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 Right-Sided Colon Cancer With an NRG1 Fusion

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

Biomarkers: KRAS mutation; POMK-NRG1 fusion

Metastatic Site: liver|lungs

He had persistent metastatic disease after 16 months of afatinib and entered a phase I trial in January 2020.

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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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Scurvy and Severe Bruising During Metastatic Colon Cancer Care

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

Metastatic Site: vagina|sacrum

She died one year after hospitalization for scurvy and Klebsiella bacteremia, following progressive malignancy, recurrent infections, and community palliative care.

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

Patient Info: Saila Hanninen, Under 40 | Stage IV

Biomarkers: EGFR mutation

After progression on earlier EGFR-directed treatment and other therapies, Saila began chemotherapy and her cancer was stable at the time of the story.

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Occult lobular breast cancer first discovered through colon metastases

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

Biomarkers: ER-positive; PR-negative; HER2-negative; E-cadherin-negative

Metastatic Site: colon

Her tumour marker decreased during letrozole and palbociclib treatment, but recurrent infections interrupted therapy, and she died from urosepsis 2 years after diagnosis.

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HER2-positive breast cancer diagnosed during pregnancy and later spread to bone and brain

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

Biomarkers: Initial tumour: ER 0%, PR <1%, HER2 3+

Metastatic Site: bone (L3)|brain

After treatment and surveillance without new lesions, she developed a large symptomatic occipital brain metastasis 14 months after completing paclitaxel and radiation and died after rapid neurological deterioration.

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Stage IV Breast Cancer: Pam's Patient Story

Patient Info: Pam Benchley, Female, 50s | Stage IV

Biomarkers: Not explicitly reported; treated with anti-estrogen therapy and a CDK4/6 inhibitor

Metastatic Site: Liver

As of October 2020, Pam had responded favorably to anti-estrogen therapy plus a CDK4/6 inhibitor, surgery, radiation and liver radiofrequency ablation; her oncologist described her as free of evidence of active cancer, while avoiding the term cancer-free for metastatic disease.

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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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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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Treatment-Related Inflammation Mimicked Metastatic Colon Cancer Recurrence

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

Biomarkers: KRAS mutation

Metastatic Site: liver|peritoneum

Biopsy showed that new lymph-node, liver, and spleen findings were a treatment-related sarcoid-like reaction rather than recurrence, and 18 months of surveillance found no evidence of cancer.

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Stage IV Colorectal Cancer: Scott's Patient Story

Patient Info: Scott Sterling, 50s | Stage IV

Metastatic Site: liver

After nearly 2 years of treatment for Stage IV colorectal cancer, Scott was able to have his primary tumor removed in August 2020 and was recovering while the metastatic disease continued to be managed.

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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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HER2-Positive Breast Cancer Linked to a Rare Immune-Related Neurological Syndrome

Patient Info: Anonymized, Female, 40s

Biomarkers: HER2-positive in both foci; one focus ER-negative/PR-positive with Ki-67 45%; second focus ER-negative/PR-negative with Ki-67 35%; anti-Yo antibodies positive in serum and CSF; tumour-susceptibility gene panel negative

At 1 year, she had completed trastuzumab, continued tamoxifen, and had no evidence of recurrent breast cancer; intensive rehabilitation improved her mobility, although balance and right-sided neurological deficits persisted.

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Heart Failure and Electrical Conduction Changes During Trastuzumab Treatment

Patient Info: Anonymized, Female, 70+

Biomarkers: HER2-positive; ER-positive

Trastuzumab was suspended after acute heart failure and electrical conduction abnormalities; 4 weeks later, left ventricular function recovered and the ECG returned to normal during cardio-oncology follow-up.

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Small Cell Lung Cancer With Unusual Colon Metastases After Afatinib

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

Biomarkers: EGFR exon 19 deletion

Metastatic Site: liver|adrenal glands|bone|brain|ascending…

The cancer progressed after an initial response to afatinib, with new brain and colon metastases. She died from respiratory failure on August 1, 2016.

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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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Fatal Bowel Infection After the First Chemotherapy Cycle for Early HER2-Positive Breast Cancer

Patient Info: Anonymized, Female, 70+

Biomarkers: ER-positive; PR-positive; HER2-amplified

Nine days after the first TCH cycle, she developed fulminant febrile neutropenia and Clostridium septicum sepsis with extensive bowel ischaemia; despite emergency treatment and resuscitation, she died 4 hours after hospital arrival.

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Long response to afatinib in EGFR-mutated lung cancer

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

Biomarkers: EGFR L861Q mutation; EGFR G719X mutation

Metastatic Site: multiple bilateral ribs

CT at 30 months showed no recurrence, and he remained well 32 months after starting afatinib.

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Occult breast cancer found in the axillary lymph nodes during diagnosis of four cancers

Patient Info: Anonymized, Female, 70+

Biomarkers: ER 90% positive; HER2 overexpression; CK19-positive; mammaglobin-positive.

Almost four years after the synchronous cancer diagnoses, she was alive without recurrence and continued letrozole and oncology follow-up.

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Stage IV HER2-Positive Breast Cancer: Christine's Survivor Story

Patient Info: Christine Hodgdon, Female, Under 40 | Stage IV

Biomarkers: HER2-positive

Christine had no evidence of disease after 1 year and continued HER2-targeted treatment with regular surveillance scans.

ROS1-positive lung adenocarcinoma presenting with cancer spread across the abdomen

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

Biomarkers: ROS1 rearrangement-positive; high PD-L1 expression.

Metastatic Site: peritoneum and omentum; pleura

Crizotinib relieved his respiratory and abdominal symptoms, and six-month imaging showed no residual disease or progression while treatment continued.

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

Patient Info: Tomma Hargraves, Female | Stage IV

Metastatic Site: brain

After a later brain and lymph-node relapse was brought under control, Tomma had no further cancer treatment and remained active in survivorship advocacy. She died on September 7, 2023.