Clinical Trial Hope for ROS1 Lung Cancer
Why ROS1 Patients Should Be Watching Zidesamtinib
For people living with ROS1-positive non-small cell lung cancer, Zidesamtinib is one of the most important new developments to watch. It is being studied in the ARROS-1 clinical trial, and public trial listings show Memorial Sloan Kettering Cancer Center and Emory Winship Cancer Institute as active sites.
This matters because clinical trials should not be treated as a last resort for ROS1 patients. In some cases, a trial may be worth discussing earlier, especially when side effects, quality of life, or long term planning are already becoming part of the treatment decision. ARROS-1 includes multiple patient groups, including some who are TKI-naïve (not previously treated with a ROS1 targeted drug), which reinforces that this is not only a trial for people who have run out of standard options.
Zidesamtinib for ROS1 Lung Cancer: New Trial Hope
What Is Zidesamtinib?
Zidesamtinib is a targeted medicine being studied for cancers driven by a ROS1 fusion, a specific gene change that can fuel cancer growth. It was designed to help address some of the hardest problems ROS1 patients face, including when earlier targeted drugs stop working and when cancer spreads to the brain. Public company materials also describe activity against certain ROS1 resistance mutations, including G2032R.
Zidesamtinib is not yet FDA approved, but it is moving through FDA review after encouraging trial results. Nuvalent has announced that the FDA accepted its New Drug Application for priority review, with a target action date of September 18, 2026.
Why Is It Getting So Much Attention?
Zidesamtinib has received FDA Breakthrough Therapy Designation for patients with ROS1-positive metastatic non-small cell lung cancer who have already been treated with 2 or more ROS1 targeted drugs. That does not mean the drug is already approved, but it does reflect the significance of the early data and can help speed development and review.
Early public results from ARROS-1 have also been encouraging in previously treated ROS1-positive lung cancer, including reported responses, durable benefit in many responders, and activity in patients with brain metastases and certain resistance mutations. These are still results from an ongoing study, but they are one reason many ROS1 patients and doctors are watching zidesamtinib closely.
Who Should Ask About This Trial?
ARROS-1 is not limited to one narrow patient group. According to the public trial listing, the Phase 2 portion includes patients who are TKI-naive, patients who have had 1 prior ROS1 inhibitor, patients who have had 1 prior ROS1 inhibitor plus platinum chemotherapy, patients who have had 2 or more prior ROS1 inhibitors, and a separate cohort for other advanced solid tumors with a ROS1 rearrangement.
That means this trial may be worth asking about in more than one situation. If you are newly diagnosed and TKI-naive, it may be worth discussing. If your current ROS1 treatment is still controlling your cancer but the side effects are significantly hurting your quality of life, it may also be worth discussing. For ROS1 patients, the right time to talk about a trial is not always after progression. Sometimes it is earlier, while there is still time to make a thoughtful decision.
Where Is It Available?
The main study is ARROS-1, an active Phase 1/2 trial listed by the National Cancer Institute. Public listings show both MSK and Winship as active locations.
MSK also lists a separate expanded access pathway for zidesamtinib for certain adults with advanced ROS1-positive cancers whose disease is still growing after treatment. That means some patients may have more than one path to ask about, depending on their situation and eligibility.
Why This Matters for ROS1 Patients
For ROS1-positive lung cancer, this is a real step forward.
The treatment landscape is still moving. New options are still being developed. Clinical trials may offer access to promising therapies earlier than many patients realize. That is why trial review should be part of the conversation for ROS1 patients, especially at leading cancer centers that see these cases often and understand the evolving science.
Too often, patients hear about trials only when they are running out of options. That is too late for some people. For ROS1 patients, the better question is not only, “What do I do after this stops working?” It is also, “Should I already be exploring what comes next?”
What To Do Next
If you or someone you love has ROS1-positive lung cancer, now is a good time to ask:
- Has full molecular testing been done and reviewed recently?
