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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 – Tiragolumab Plus Atezolizumab Survival

Overview

Lung cancer is a very challenging condition to manage, especially when discovered late. The incredibly high incidence of lung cancer – mostly caused by smoking tobacco products – made it the second most common cancer in the world.

Today, scientists are shifting focus to synergetic combination therapies to effectively manage different types of lung cancer.

In this article, we will review the clinical evidence to understand how Tiragolumab and Atezolizumab help with non-small cell lung cancer (NSCLC). But first, let us quickly define both drugs.

What is Tiragolumab?

Tiragolumab is a monoclonal antibody that binds with T cell immunoreceptor with Ig and ITIM domains (TIGIT), which is a member of the Ig superfamily and an inhibitor of immune responses. TIGIT is also involved in tumor cell immune evasion, allowing cancer cells to grow and proliferate.

Tiragolumab produces a more amplified immune response by blocking the interaction of TIGIT with a protein known as poliovirus receptor, or PVR (i.e., CD155). This reaction can suppress the body’s immune responses.

What is Atezolizumab?

Atezolizumab is also a monoclonal antibody sold under the brand name Tecentriq. Researchers used this medication to treat the following cancers:

  • Small cell lung cancer
  • Non-small cell lung cancer
  • Hepatocellular carcinoma
  • Urothelial carcinoma
  • Trible-negative breast cancer

Atezolizumab works by binding to programmed cell death-ligand 1 (PD-L1), which is a protein that aids in cancer proliferation.

When used as monotherapy, atezolizumab may cause the following side effects:

  • Nausea and vomiting
  • Cough
  • Anorexia (i.e., reduced appetite)
  • Diarrhea
  • Fever with a rash
  • Back pain
  • Myalgia (i.e., muscle pain)
  • Urinary tract infections

However, the relatively low incidence of these side effects and the risk/benefit analysis makes the use of this drug worth it in some cases.

What does the new study reveal about the Tiragolumab and Atezolizumab combination?

A few days ago, Roche revealed that the use of tiragolumab and atezolizumab in treating NSCLC can significantly improve survival in patients. The results were contrasted with using atezolizumab alone, and they are most impactful for patients with PD-L1-positive metastatic NSCLC.

These findings were part of phase II clinical trial called CITYSCAPE (NCT03563716).

The trial enrolled 135 patients. One group received a fixed dose of atezolizumab (1,200 mg) administered once every 3 weeks – intravenous infusion. This group also received placebo at the same time.

The other group received 600 mg of atezolizumab and Tiragolumab each following the same timeline and administration protocols.

The 2.5-year follow-up showed that the overall survival (OS) of patients who received both medications was 23.2 months. On the other hand, the group who received monotherapy with a placebo had an OS of 14.5 months.

Takeaway message

The findings revealed in this clinical trial make us look forward to seeing what phase III clinical trial will unveil. This could prove significant for patients with metastatic non-small cell lung cancer.

Talk to us so see if we can help you to actually get the most advanced treatments

TRIAL•IN Pharma

Because we, do not give up on life!

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Lung cancer - Tiragolumab Plus Atezolizumab Survival Benefit
Lung cancer – Tiragolumab Plus Atezolizumab Survival Benefit

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