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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Recurrent Mucinous Lung Cancer With Dose-Dependent Afatinib Responses

Patient Info: Anonymized, Female, Under 40 | Stage Metastatic/Advanced

Biomarkers: SDC4-NRG1 fusion; PD-L1 not expressed; low tumor mutation burden

Metastatic Site: bilateral lungs

She had progressive lung disease after several targeted-treatment attempts and was receiving paclitaxel with bevacizumab as of February 2020.

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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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Osimertinib rechallenge after severe pneumonitis in Stage IV lung cancer

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

Biomarkers: EGFR exon 19 deletion; acquired EGFR T790M mutation

Metastatic Site: pleura, liver, bone, leptomeninges

She initially regained a significant response after osimertinib rechallenge without recurrent pneumonitis, but developed progressive leptomeningeal disease after 11 months.

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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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Osimertinib Improved Spinal Cord Metastases in Long-Standing Lung Cancer

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

Biomarkers: Initial surgical specimen: no detected EGFR mutation and ALK-negative. Later pleural-fluid tumor: acquired EGFR T790M mutation with no other detected EGFR mutation.

Metastatic Site: cervical and mediastinal lymph nodes; bone; brain;…

Osimertinib improved neurologic function and kept the lung cancer stable for 14 months; he later died from bacterial pneumonia.

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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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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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Lung Cancer Treatment Complicated by Atezolizumab-Related Pneumonitis

Patient Info: Anonymized, Male, 70+

Biomarkers: EGFR mutation not detected; BRAF mutation not detected; ALK rearrangement not detected

The cancer progressed after chemoradiation. Atezolizumab was stopped because of pneumonitis, and he later began pemetrexed after a right adrenal mass became highly suspicious for malignancy.

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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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EGFR-Mutated Stage IV Lung Adenocarcinoma With Painful Finger Lesions During Osimertinib

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

Biomarkers: EGFR-mutated; EGFR T790M-positive at relapse

She remained on active osimertinib treatment; the finger lesions persisted but were controlled with colloidal oatmeal.

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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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ERBB2-Mutated Stage III Lung Cancer With Liver Recurrence and Multiple Lines of Therapy

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

Biomarkers: ERBB2 exon 20 insertion

Metastatic Site: liver

After 6 months of disease control on vinorelbine plus trastuzumab, the cancer progressed in all sites and she chose hospice care.

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Stage IV ERBB2-Mutated Lung Adenocarcinoma Responding to HER2-Targeted Therapy

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

Biomarkers: ERBB2 exon 20 insertion

Metastatic Site: bilateral lungs

Afatinib showed a response after 1 month, but insurance denial required a return to trastuzumab-based treatment.

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Stage IV ERBB2-Mutated Lung Cancer With Extensive Bone Metastases

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

Biomarkers: ERBB2 exon 20 insertion. A PIK3CA mutation was later detected at progression and considered a possible resistance mechanism.

Metastatic Site: bone

After progression on pemetrexed following several earlier treatment lines, she transitioned to hospice care.

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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 With Treatment Intolerance and Progression

Patient Info: Anonymized, male

Biomarkers: ERBB2 A775_G776 insYVMA mutation

After poorly tolerated earlier regimens with stable disease, he developed symptomatic progression during 1 month of afatinib.

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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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ERBB2-Mutated Metastatic Lung Adenocarcinoma With Progression Across Multiple Regimens

Patient Info: Anonymized, male

Biomarkers: ERBB2 V777delinsVGSP mutation

After a brief period of stable disease on cisplatin plus docetaxel, the cancer progressed through erlotinib, gemcitabine and afatinib.

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ERBB2-Mutated Metastatic Lung Adenocarcinoma With Limited Disease Control Across Multiple Therapies

Patient Info: Anonymized, female

Biomarkers: ERBB2 V776delinsVC mutation

After temporary stable disease when bevacizumab was added to chemotherapy, the cancer progressed on trastuzumab plus paclitaxel and then erlotinib.

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Lung Cancer: Diego's Patient Story

Patient Info: Diego, Male | Stage Metastatic/Advanced

Metastatic Site: Hip / left iliac region pain treated with radiotherapy

On 27 March 2017, Diego was recovering from hospitalization and radiotherapy for severe hip/left iliac-region pain, with pain improved and pemetrexed chemotherapy planned after his next oncology visit.

Lung Cancer Presenting With Tongue and Gastrointestinal Metastases

Patient Info: Anonymized, male, 40s

The cancer progressed after 2 cycles of carboplatin and pemetrexed, with worsening performance status, and chemotherapy was stopped.

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