- Is my current treatment still the best fit for both cancer control and quality of life?
- Should a leading cancer center review my case now?
- Should a ROS1 clinical trial be part of my plan now, not later?
- Is ARROS-1 or another trial worth discussing?
At Stage4Hope, we help patients move faster toward leading cancer centers, clinical trial opportunities, and practical support. If distance is part of the challenge, our Travel Expense Grants may also help.
Have ROS1-positive lung cancer? Ask us about expert care, clinical trial options, and travel support.
Stage 4 Cancer: What to Do First
Stage 4 Cancer: What to Do First After Diagnosis
A new cancer diagnosis can make everything feel urgent. Most people are frightened, overwhelmed, and pushed to make decisions before they even understand all their options.
But the earliest days after diagnosis are not just about moving fast. They are about making sure you do not lose options by moving too fast in the wrong direction.
Just Diagnosed with Advanced Cancer? 5 Things to Do Before Starting Treatment
Here are five of the most important things to do before starting treatment.
1. Slow things down and get the right testing first
Do not rush into treatment, especially chemotherapy, before the right information is back.
In many advanced cancers, biomarker testing can affect first line treatment decisions. NCI explains that biomarker testing looks for genes, proteins, and other substances that may help doctors choose treatment, and it can identify changes that affect how certain cancer treatments work.
Ask whether both tissue testing and, when appropriate, blood-based testing have been ordered. If those results could change your first treatment, they should be reviewed before you commit to a plan.
That means the first question should not be, “How fast can I start chemo?” It should be:
“Has my cancer been fully tested so I know all of my treatment options first?”
2. Do not choose first treatment until all options are discussed
The first treatment often matters the most because it can shape what options remain later.
Clinical trial eligibility commonly depends in part on prior treatment history, along with cancer type, stage, biomarkers, and overall health. In other words, the treatment you start first can affect what you may qualify for next.
Before deciding, ask your doctor to review all appropriate options, including:
- targeted therapy
- immunotherapy
- chemotherapy
- clinical trials
Do not let urgency push you into chemotherapy before you understand whether another option should be considered first.
3. Ask about clinical trials early, not as a last resort
Many patients think clinical trials are only for people who have run out of options. That is not true. Some trials are available for patients who are newly diagnosed or who have not yet started treatment.
Clinical trials matter because some of the newest cancer drugs are available there first.
Many phase 1 cancer trials, especially for patients with advanced cancer, are dose escalation studies in which participants receive the investigational treatment at different dose levels while researchers study safety and dosing. Patients often worry that joining a clinical trial means getting a placebo and no treatment. In cancer trials, that fear is often misunderstood. NCI says placebos are rarely used in cancer clinical trials and that giving a placebo is not ethical when an effective treatment is available.
A better question to ask is:
“Should a clinical trial be considered before I start standard treatment?”
4. Get treated at, or at minimum get a second opinion from, a major cancer center
Do not assume the first local referral is the best or only option.
NCI-Designated Cancer Centers are recognized for scientific leadership in laboratory and clinical research, and these centers often provide disease-specific expertise, broader access to clinical trials, and treatment approaches that smaller institutions may not offer.
This matters because a major cancer center may see treatment opportunities that a smaller local practice does not.
Even if you ultimately receive treatment locally, getting a second opinion from an NCI designated or other major cancer center can be one of the most important steps you take. Many insurance plans do cover major cancer centers, although referral rules, prior authorizations, and network requirements vary by plan and should be checked quickly.
5. Get support early so you can make clearer decisions
A cancer diagnosis affects far more than the body. It affects how you think, how you sleep, how you process information, and how you handle fear.
That is one reason support matters early. Patients often need space to steady themselves emotionally so they can make informed decisions medically.
At Stage4Hope, we understand that the earliest days after diagnosis can feel like the hardest. That is why we offer Strength for the Journey, our therapist-led virtual support designed specifically for people facing advanced cancer, including Still Me, our program for those who are newly diagnosed.
