Managing Metastatic NSCLC With Rapid Progression

Case: A 53-Year-Old Woman with mNSCLC Rapid Progression

• A 53-year-old woman presents with a lump in her left deltoid and no other signs or symptoms
  • PMH: insignificant, currently on no medications, no smoking history
• Chest X-ray showed a 5-cm soft tissue mass
• Biopsy showed advanced squamous cell carcinoma, TTF-1-
  • Molecular testing negative for known actionable mutations
• PET CT revealed a liver lesion and adrenal mass
• Brain MRI showed no evidence of CNS metastasis
• Staging: T2aN3M1b
• 22C3 antibody testing; PD-L1 TPS, 0%
• The patient is started on cisplatin/gemcitabine
• Imaging at 3 months shows widespread progression with new and enlarging lesions including a significant increase in her soft tissue and lymph node disease, collapse of her right lower lobe and new liver lesions