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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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Breast Cancer – Topical Ointment for Cutaneous Metastases

Purpose

This Phase 1/2 study evaluated safety and efficacy of a topical anhydrous ointment, SOR007, which contains submicron particles of the chemotherapy Taxol primarily in breast cancer patients with cutaneous metastases.

Methods

One of three concentrations of SOR007 (0.15%, 1.0%, or 2.0%) was applied twice daily over an area of 50 cm2 for up to 28 days, with the option for expansion to an additional 28 days at the highest dose under a Phase 2a study once safety was established.

Efficacy was analyzed by lesion measurements and photographs to determine Response Rate (reduction in size by at least 30%), Complete Response (100% reduction, disappearance), and Progression Free Survival (time until the metastases came back) by day 28 or 56.

Results in Cutaneous Metastases of Breast Cancer

23 patients were enrolled, 21 with cutaneous metastases of breast cancer. 4 patients received SOR007 0.15% for a median of 28 days, 3 at a dose of 1.0% for a median of 28 days, and 16 at 2.0% for a median of 55 days.

All doses were well tolerated, and 19 patients were evaluable for efficacy.

At day 28 across all dose levels, 16% of patients achieved a Response Rate and another 63% had Stable Disease.

The proportion of patients being without progression at 28 days across all treatments was 79%.

Conclusion

Application of SOR007 0.15%, 1.0%, and 2.0% to cutaneous metastases of breast cancer was safe and well tolerated with some reduction in lesion pain, and minimal systemic absorption of Taxol.

Lesion stabilization was observed in most subjects over the study period.

Key Messages for Breast Cancer Patients

This phase I/II trial evaluated the safety and effectiveness of topical submicron particle Taxol in an anhydrous ointment base, SOR007, in patients with breast cancer with cutaneous metastases.

The findings showed that topical SOR007 was well-tolerated, with pain reduction in 64% of the patients.

Topical SOR007 led to cutaneous metastases lesion stabilization or improvement in the majority of the patients over a 1- to 2-month period.

Systemic Taxol absorption was negligible.

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Breast Cancer – Topical Ointment for Cutaneous Metastases
Breast Cancer – Topical Ointment for Cutaneous Metastases

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