You do not need to have everything figured out immediately. But you do deserve the chance to make decisions from a place of clarity, not panic.
After a Stage 4 diagnosis, everything can feel urgent. But the goal is not simply to start treatment fast.
The goal is to make sure you start the right treatment first.
Need help taking the next step?
Learn how Stage4Hope helps patients access leading cancer centers and second opinions faster.
Explore our therapist-led virtual support programs for people newly diagnosed with advanced cancer.
Accelerating Access to Life-Saving Cancer Care
Donate to Cancer Patient Travel Assistance
Donate to help cancer patients access top treatment centers faster. Support travel, clinical trials, and life-saving care today.
A $2.5 Million Commitment Is Just the Beginning
Stage4Hope has committed $2.5 million to Memorial Sloan Kettering Cancer Center to advance breakthrough cancer research.
But for patients facing advanced cancer, breakthroughs only matter if they can reach them.
And too many patients never do.
❤️DONATE NOW
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The One Thing Patients with Advanced Cancer Want
More time.
More time to live.
More time with the people they love.
More time for treatments to be invented, approved, and then to work.
Because in advanced cancer, time is what creates options.
The best cancer care in the world exists at premiere hospitals like Memorial Sloan Kettering, MD Anderson and City of Hope.
But too many patients never get there in time.
Not because they don’t want to.
Because they can’t afford to travel.
Because access takes too long.
Because the system is hard to navigate when time matters most.
Stage4Hope exists to change that.
- We are building a network of cancer centers committed to faster access.
- We fund travel so patients can reach the care that could change their outcome.
- We invest in research to create new treatment options.
- And we provide professional mental health support to help patients hold on and keep fighting.
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Help Us Move Faster
We’ve committed millions to advancing the future of cancer treatment.
Now help us deliver that future to patients today.
Your support directly helps patients reach leading cancer centers sooner, access targeted therapies and clinical trials, and receive the emotional support they need along the way.
It turns waiting into action, and uncertainty into a clear path forward.
Every dollar helps a patient reach the right care when it matters most.
❤️DONATE NOW
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What Your Donation Does
Every dollar you give helps patients who cannot afford to wait.
The Real Outcome
Your donation will help a patient:
- Get to a premiere cancer center like Memorial Sloan Kettering, who can potentially save their life
- Connect with one of the best specialists in the country
• Access a clinical trial or the right treatment for their specific cancer
• Do it in days instead of weeks
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The Reality We’re Solving
Everyday matters when facing advanced cancer.
Faster access to the right care can mean more options, more time, and more hope for patients and their families.
By getting involved, you are helping ensure that more patients don’t have to navigate this journey alone—or wait longer than they should for the care that could change their outcome.
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Does Treatment Timing Matter in Lung Cancer?
Does Immunotherapy Treatment Timing Matter in Lung Cancer?
Could Timing Give Your Cancer Treatment a Boost?
A new clinical trial is sparking real conversation in the lung cancer community by asking a surprisingly simple question: Does the time of day you receive treatment affect how well it works? For people living with advanced non-small cell lung cancer (NSCLC), this research offers a hopeful — and low-cost — idea that could one day improve outcomes without changing the drugs themselves.
Morning vs. Afternoon Immunotherapy for Lung Cancer
In a randomized clinical trial, researchers found that patients who received immunochemotherapy earlier in the day lived longer and had better control of their cancer compared to those treated later in the afternoon. Immunochemotherapy is a combination of immunotherapy (which helps your immune system recognize and attack cancer) and chemotherapy (which directly kills cancer cells). Patients treated earlier had a 60% lower risk of cancer progression and a 48% lower risk of early death.
