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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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Lung Cancer – Another new drug for EGFR: Ameile

Background

Epidermal Growth Factor Receptor, EGFR, mutations are one of the most common driver mutations in Non–Small-Cell Lung Cancer, NSCLC.

Tagrisso, a third-generation EGFR tyrosine kinase inhibitor, TKI, is approved for first-line treatment of patients with advanced NSCLC and EGFR exon 19 deletion or L858R mutations.

In the pivotal FLAURA study, treatment with Tagrisso resulted in a 54% reduction in the risk of disease progression or death as compared with treatment with a first-generation EGFR TKI.

However, the toxicities of rash and diarrhea are strongly associated with inhibition of wild-type EGFR.

There is a need for additional third-generation EGFR inhibitors that both offer effective first-line treatment of EGFR-mutant NSCLC and are well-tolerated.

About the AENEAS Trial

This is a phase III trial of Ameile (Aumolertinib) vs Gefitinib as first-line therapy for locally advanced or Metastatic Non–Small-Cell Lung Cancer with EGFR Exon 19 Deletion or L858R Mutations

Purpose

Ameile is a novel third-generation Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor approved in China.

This double-blind phase III trial evaluated the efficacy and safety of Ameile compared with Iressa as a first-line treatment for locally advanced or metastatic EGFR-mutated non–small-cell lung cancer

Methods

Patients were randomly assigned to receive either Ameile (110 mg) or Iressa (250 mg) once daily.

The primary end point was Progression-Free Survival, PFS, per investigator assessment.

Results of the AENEAS Trial

A total of 429 patients who were naïve to treatment for locally advanced or metastatic NSCLC were enrolled.

PFS was significantly longer with Ameile compared with Iressa.

The median PFS with Ameile was 19.3 months versus 9.9 months with Iressa.

Objective Response Rate and Disease Control Rate, which the percentage of patients whose disease had stopped growing or decreased in size of tumor, were similar in the Ameile and Iressa groups.

The median Duration of Response was 18.1 months with Ameile versus 8.3 months with Iressa.

Adverse events of high 3 severity were observed in 36.4% and 35.8% of patients in the Ameile and Iressa groups, respectively.

Rash and diarrhea were observed in 23.4% and 16.4% of patients who received Ameile compared with 41.4% and 35.8% of those who received Iressa, respectively.

Conclusion

Ameile is a well-tolerated third-generation epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor that could serve as a treatment option for EGFR-mutant NSCLC in the first-line setting.

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Lung Cancer - Another new drug for EGFR: Ameile
Lung Cancer – Another new drug for EGFR: Ameile

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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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