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Stage 4 Cancer

Metastatic Cancer or Stage 4 Cancer, Stage IV

Metastatic cancer, or stage 4 cancer, is a medical term describing a condition where the tumor that started in a specific organ is detected in another organ or location distant from that source organ, also called the “primary tumor”. For example, breast cancer metastases can be diagnosed in the lungs, brain, bones, and liver.

It is important to note that a metastasis is the same tumor as the original tumor, even if it has settled in another organ, and the treatment is addressed accordingly. For example, treatment for lung cancer that has metastasized to the liver will be determined according to the treatment for metastatic lung cancer, not according to the treatment for liver cancer.

The Process of Metastasis Formation

Cancer cells from the original, primary tumor can be released into the bloodstream and lymphatic system, flow through them to distant organs or those adjacent to the primary tumor, “settle” there, and grow.

There are types of cancer for which it is known where metastases can form, for example:

  • Breast cancer can send metastases to the bones, brain, liver, and lungs.
  • Lung cancer can send metastases to the brain, bones, liver, and kidney.
  • Prostate cancer can send metastases to the bones.
  • Colon and rectal cancer can send metastases to the liver and lungs.
Breast cancer metastasis formation process

Chances of Recovery from Metastatic Cancer, Stage 4

In the vast majority of metastatic cases, treatments are not curative. The therapeutic goals are slowing the tumor growth rate, extending life, reducing disease symptoms, and improving the patient’s quality of life.

The efficacy of treatments is affected by multiple factors, including: cancer type, number and location of metastases, tumor burden in the patient’s body, growth rate of cancerous lesions, the patient’s treatment history, background diseases, the tumor microenvironment among the cancer cells themselves, resistance the cancer has developed to previous treatments, and more.

Innovative Personalized Treatments and Clinical Trials in Metastatic Stage 4 Cancer

For most cancer patients, existing treatments do not cure the cancer, hence the need for innovative and effective strategies to fight the disease.

The National Cancer Institute in the USA, the NCI, recommends that patients with advanced-stage cancer participate in one of the many clinical trials existing worldwide to increase therapeutic success chances. Joining this recommendation is the umbrella organization of leading US cancer centers, the NCCN, emphasizing that every patient should be encouraged to participate in clinical trials at every stage of the disease:

“Patients with cancer should be encouraged to participate in clinical trials during all aspects of their diagnosis and treatment”

Today, every patient will be treated with the standard protocols mentioned above, and sometimes the oncologist will offer to join trials open at their institute.

Advancement in cancer treatments lies in clinical trials, where the most advanced and interesting drugs are found, some of which have even earned FDA recognition as “Breakthrough Therapies,” with more data required from studies until final official approval.

A whole world of trials and compassionate use treatments is open and available globally, and it is important to know which treatments from the forefront of science exist worldwide that the patient can benefit from much more than any conventional treatment offered.

For most patients with malignant cancer, existing treatments do not cure the cancer, hence the need for innovative and effective strategies to fight the disease.

You are invited to read our publications about innovative and breakthrough treatments from around the world for metastatic stage 4 cancer >>


Common Questions about Stage 4 Cancer (Summary)

Q: What is the difference between metastatic cancer and primary cancer?

Metastatic cancer (Stage 4) is a condition where cells from the original tumor have migrated to other organs. Treatment is always determined by the origin of the primary tumor, not the organ where the metastasis was detected.

Q: Are there treatments beyond the standard protocol?

Yes. Beyond the standard protocol, there are clinical trials worldwide, compassionate use drugs, and advanced biological treatments (Off-label) that may suit the specific characteristics of the tumor.

Q: Why does the NCI recommend clinical trials?

Because that is where progress lies. Clinical trials allow access to breakthrough drugs that have not yet reached final approval and may be more effective than existing standard treatment.

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HER2 breast cancer patients! 6% complete remission 54.9% shrinkage with Trastuzumab Deruxtecan, DS-8201

When was it reported?

The outcome of the phase II, multicenter, open-label, single-arm DESTINY-Breast trial was reported at the 2019 San Antonio Breast Cancer Symposium, SABCS, from December 10 – 14.

Trastuzumab Deruxtecan, DS-8201,has demonstrated durable objective responses in patients with HER2-positive breast cancer who were HEAVILY PRETREATED, including with Kadcyla and other HER2-targeted treatments.

The problem

HER2-directed therapies, including Perjeta, Herceptin, and Kadcyla, have resulted in improved patient outcomes among those with HER2-positive, advanced breast cancer. However, the development of drug resistance is almost inevitable and there is no formal standard of care for patients once this happens. This highlights a clear, unmet medical need for novel, improved therapies for this patient population.

About the study

253 patients with metastatic HER2-positive breast cancer previously treated with Kadcyla participated in the trial. 184 patients received the recommended phase II dose and the overall shrinkage was 60.9%, of which 6% complete remission!.

Median time until disease progression under the DS-8201 treatment was 16.4 months!

97% of the 184 patients experienced stopping disease growth. This suggests that most cancers found in this population are sensitive to this drug.

A limitation of the study was that it was a single-arm trial and therefore it was not possible to determine whether Trastuzumab Deruxtecan, DS-8201, is more effective than other therapies.

The FDA granted “breakthrough therapy designation” to Trastuzumab Deruxtecan, DS-8201, prior to its final approvel.

Adverse events

99% of patients suffered from adverse events, including decreased neutrophil count, nausea, anemia, decreased lymphocyte count and fatigue. 15% of patients discontinued treatment because of adverse events. Interstitial lung disease, ILD, was observed in 25 patients and there were 4 deaths related to it. If diagnosed, discontinuation or lowering of dosage of the drug is needed and prompt intervention with steroids is recommended.

The best treatment for a cancer patient is to get the most advanced cancer drugs in advanced stages of development. There, the hope and the chance to extend life go far beyond the standard protocols.

Contact us to find out what is the best treatment for YOU

TRIAL•IN Pharma

Do not give up on life!

Contact us 24/7 for free service matching:

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www.trial-in.com

 

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Improving therapeutic success, extending life and quality of life are our main business. We extend to metastatic cancer patients and patients with brain tumors, the most advanced treatment options in the world and the best experts in Israel and abroad.

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