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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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Glioblastoma – A new kid on the block, MDNA55

Background – Glioblastoma and MDNA55

The interleukin-4 receptor–targeted immunotherapeutic MDNA55 has demonstrated improved survival and disease control in patients with recurrent Glioblastoma who are treated at high dose, irrespective of interleukin-4 receptor expression.

This outcome of the MDNA55-05 study was reported at the 2020 Society for Neuro-Oncology, SNO, Virtual Meeting about two weeks ago.

MDNA55 is an interleukin-4 receptor–targeted toxin in development for Glioblastoma. Interleukin-4 receptors. IL4Rs, are overexpressed in Glioblastoma and the tumor microenvironment.

About the Study

The Duke University Medical Center researchers delivered MDNA55 by convection Enhanced Delivery, CED, as a single treatment for recurrent Glioblastoma at first or second recurrence.

A control arm was constructed from patient registries.

Results

  • In all 44 patients the median survival was 11.6 months
  • 46% of participating patients were alive at 12 months
  • A subpopulation consisting of 32 patients with high expression of interleukin-4 receptor + only patients with low expression of interleukin 4 receptor who were treated with a high dose exhibited the most benefit: Median survival is 15 months and 55% were alive at 12 months.
  • Disease control was seen in 81% of this subpopulation
  • Comparison against the control arm demonstrated >100% increase in median survival: 15.7 vs 7.2 months and the mortality risk during the treatment was reduced by nearly half

Conclusions

  • No approved therapies for recurrent Glioblastoma can extend survival by 50%
  • The potential of MDNA55 to extend survival by >100% in Glioblastoma is promising

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About Glioblastoma>>

About Glioblastoma

Glioblastoma Multiforme, or GBM, is a type of cancer which originates in the brain and made of brain cells known as “gliomas.”

Gliomas are neuron supporting cells, constituting a part of the nervous system.

The disease tends to develop into a star shaped formation. They are particularly aggressive tumors with the potential to grow fast and spread to other parts of the brain relatively quickly.

Glioblastoma creates its own independent blood supply which feeds it, promoting its growth and even enabling it to invade additional areas of the brain and establish more foci, hence the name “multiforme.”

GBM is a stage 4 cancer and constitutes about 50% of all brain tumors among patients aged 18 and older. Glioblastoma does not metastasize outside the brain.

The existing therapies used for GBM are not curative, and this is a source of the need for innovative and effective treatment strategies in order to fight the disease.

Glioblastoma – A new kid on the block, MDNA55
Glioblastoma – A new kid on the block, MDNA55

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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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