His general condition improved as the tumors shrank, and he remained well 7 months after diagnosis with maintenance pembrolizumab planned.

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Stage III Non-Small Cell Lung Cancer: Renee's Patient Story

Patient Info: Renee Shine, Female, 60s | Stage III

Renee’s tumor responded to pembrolizumab, and she remained on treatment through the clinical trial while describing herself as thriving.

Pembrolizumab Produced a Complete Response but Multiple Immune Side Effects

Patient Info: Anonymized, Female, 70+

Biomarkers: PD-L1 expression 100%. Seronegative for acetylcholine-receptor and listed paraneoplastic antibodies during myasthenia-gravis evaluation.

Imaging showed a complete oncologic response that persisted for at least six months after pembrolizumab stopped, while the immune complications resolved after intensive treatment.

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Rapidly Progressive Stage IV Lung Adenocarcinoma With a Miliary Imaging Pattern

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

Biomarkers: TTF-1-positive; p40-negative; chromogranin-negative; synaptophysin-negative; EGFR-negative; ALK-negative; ROS1-negative; PD-L1 expression 5%–10%.

The cancer progressed rapidly, and he died approximately four months after diagnosis while being transported to inpatient hospice.

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Durable brain and leptomeningeal response to pembrolizumab in Stage IV lung cancer

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

Biomarkers: PD-L1 high positive; EGFR negative; BRAF negative; KRAS negative; ROS1 negative; ALK negative

Metastatic Site: right adrenal gland, left sixth rib, brain,…

After 29 pembrolizumab cycles over 20 months, imaging showed no leptomeningeal disease, resolution of 3 brain lesions and marked reduction of the dominant frontal lesion; she remained neurologically intact and radiographically stable.

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Stage IIIB Squamous Lung Cancer With Fatal Pembrolizumab Pneumonitis

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

Biomarkers: PD-L1 60%; EGFR negative

She died from severe treatment-related pneumonitis after declining further immunosuppression.

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Stage III Ovarian Cancer: Dianne's Patient Story

Patient Info: Dianne Simpson, female, 70+ | Stage III

Dianne completed treatment in April 2017 after chemotherapy, hysterectomy and a pembrolizumab clinical trial and was looking ahead to survivorship.

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Lung Cancer Immunotherapy Caused New Type 1 Diabetes

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

Biomarkers: No ALK, ROS1, KRAS or EGFR alteration was detected; CK7-positive; TTF-1-negative; PAX-negative; CK20-negative

Metastatic Site: Pleura

After 4 combination-treatment cycles, the right-lung nodules had decreased markedly and nearly resolved. He continued maintenance pembrolizumab every 3 weeks and remained on insulin with stable glucose control.

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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.