A 64-Year-Old Woman With Metastatic NSCLC
- A 64-year-old woman reported having cough and shortness of breath on exertion for the past 2 years, but now having persistent symptoms even without exertion.
- PE: revealed diminished breath sounds and minimal expiratory wheezing in right lung; not physically fit
- PMH: mild hypertension well managed on lisinopril
- SH: smoker, 15 pack-years
- CT scan revealed 2 masses in RUL and several small masses in the liver
- Biopsy of right lung mass confirmed grade 2 adenocarcinoma
- EGFRnegative,KRASnegative
- IHC negative forALK-rearrangement,ROS1-rearrangement
- PD-L1 TPS: 56%
- PET scan showed multiple areas of FDG uptake in liver, SUVmax, 7.8
- Brain MRI, negative for metastases
- Diagnosis: stage IV lung adenocarcinoma
- Patient started on treatment with pembrolizumab/pemetrexed/carboplatin