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Stage 4 Cancer

Stage 4, Stage IV metastatic cancer

“Metastases cancer” or stage 4 cancer, is the medical term for describing a condition where a tumor originating in a certain organ, “primary tumor”, is identified in another organ or in a distant location from the original organ, e.g., metastases of breast cancer can be found in the lungs, brain, bones and liver.

It is important to note, metastases are the same type of the original primary tumor, even if its location is in distant organs and so are the treatments regarded as such, for example, a treatment for a metastatic lung cancer that has spread to the liver, is determined by the treatment for metastatic lung cancer and not by the treatment for liver cancer.

Metastases formation

Cancer cells of the primary tumor can be released into the bloodstream and lymphatic system and circulate to distant organs or adjacent organs and tissues to the primary tumor and “settle” in them and grow.

There are different types of cancer which is known where metastases can be formed, for example,

  • Breast cancer can spread to the bones, brain, liver and lungs
  • Lung cancer can spread to the brain, bones, liver and kidney
  • Prostate cancer can spread to the bones
  • Colon cancer, rectal cancer, colorectal cancer can spread to the liver and lungs
Breast cancer can spread to the bones, brain, liver and lungs
Breast cancer can spread to the bones, brain, liver and lungs

Stage IV metastatic cancer and recovery

In the vast majority of the metastatic cases, the treatments do not cure. Treatment goals are slowing tumor growth rate, prolonging life and reducing the symptoms of the disease, improving the quality of life of the patient.

The efficacy of the treatments is affected by many factors, among them are the type of cancer, number of metastases (also called “lesions”) and their location, how much cancer the patient has in his or her body, growth rate of the tumor lesions, medical history of the patient, background diseases, microenvironment between the tumor cells themselves, resistance the tumor has developed to previous treatments and other.

Advanced treatments and clinical trials for stage 4

The National Cancer Institute (NCI) highlights the fact that for a certain group of metastatic cancer patients, the best treatment option is to join one of the many clinical trials existing worldwide aiming to increase their chances of therapeutic success.

This is also recommended by the USA national comprehensive cancer network, NCCN,  (USA national comprehensive cancer network)

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

Currently, every patient will be offered the standard protocols described above. Sometimes the oncologist may suggest integrating these therapies with trials carried out in the Institute.

Advances in cancer therapies may be found in clinical trials prescribing cutting edge, interesting drugs, some of which have already been recognized by the FDA (US Food & Drug Administration) as “breakthrough treatments” and require further information input before being finally and fully approved.

An entire world of clinical trials and compassionate drugs and treatments are open and available worldwide. It is important to know which cutting edge treatments exist which patients can gain far more from them than the standard care offered.

For most patients with stage 4 metastatic cancer, current treatments are insufficiently effective. This gives rise to the need for innovative strategies with greater efficacy in fighting the disease.

Read our publications on innovative treatments for stage 4 metastatic cancer:

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Renal Cell Cancer – Triplet Therapy Improves Outcomes

Background

A significant period until disease progression was seen in patients with metastatic renal cell cancer (RCC) receiving the triplet combination of Cometriq plus Yervoy and Opdivo, according to a study presented at the annual meeting of the European Society for Medical Oncology, held Sept. 9 to 13 in Paris.

The name of the study is “COSMIC-313”.

About the Study

The COSMIC-313 phase 3 trial compared the modern active control of doublet therapy (Opdivo plus Yervoy) to triplet therapy (Cometriq plus Yervoy and Opdivo) for first-line treatment of metastatic RCC.

855 previously untreated renal cell cancer patients were randomly assigned to Cometriq (40 mg daily; 428 patients) or placebo (427 patients).

All patients received Opdivo (3 mg/kg every three weeks) plus Yervoy (1 mg/kg every three weeks) for four cycles followed by Opdivo (480 mg every four weeks for up to two years).

Study Outcomes

The international group of researchers found that the primary endpoint which was the period until disease progression was achieved in the triplet therapy group:

The was a reduction of 27% in the risk of disease progression or death in the triplet group.

43 percent of patients experienced a shrinkage in tumor size for those receiving triplet therapy versus 36 percent for those receiving doublet therapy.

Median period until disease progression was not yet reached for patients receiving triplet therapy but was 11.3 months for patients receiving doublet therapy.

Side Effects

As might be anticipated with treatment intensification, side effects were higher with the triplet combination. No new safety signals were identified for any of the components.

Nearly three-fourths of patients receiving triplet therapy experienced harsh side effects versus 41 percent with doublet therapy.

Discontinuation of all treatment components due to treatment-related side effects occurred in 12 percent of patients receiving triplet therapy versus 5 percent receiving doublet therapy.

Conclusion

We must see next how to integrate this regimen – Cometriq plus Yervoy and Opdivo – into practice as first line treatment in metastatic renal cancer, if approved by regulatory authorities.

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Renal Cell Cancer - Triplet Therapy Improves Outcomes
Renal Cell Cancer – Triplet Therapy Improves Outcomes

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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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