What the Study Found — In Plain Language
The phase 3 LungTIME-C01 trial followed 210 people with advanced (stage IIIC or stage 4) non-small cell lung cancer who did not have known genetic driver mutations. Everyone received the same drugs — the only difference was when treatment was given:
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Early group: Treatment before 3:00 PM
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Late group: Treatment after 3:00 PM
After more than two years of follow-up, the differences were striking:
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Cancer stayed under control for about 11 months in the early-day group
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Cancer worsened in about 6 months for those treated later
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Overall survival was 28 months vs. 16.8 months, favoring earlier treatment
Researchers believe this benefit may be tied to the body’s circadian rhythm — the natural 24-hour cycle that regulates hormones, immune activity, and cell behavior.
Why the Immune System’s “Clock” Matters
Your immune system doesn’t work the same way all day long. Certain immune cells — especially CD8+ T cells, often called “killer” T cells — appear to be more active and effective earlier in the day.
In this study, patients treated in the morning had:
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More circulating CD8+ T cells
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A healthier balance of activated (ready to fight cancer) vs. exhausted immune cells
This may explain why immunotherapy worked better earlier in the day — the immune system was simply more prepared to respond.
Should Patients Change Their Treatment Time Now?
Not yet — and that’s important to say clearly.
While many experts find the results exciting, others urge caution. This is the first randomized trial to confirm what earlier observational studies only suggested. Larger studies and reviews of past trials are still needed before treatment timing becomes part of standard care.
That said, this approach is especially intriguing because:
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It doesn’t add new drugs
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It doesn’t increase toxicity
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It could be easier to implement than many medical advances
Some researchers believe timing may matter most during the first cycle of immunotherapy, when the immune system is being “trained” to recognize cancer.
What This Means for Patients Today
If you’re receiving or considering immunochemotherapy:
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Timing is not part of standard treatment guidelines yet
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This study is promising, but still early
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It may be worth asking your oncologist whether infusion timing is flexible — especially at the start of treatment
As always, treatment decisions should be personalized, balancing science, logistics, and what’s realistic for you.
At Stage4Hope, we believe progress often comes from unexpected places — and sometimes, hope comes from asking new questions about familiar treatments. We’ll continue to follow this research closely and share updates as more data becomes available.
Questions to Ask Your Doctor
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Does treatment timing matter for my specific cancer?
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Is morning treatment an option for me?
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How does immunotherapy work with my immune system?
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What side effects should I watch for?
Stay Connected with Stage 4 Hope
Meet Dr. Sharon May
Meet Dr. Sharon May: The Trusted Guide Behind Stage4Hope Retreats
When you’re facing a Stage 4 cancer diagnosis, who leads you matters.
Not just their kindness — but their depth, training, experience, and ability to hold space when emotions are raw and life feels uncertain. At Stage4Hope, our retreats are led by Dr. Sharon May, a therapist, educator, and nationally respected voice in emotional healing and relational care.
Dr. May doesn’t simply facilitate conversations. She brings decades of clinical expertise and human wisdom into a space designed for people navigating one of the hardest moments of their lives.
A Foundation of Clinical Excellence
Dr. May holds a Ph.D. in Marriage and Family Therapy and a Master’s degree in Theology from Fuller Graduate School of Theology, grounding her work in both evidence-based psychology and deep understanding of meaning, identity, and emotional resilience.
She is a licensed therapist and a Certified Emotionally Focused Therapy (EFT) Therapist and Supervisor, trained in one of the most research-validated therapeutic models for emotional regulation, attachment, and secure connection. EFT is widely recognized for helping people manage fear, grief, and relational disruption — all central experiences for those facing advanced cancer.
Her academic research and doctoral work focused on attachment theory and emotional bonding, exploring how people find safety, steadiness, and connection during times of crisis. This research-informed foundation shapes every retreat she leads.
Leadership, Teaching, and National Influence
Dr. May is the Founder and President of Safe Haven Relationship Center, where she has spent years developing therapeutic curriculum, training clinicians, and guiding individuals and families through trauma, loss, and major life transitions.
She also serves on the Executive Board of the American Association of Christian Counselors (AACC), reflecting her standing as a trusted leader within the counseling profession.
