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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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Unheard of efficacy with combination of two approved drugs in the treatment of ovarian and endometrial cancers

In mid March 2019, the international annual meeting of the Society of Gynecologic Oncology, the SGO, was held.

At the meeting, experts from the field presented their work in the areas of endometrial cancer, cervical cancer and ovarian cancer.

One of the most powerful studies presented, was a pilot study using combination of chemotherapy and a targeted agent in platinum-resistant ovarian cancer and recurrent endometrial cancer. The two drugs are Lenvima, which a cancer drug belongs to a family of targeted drugs and the second drug is a common chemotherapy named Taxol.

Study description

In this phase I trial, patients with recurrent endometrial and patients with platinum-resistant epithelial ovarian cancer were treated with the combination of Lenvima®, a tyrosine kinase inhibitor, and a weekly dose of Taxol.

Results

Weekly Taxol has been used for these diseases for many years with a very modest and unsatisfactory response rate.

The addition of Lenvima® to Taxol has dramatically raised treatment efficacy to overall response rate of 65% – About two third of patients responded to the combination: Their disease either stopped from growing or shrunken.

Yet, there are adverse events to the combination treatment and they are common, that may become a limitation in a larger population.

The News

The response rate was 71% in patients in the ovarian cancer group and 50% in patients with endometrial cancer.

The primary objective of the trial was to identify the right and most suitable dose of the combination for a continuing Phase II clinical trial.

In addition, secondary endpoints included follow-up on safety and tolerability, antitumor activity, pharmacokinetics and duration of treatment until further progression of disease.

To Summarize

It is almost unheard of such results in this population. Even though it was a very small trial on 26 patients, the efficacy observed was impressive!

There is no doubt that participation in Phase I clinical trials can also be of great benefit to cancer patients and by the time Phase II and Phase III clinical trials will be launched, the same patients who had joined this study – had won!

 

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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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