Maryland Woman, 62, Says Daily Immunotherapy Pill Changed Her Outlook on Living with Stage 4 Lung Cancer, Six Years After Diagnosis

However, Richburg’s diagnosis came at a time when more options exist for people facing advanced disease. “I just try to have a positive outlook, a positive view on everything,” she told WBAL News.

WATCH: How targeted therapies can be used for advanced lung cancer.

Her care team recommended an immunotherapy pill designed to harness the body’s own immune system to target and attack cancer cells. It marked a major shift from traditional chemotherapy and offered new hope.

Before her diagnosis, Richburg had been experiencing persistent symptoms that steadily worsened.

“I was tired, I was drained, and I knew something was going on within my body,” she said.

Testing confirmed metastatic non‑small cell lung cancer (NSCLC).

Lung cancer develops when abnormal cells form in lung tissue. It is the second most common cancer in the U.S. and the leading cause of cancer deaths in both men and women.

The disease often goes unnoticed until it spreads.

“It’s completely asymptomatic,” says Dr. Joseph Friedberg, thoracic surgeon‑in‑chief at Temple University Health System. “It causes no issues until it has spread somewhere. So, if it spreads to the bones, it may cause pain. If it spreads to the brain, it may cause something not subtle, like a seizure.”

Imaging tests such as X‑rays can reveal suspicious shadows that prompt further evaluation. Doctors classify lung cancer into two main types:

• Non‑small cell lung cancer (NSCLC): the most common, accounting for about 85% of cases
• Small cell lung cancer (SCLC): less common but faster‑growing and treated differently

Richburg’s cancer carried an epidermal growth factor receptor (EGFR) mutation, which is a genetic change found in roughly 10–15% of lung cancers in the U.S., most often in the adenocarcinoma subtype of NSCLC.

WATCH: Detecting lung cancer in the absence of symptoms.

According to the American Lung Association, EGFR mutations can drive uncontrolled cell growth.

“In general, lung cancers are driven by certain genetic mutations, and if we discover that gene, we may be able to treat the cancer with targeted therapy that attacks that gene without affecting the rest of the body cells,” explains Dr. Mohamed Kamel Mohamed, a thoracic medical oncologist at Cone Health Cancer Center.

The National Comprehensive Cancer Network (NCCN) recommends testing for nine key biomarkers before starting treatment for advanced lung cancer — EGFR among them. EGFR testing is now routine, thanks to landmark discoveries in 2004 that first identified the mutation.

Richburg didn’t specify which immunotherapy she was prescribed, but six years after her diagnosis, the treatment has worked, and her commitment to staying positive helped carry her through.

When Is Immunotherapy Used for Lung Cancer?

Immunotherapy has rapidly reshaped lung cancer treatment over the past five years. Once reserved only for people with stage 4 (metastatic) disease, it is now used after radiation and chemotherapy for stage 3 lung cancer and is being actively studied in earlier, more localized stages — including stage 1 and 2. This expansion reflects how transformative immunotherapy has been, helping many patients live longer with fewer side effects than traditional chemotherapy.

WATCH: Will Immunotherapy Work For Me?

For metastatic lung cancer, immunotherapy can be delivered in several ways depending on the individual patient and the biology of their tumor:

• Immunotherapy alone: In some cases, a single immunotherapy drug is used without chemotherapy. A pathologist evaluates tumor tissue from a biopsy or surgery to measure PD‑L1 — a marker that helps determine whether immunotherapy is likely to be effective. When PD‑L1 levels are very high, immunotherapy alone may be appropriate.
• Immunotherapy plus chemotherapy: When PD‑L1 levels are low, studies show that combining immunotherapy with chemotherapy improves outcomes.
• Two immunotherapy drugs together: In certain situations — often with advanced disease or when a more aggressive approach is needed — doctors may use a dual‑immunotherapy strategy.

Treatment decisions are highly individualized. Tumor stage, PD‑L1 expression, biomarker results, overall health, and personal treatment goals all play a role in determining the best approach.

What Are the Side Effects of Immunotherapy?

Immunotherapy works by activating the immune system to recognize and attack cancer cells. Because of this, it can sometimes cause the immune system to mistakenly target healthy organs. Side effects vary widely, and it’s important for patients to report any new symptoms to their care team — even if they don’t seem related.

Common side effects include:

• Infusion reactions
• Fatigue
• Lung inflammation
• Diarrhea
• Skin rashes
• Autoimmune‑related conditions

Immunotherapy’s side‑effect profile is different from chemotherapy, and many patients experience fewer or milder symptoms overall, but staying in close communication with the medical team is essential.

How Molecular Testing Helps Lung Cancer Patients

Lung cancer treatment has seen notable progress, partly because of molecular testing and profiling. This type of testing helps better understand specific genetic alterations and mutations that drive the growth, development, and progression of cancer cells. Some of these molecular characteristics can be targeted using precise and effective new therapies to improve patient outcomes. Ultimately, understanding the molecular profile of each person’s cancer allows oncologists to use customized and personalized treatments.

There are several next-generation sequencing (NGS) tests you may encounter, depending on where you are getting treatment and what you are getting treatment for. Here are some of the common ones currently on the market:

• FoundationOne®CDx looks at 324 genes in solid tumors and says results can take up to 12 days. Test results include microsatellite instability (MSI) and tumor mutational burden (TMB) to help inform immunotherapy decisions.
• OmniSeq Insight provides comprehensive genomic and immune profiling for all solid tumors. It looks for 523 different genes. Test results include microsatellite instability (MSI) and tumor mutational burden (TMB), as well as PD-L1 by immunohistochemistry (IHC).
• Cobas EGFR Mutation Test v2 identifies 42 mutations in exons 18, 19, 20, and 21 of the epidermal growth factor receptor (EGFR) gene. It is designed to test tissue and plasma specimens with a single kit, allowing labs to run tissue and plasma simultaneously on the same plate.

Questions for Your Doctor

SurvivorNet invites you to use our powerful AI-powered tool, “My Health Questions,” to help you form questions to ask your doctor about your symptoms, side effects and treatment options.

Here are some questions to help you kickstart your journey to learning more:

• Has my cancer spread to other parts of the body?
• Based on my cancer stage, what are my treatment options?
• What are the side effects of my recommended treatment?
• Are there ways to help minimize the effects of treatment?
• How long will I be unable to work or carry out my daily activities?
• What financial resources are available to get the treatments I need?

Learn more about SurvivorNet's rigorous medical review process.

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