In addition to her clinical practice, Dr. May is an adjunct professor who has taught counseling and therapy courses, helping shape the next generation of clinicians. She is also a frequent national speaker, presenting workshops and trainings across the U.S. and internationally.
Many people may recognize her from radio and television appearances, including Focus on the Family, Family Talk, Life Today, and her own program Arguing with Dr. Sharon. She is also the author of two books on emotional connection and communication, extending her reach well beyond the therapy room.
Why This Matters for Stage4Hope Retreats
Credentials matter — but how they translate into care matters more.
Dr. May brings all of this experience into Stage4Hope retreats with a grounded, human approach. She creates spaces that feel safe, steady, and deeply respectful. Participants are never pressured to share. Silence is welcome. Listening is participation.
In retreats like Still Me, Dr. May guides participants through:
- Grounding practices that calm racing thoughts and emotional overwhelm
- Reflection and journaling that help process shock and fear
- Gentle guidance on communicating with loved ones and setting boundaries
- Group connection rooted in dignity, confidentiality, and understanding
- Identity-centered reflection that honors the person beyond the diagnosis
This is not surface-level support. It is carefully facilitated emotional care led by someone who understands both the science of healing and the humanity of suffering.
A Guide You Can Trust
People come to Stage4Hope retreats for support — and they stay because they feel seen.
Dr. Sharon May brings credibility, calm, and compassion into every retreat she leads. Her presence reassures participants that they are in capable hands — guided by someone who understands trauma, connection, fear, hope, and the complexity of being human in the face of cancer.
That trust is everything.
If you are seeking a retreat led by a therapist with true depth, experience, and heart, you will find it here.
How 2025 Changed Cancer Care
Real Progress for Advanced Cancer Patients
For people living with advanced or hard-to-treat cancer, progress is not just about science — it’s about more time, fewer side effects, and better quality of life. In 2025, doctors and researchers reported major treatment advances that are already changing how cancer is treated today. These developments are especially meaningful for patients with stage 4 cancer who may feel they are running out of options.
Many of these breakthroughs were led or supported by research teams at Memorial Sloan Kettering Cancer Center, and they reflect a growing shift toward personalized, less invasive, and more effective cancer care.
Below is what patients need to know — without the medical jargon.
Immunotherapy Alone Is Treating Some Cancers Successfully
One of the most hopeful advances of 2025 involves cancers with a genetic feature called mismatch repair deficiency (MMRd). This feature makes cancer cells easier for the immune system to recognize and destroy.
In a large clinical trial, nearly 80% of patients with MMRd cancers — including colorectal, stomach, esophageal, bladder, and other cancers — were successfully treated using immunotherapy alone. Many patients did not need surgery, chemotherapy, or radiation.
For patients, this matters deeply. Avoiding major surgery or harsh treatments can preserve organs, reduce long-term side effects, and protect quality of life. For people with advanced cancer, it also shows that less treatment can sometimes be more effective.
New Targeted Therapies Bring Hope for Lung Cancer
For people with non-small cell lung cancer, treatment options can become limited once chemotherapy or immunotherapy stop working. In 2025, researchers reported promising results from a new targeted therapy aimed at a mutation called KRAS-G12D — a mutation that until recently had no effective treatment.
In an early clinical trial, more than 60% of patients saw their tumors shrink, even though many had already tried multiple treatments without success. This is especially important for patients searching for new targeted therapy for lung cancer after being told there are no remaining options.
This breakthrough reinforces the importance of genetic testing, even later in the disease, because new drugs continue to emerge for specific cancer mutations.
Breast Cancer Patients Are Living Longer With New Combinations
Patients with advanced breast cancer also saw meaningful progress in 2025. A large clinical trial found that combining a new targeted therapy with standard hormone treatments helped patients live about 26% longer than with standard treatment alone.
This matters because many people with metastatic breast cancer stay on treatment for years. Extending survival while maintaining daily function and independence is a major win — and another reminder that treatment plans can evolve over time.
