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

February 8, 2021
Kartik Konduri, MD

Kartik Konduri, MD, reviews the case of 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