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