NonDriver Metastatic Lung Large Cell Carcinoma
NonDriver Metastatic Lung Large Cell Carcinoma
- A 70-year old woman presented with persistent cough and congestion lasting more than 6 months
- She is a non-smoker; drinks alcohol 1-2 times/week
- PMH: Crohn’s disease managed on infliximab; hypothyroidism, moderately well-managed on levothyroxine; osteoarthritis managed PRN on naproxen
- Her physical exam and cardiac workup were normal
- CBC; WNL
- PS by ECOG assessment is 2
- Chest X-Ray showed mass in the upper right lung
- CT of the chest, abdomen, and pelvis showed a solid 6 X 8 cm. Right-sided pleural mass abutting the apical aspect of the chest wall and 2 small hepatic nodules measuring 1.5 cm and 2 cm.
- Bronchoscopy and biopsy of the lung mass was performed; pathology was consistent with large cell carcinoma
- Genetic testing was negative for known driver mutations
- PD-L1 testing by IHC showed expression in 2% of cells
- Brain MRI showed no evidence of CNS disease
- Diagnosis; stage IV NSCLC
- The patient was started on therapy with carboplatin and paclitaxel and bevacizumab
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