Managing Metastatic NSCLC With Rapid Progression

July 19, 2018

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