December 15, 2016

Case Scenario 2:

SR is a 58 year-old female, former smoker 20 PPY (stopped smoking 5 years ago), presents with cough and SOB. She experienced an unintended 10 lb weight loss over a 3-month period.

  • Tissue analysis identified adenocarcinoma, EGFR, ALK, ROS1 negative.
  • PD-L1 expression was < 50%.
  • Patient has stage IV disease with metastasis to the liver.
  • A chest CT scan confirmed the primary mass in the upper lobe of the right lung, with several pleural metastases and malignant pleural effusion.
  • MRI of the brain was negative for intracranial metastases.
  • Patient has not complained of blood in the sputum.
  • Patient has history of well controlled HTN.
  • Her performance status was 1 at diagnosis.

Patient was started on carboplatin/paclitaxel/bevacizumab for 4 cycles. Patient showed partial response and was continued on bevacizumab until progression.