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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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New Biological Drug for Melanoma – Relatlimab

Overview

Advanced Melanoma is a challenging type of cancer to deal with, especially when it spreads to multiple sites in the body, metastasizes. Moreover, the poor response of this tumor to different chemotherapeutic agents made it challenging for doctors to treat it properly.

Unfortunately, the benign-looking shape of Melanoma makes patients consult very late. As a result, the cancer cells will usually spread before getting diagnosed.

In this article, we will cover the new evidence that showcases the effects of Relatlimab on Melanoma. But first, let us quickly define this drug and its mechanism of action.

What is Relatlimab?

Relatlimab is an immunotherapeutic agent that was developed by Bristol-Myers Squibb (BMS). Today, this treatment already proved its effectiveness in the management of Melanoma. Ongoing clinical trials are seeing whether Relatlimab helps with other cancer.

The purpose of this drug is to modify the body’s immune reaction in order to fight cancer more efficiently.

How does Relatlimab work?

Relatlimab is an anti-LAG-3 antibody. This means that it binds to the LAG-3 protein, which is present on our natural immune cells called T-cells.

The function of LAG-3 is to regulate the immune response, including activation, suppression, and growth of antitumor T-cells.

Melanoma releases some molecules that interfere with the action of LAG-3, blocking the process of T-cell proliferation. In a sense, these tumors apply the brakes to these specialized immune cells.

Relatlimab releases these brakes, stimulating T-cells to neutralize cancer cells. Consequently, your immune system becomes more active and slows down the growth of these tumors.

The effects of Relatlimab on Melanoma

In phase II/III clinical trial, researchers gave patients with advanced Melanoma two medications:

  • Relatlimab
  • Nivolumab – a PD-1 blocker

They assessed the effectiveness of this combination by giving a group of patients a fixed dose of Relatlimab and Nivolumab while giving a second group Nivolumab alone.

The subjects all had previously untreated metastatic or unresectable cases of Melanoma. The primary endpoint was the length of time it took for the disease to worsen, also called PFS, Progression Free Survival.

The results showed that the median PFS for the first group (i.e., patients who received Relatlimab and Nivolumab) was 10.1 months. The second group (i.e., Nivolumab alone), however, had a much lower median PFS of only 4.6 months.

At 12 months, 47.7% of the first group had not had disease progression while it was 36.0% for the second group.

This groundbreaking work demonstrated that blocking a novel immune checkpoint can be conducted safely and provide better outcomes for patients.

Speak with your oncologist for tailored medical advice about the effectiveness of Relatlimab and your eligibility to receive it.

Takeaway message for Melanoma patients

Metastatic or unresectable cases of Melanoma are extremely challenging to manage. These tumors spread across different tissues and respond poorly to medication. Fortunately, the new biological treatment gives us hope that Melanoma management will be more robust and efficient in the upcoming years.

We hope that this article managed to provide a simple explanation of Relatlimab and how it may help patients with Melanoma.

To learn more about other treatments of Melanoma, do not hesitate to check our other articles.

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Read more about Melanoma>>

New Biological Drug for Melanoma – Relatlimab
New Biological Drug for Melanoma – Relatlimab

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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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