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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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Lung cancer – A novel treatment with Sugemalimab

Overview

Smoking tobacco products has made lung cancer one of the most common tumors in the world. The prevalence of lung cancer is especially predominant in men.

Besides chemotherapy and radiation therapy, scientists have been trying to come up with biological treatments that effectively treat advanced cases of lung cancer.

In general, scientists categorize this cancer into two types:

Non-small cell lung cancer (NSCLC) – represents 80–85% of all cases. It is typically milder than SCLS.

Small-cell lung cancer (SCLC) – accounts for 15–20% of all cases. SCLC has a rapid proliferation rate and tends to spread to other tissues of the body. It is quite sensitive to chemotherapeutic agents. However, relapse rates are high due to metastases.

In this article, we will cover the effects of a new drug called Sugemalimab on lung cancer. Before we do that, let us quickly define this drug and explain its mechanism of action.

What is Sugemalimab?

Sugemalimab is a monoclonal antibody that targets the PD-L1 receptors. This drug proved to be effective for advanced stages of NSCLC, according to clinical trials. Mainly, it improves the survival  outcomes compared to chemotherapy when used as first-line treatment.

Initially, the drug was discovered by CStone Pharmaceuticals in treating lymphoma, a type of blood cancer.

How does Sugemalimab help?

To conduct this study, researchers assessed 846 patients for eligibility. Only 479 were eligible and were randomly assigned to receive Sugemalimab (320 patients) or placebo (159 patients).

In the interim analysis that checked for the primary endpoint – the time the disease worsens from the start of the treatment, also called Progression-Free Survival (PFS) – researchers met their goals with a large margin. The group that received the treatment had a PFS of 7.8 months, whereas the placebo group had a PFS of 4.9 months.

At 17.8 months into the clinical trial, the PFS of the two groups was as follow:

  • Sugemalimab group – 9 months
  • Placebo group – 4.9 months

The most common side effects of Sugemalimab were hematological in nature (e.g., decreased platelet count).

Analyzing these results demonstrates that Sugemalimab plus chemotherapy yield significantly better clinical outcomes compared to placebo plus chemotherapy. The intriguing part about these results is that they are present in all patients with non-squamous metastatic NSCLC, regardless of PD-L1 expression.

The authors of this study believe that Sugemalimab could be a new first-line therapy for squamous and non-squamous NSCLC.

Takeaway message

Sugemalimab seems to have a lot of potential in the treatment of advanced non-small cell lung cancer. Speak with your doctor about your eligibility to receive this drug.

Hopefully, this article managed to simplify the mechanism and efficacy of Sugemalimab in treating lung cancer.

To learn more about other treatments of Non Small Lung Cancer, do not hesitate to check our other articles.

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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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