Skeletal metastases are prevalent in 20-30 % of patients with non-smaii cell lung cancer (NSCLC) at the time of diagnosis, up to 60 % of patients will develop bone metastases - up to half of those are presenting with spine metastases. Selected demographic of patients is at great risk of developing skeletal related events, that include severe chronic pain, pathological fractures, spinal compression, neurologic deficit, hypercalcemia.
They are a source of great morbidity and significantly worsen patients' quality of life, with overall survival median of 6-7 months at the time of diagnosis. Here we are presenting two cases of patients with NSCLC with bone metastases, who underwent surgical spine stabilization, and were subsequently treated with pembrolizumab in the first line of treatment.