A 68-Year-Old Woman with Small-Cell Lung Cancer

Case: A 68-Year-Old Woman with Extensive-Stage Small-Cell Lung Cancer

Initial Presentation

• A 68-year-old woman presented with fatigue and a cough
• PMH/PSH: hysterectomy at age 55
• SH: 55-pack year smoking history
• PE: decreased breath sounds in the left lung, cervical lymph node enlargement

Clinical Workup

• Labs: WNL
• Lymph node biopsy showed small cell carcinoma
• Chest/abdomen/pelvic CT showed a 7.4 cm mass above the diaphragm, a small contralateral lung nodule and evidence of invasion into the left side of the pericardium
• PET scan showed activity in both lungs, above the diaphragm with small hypermetabolic activity in the surrounding area
• Contrast‐enhanced MRI of the head was negative for brain metastases
• Stage IV extensive-stage small-cell lung cancer; ECOG PS 0
  
  

Treatment

• Initiated carboplatin + etoposide + atezolizumab for 4 cycles; followed with atezolizumab as maintenance therapy
• Repeat CT scan showed a suspicious hepatic mass
• Initiated lurbinectedin 3.2 mg/m2 IV q21 Days