A 61-Year-Old Man With Small Cell Lung Cancer

Case: A 61-Year-Old Man With Small-Cell Lung Cancer

Initial Presentation

• A 61-year-old man presented with a cough, fatigue, progressive shortness of breath
• PMH: unremarkable
• SH: 25-pack year smoking history; social alcohol use
• PE: Right lower lobe wheezing on auscultation, axillary lymph node enlargement

Clinical Workup

• Labs: WNL
• Axillary lymph node biopsy revealed small cell carcinoma
• Chest/abdomen/pelvic CT showed a 7.1 cm mediastinal conglomerate mass, with invasion into the right main and lobar pulmonary arteries; 2 small left pulmonary nodules; hypermetabolic axillary lymph node
• PET scan showed large focal hypermetabolic activity in the mediastinum and small hypermetabolic activity in the surrounding area
• Contrast‐enhanced MRI of the head showed no brain metastases
• Stage IV small-cell lung cancer; ECOG PS 0

Treatment

• Initiated carboplatin + etoposide + atezolizumab for 4 cycles; followed with atezolizumab as maintenance therapy

Follow-up

• 7 months after starting treatment he complained of shortness of breath, right upper quadrant pain and back pain
• CT showed hematogenous metastases in the liver and right adrenal gland
• Initiated lurbinectedin 3.2 mg/m2 IV q21 Days