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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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Liver cancer – New and effective treatment with Toripalimab and HAIC Plus Lenvima

Background – New option for Liver cancer

Hepatic Arterial Infusion Chemotherapy, HAIC, is a medical procedure that delivers chemotherapy directly to the liver and widely used.

Toripalimab an antibody against PD-1. Toripalimab is approved in China for other indications.

Lenvima is a cancer medicine that interferes with the growth and spread of cancer cells in the body. Lenvima is approved for different indications among is as the first treatment for advanced liver cancer.

Study showed that adding Toripalimab and HAIC to Lenvima represents a potential new treatment option for patients with advanced liver cancer in the first line setting, as it yielded robust, durable responses.

About the Study, LTHAIC study

This single-arm, phase II study included treatment-naive patients with advanced HCC (NCT04044313).

Patients initiated Lenvima 3-7 days prior to initial HAIC and then continued to receive Lenvima but with Toripalimab and HAIC with chemotherapy which was the FOLFOX regimen.

The trial enrolled 36 patients.

Study Results

  • At 6 months from the start of the treatment, the disease did not progress in 80.6% of patients
  • The median time the disease had progressed was 10.5 months
  • About two-third of patients had their disease shrunked or stopped from growing
  • More impressive was the fact that at the time of the analysis, the median survival was not reached
  • In about 14% of patient, not disease was seen in the scans!
  • Patients experienced a median duration of response of 12.1 months

Side Effects

Serious side effects occurred in 72.2% of patients, the most common being thrombocytopenia (13.9%), elevated aspartate aminotransferase (AST; 13.9%) and hypertension (11.1%).

Moreover, the most common any side effects were hypoalbuminemia (69.4%), elevated AST (66.7%), and elevated alanine aminotransferase (ALT; 58.3%).

However, all side effects were expected and managed, with no treatment-related deaths occurring on the study.

Conclusion

Adding Toripalimab and hepatic arterial infusion chemotherapy to Lenvima yielded robust, durable responses for patients with advanced liver cancer.

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

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For further reading>>

More information about liver cancer>>

About Liver Cancer

Liver cancer, also called “Hepatocellular carcinoma”, HCC, has several types based on the type of cells which turn cancerous.

Liver cancer is aggressive, since most of the patients are diagnosed in an advanced stage, where the disease is considered incurable, for the most part.

The patient’s life expectancy is poor and currently stands on 3-5 year; this is with the support of the standard treatments.

Liver cancer - New hope
Liver cancer – New hope

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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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