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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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Rechallenge Treatment for Metastatic Colorectal Cancer Patients

Overview

Over the past few years, researchers have been trying to find new treatment protocols for colorectal cancer by combining anticancer drugs.

Fortunately, these efforts seem to be yielding some great results! A few months ago, a phase-two clinical trial was conducted to see the efficacy of Erbitux and Bavencio in treating metastatic colorectal cancer.

The first drug, Erbitux, already has approval for the treatment of colorectal cancer. On the other hand, Bavencio is still in clinical trials to evaluate its efficacy on this type of tumor. However, it is the first-line maintenance treatment already approved for adults with advanced urothelial carcinoma.

In this article, we will briefly cover the results of the clinical trial to unveil the real potential of this combo.

What does the new trial tell colorectal cancer patients?

The phase-two clinical trial using a combination treatment of Erbitux and Bavencio revealed its results a few weeks ago.

The trial implemented this treatment in 77 individuals who had the diagnosis of metastatic colorectal cancer. Note that 49% of these patients were treated with Erbitux before, and 51% had received Vectibix (approved for treating patients with wild-type RAS metastatic colorectal cancer) in addition to chemotherapy during their first line of treatment for their metastatic condition.

The inclusion criteria for this trial were:

  • Histological diagnosis of colorectal cancer
  • Previous treatment with a first-line chemotherapeutic agent plus an EGFR inhibitor, like Erbitux or Vectibix, that produced a highly positive response

In other words, patients needed to have a proven diagnosis of colorectal cancer using pathological evidence, not just clinical or imaging findings. Secondly, patients need to have received treatment before that consisted of an antitumor drug plus an EGFR inhibitor.

Once approved for the trial, they received 400 mg/m2 followed by a weekly 250 mg/m2 dose of Erbitux. Patients also received 10 mg/kg of Bavencio every 2 weeks.

Researchers set the Survival as the primary endpoint of the study. Secondary endpoints were time-to-disease-progression,  percentage of individuals who achieved stabilization of their lesions and/or size reduction of lesions and safety.

After all of this scientific talk, let us see the actual results of this trial, and why we should pay attention.

Median Survival was 11.6 months and reached 17.3 months in patients with baseline RAS/BRAF WT ctDNA.

As for individual cases, here are the results:

  • 1 patient achieved a complete response, meaning there was no sign of the cancer
  • 5 patients achieved a partial response, meaning the lesions of the tumor decreased in volume
  • 44 patients had stable disease – out of these patients, 36% were stable for 4 months or more

Common severe side effects were cutaneous eruption (14% of individuals) and diarrhea (4%).

Takeaway message for colorectal cancer patients

Combining Erbitux with Bavencio revealed highly positive results for the treatment of metastatic colorectal cancer.

We hope that this article helped you grasp the potential value of this combination treatment.

Speak with your doctor to see whether you are a candidate for this treatment.

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!

Contact us 24/7 –

Call center +44.2082.426.039

References

Martinelli, E., Martini, G., Troiani, T., Pietrantonio, F., Avallone, A., Normanno, N., … & Ciardiello, F. (2020). 397O Avelumab plus erbitux in pre-treated RAS wild type metastatic colorectal cancer patients as a rechallenge strategy: The phase II CAVE (erbitux-avelumab) mCRC study. Annals of Oncology31, S409-S410

Chidharla, A., Parsi, M., & Kasi, A. (2017). Erbitux.

Kim E. S. (2017). Avelumab: First Global Approval. Drugs77(8), 929–937. https://doi.org/10.1007/s40265-017-0749-6

Ahmed, A. A., & Abedalthagafi, M. (2016). Cancer diagnostics: the journey from histomorphology to molecular profiling. Oncotarget7(36), 58696

Hess, L. M., Brnabic, A., Mason, O., Lee, P., & Barker, S. (2019). Relationship between progression-free survival and overall survival in randomized clinical trials of targeted and biologic agents in oncology. Journal of Cancer10(16), 3717

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Rechallenge Treatment for Metastatic Colorectal Cancer Patients
Rechallenge Treatment for Metastatic Colorectal Cancer Patients

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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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