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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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Small Cell Lung Cancer – Seplulimab Prolongs Life

Background

In this randomized clinical trial that included 585 patients with extensive-stage Small Cell Lung Cancer, SCLC, who had not previously received systemic therapy, Seplulimab plus chemotherapy, compared with Placebo plus chemotherapy, significantly prolonged survival and decreased the risk for death by 47%.

Seplulimab was already approved in China in March 2022 for different indications.

The Question

PD-L1 inhibitors combined with chemotherapy has changed the approach to first-line treatment in patients with extensive-stage Small Cell Lung Cancer, SCLC.

It remained unknown whether adding a PD-1 inhibitor to chemotherapy provided similar or better benefits in patients with extensive-stage SCLC, which would add evidence on the efficacy of checkpoint inhibitors in the treatment of extensive-stage SCLC.

About the Trial

This international, double-blind, phase 3 randomized clinical trial (which is called ASTRUM-005) enrolled patients at 114 hospital sites in 6 countries between September 12, 2019, and April 27, 2021.

Of 894 patients who were screened, 585 with extensive-stage SCLC who had not previously received systemic therapy were randomized to receive either 4.5 mg/kg of סרפלולימאב or Placebo intravenously every 3 weeks.

All patients also received intravenous Carboplatin and Etoposide every 3 weeks for up to 12 weeks.

Results: Small Cell Lung Cancer

The median Survival was significantly longer in the Seplulimab group, 15.4 months than in the Placebo group, 10.9 months

The risk for death was decreased by 47%.

The median time until disease progression also was longer in the Seplulimab group, 5.7 months than in the Placebo group, 4.3 months

Treatment-related side effects that were severe were observed in 129 patients (33.2%) in the Seplulimab group and in 54 patients (27.6%) in the Placebo group.

Conclusions: Small Cell Lung Cancer

Among patients with previously untreated extensive-stage SCLC, Seplulimab plus chemotherapy significantly improved survival compared with chemotherapy alone.

These results support the use of Seplulimab plus chemotherapy as the first-line treatment for this patient population.

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Read more about Small Cell Lung Cancer >>

Small Cell Lung Cancer - Seplulimab Prolongs Life
Small Cell Lung Cancer – Seplulimab Prolongs Life

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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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