For stage 4 non-small cell lung cancer -- specifically adenocarincoma -- i would check the biomarkers alk and egfr. The response rate with oral drugs for those targets is ~80% vs.
20% with chemo. Bone mets can be treated with bisphosphonate (zometa) or Denosumab (xgeva). Palliative care provided early has a survival benefit. Ref: temel et al. Nejm http://www.Nejm.Org/doi/pdf/10.1056/nejmoa1000678.
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