The Colon Club

So my DH brother was dx with stage iv lung cancer last Dec. (non small cell adenocarcinoma). He was 42, same age as my husband at dx. Carboplatin worked great at first, shrinking the largest tumor in half, only to grow back, with new growth, as soon as chemo ended. A trip to Sloan Kettering in NYC provided no additional hope. His biomarker test showed between a 1-49% chance of Keytruda working. Insurance wont cover it so his wife wants to self pay, at $10,000 / tx, to try and buy him more time (hoping their children will have more memories of him). Obviously, they cant do this forever...Does anyone on here have any suggestions or ideas on how to win over the Insurance company? I know Beansmama had great luck with Keytruda...does anyone have any other inspiring stories of Keytruda success I can share with them. Thank you in advance!

I'm baffled that insurance won't cover Keytruda for NSCLC.

His biomarker test showed between a 1-49% chance of Keytruda working. Insurance wont cover it

His case would be second line, after platinum-based therapy failure: Keytruda is approved for that case even when patients have as little as PD-L1 expression on at least 1% of tumor cells. For first line, in the metastatic setting, is harder: patient has to have expression of PD-L1 on at least 50% of tumor cells. But for your husband's brother, this is second line.
I would search and contact some NSCLC advocacy group. Or try just Merck --Keytruda's manufacturer- legal team to help. Merck has been/ is quite wonderful to help with pembrolizumab *even* to MSS CRC, so imagine...
Here: Merk program to help access to Keytruda (pembrolizumab, anti PD-1)
https://www.merckaccessprogram-keytruda.com/hcc/ https://www.keytruda.com/keytruda-cost/
And he can always go for a trial with it.