Blood Tests Help Prevent Cancer From Returning
Another important advance involves simple blood tests, often called liquid biopsies, that can detect tiny traces of cancer left behind after surgery.
In a small study, doctors used these blood tests to identify patients who were most likely to benefit from immunotherapy after surgery. Patients who received immunotherapy based on their blood test results had strong survival rates and lower chances of recurrence.
For patients living with the fear of cancer coming back, this approach represents a more personalized and proactive strategy — treating only when needed, and earlier than before.
Progress for Rare and Overlooked Cancers
Not all breakthroughs focus on common cancers. In 2025, several advances targeted rare and aggressive diseases that historically have had few options:
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CAR T-cell therapy showed dramatic results for patients with AL amyloidosis who had stopped responding to standard treatments
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A new targeted drug helped shrink tumors in patients with histiocytosis, a rare blood cancer affecting both adults and children
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Children with an aggressive brain cancer lived far longer than expected using a new drug delivery method
For families facing rare diagnoses, these advances send a powerful message: research is not standing still.
Why This Matters for Stage 4 Patients
If you are living with stage 4 cancer, the message from 2025 is clear:
New options continue to emerge — even after standard treatments fail.
Across many cancer types, these advances mean:
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More targeted therapies with fewer side effects
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Immunotherapy replacing or delaying invasive treatments
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Blood tests guiding smarter decisions
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Clinical trials offering real benefit, not just future promise
At Stage4Hope, we encourage patients and caregivers to ask about genetic testing, clinical trials, and new treatment strategies, especially when options feel limited. Knowledge can open doors — and hope often begins with asking one more question. (Source: Memorial Sloan Kettering)
Read the complete article here >
You’re Not Alone—Connect with the Stage 4 Hope Community
Whether you’re exploring the latest cancer treatment advances like immunotherapy or targeted therapy, seeking emotional support, or trying to make sense of a new diagnosis, Stage 4 Hope is here for you. Join our community to access trusted resources, education, and encouragement from others who understand the stage 4 journey.
BLOCK-ID cancer research
BLOCK-ID: New Technique Finds Treatment Targets in Hard-to-Treat Cancers
When cancer is difficult to control, it’s often because the cancer cells have learned how to survive under intense stress. Even when their DNA is damaged or unstable — a situation that would normally cause a healthy cell to stop dividing or die — these cancer cells find ways to keep going.
This ability to survive under pressure is one reason some cancers become aggressive, resistant to treatment, or quick to return after therapy. Understanding how cancer cells manage this stress is a major focus of modern cancer research.
Researchers at Winship Cancer Institute of Emory University have now developed a powerful new research tool that helps explain how certain cancers adapt and survive under these extreme conditions. While this discovery is not a treatment yet, it offers important clues that may eventually lead to new targeted therapies for cancers that currently have limited options.
Why DNA copying matters in cancer
Every time a cell divides, it must make an exact copy of its DNA. In healthy cells, this process is carefully regulated to prevent mistakes. But in cancer cells, DNA copying often becomes chaotic.
DNA is copied at structures called replication forks, which are Y-shaped points where the DNA strands separate so new copies can be made. In many cancers, these replication forks frequently slow down, stall, or collapse. When this happens repeatedly, it creates DNA replication stress.
Replication stress is a double-edged sword. On one hand, it causes DNA damage and genetic instability — changes that can drive cancer growth and spread. On the other hand, cancer cells that learn how to survive replication stress gain a powerful advantage, allowing them to adapt, resist treatments, and continue dividing despite severe internal damage.
Many aggressive cancers exist in a constant state of replication stress. Understanding how they tolerate this stress — and which proteins help them survive it — is critical for finding new ways to disrupt cancer growth.
What is BLOCK-ID?
To better understand what happens when DNA is under stress or damage, researchers developed a new laboratory technique called BLOCK-ID, an Emory technique (short for biotinylation of lac operator array replication stress protein network identification).
In simpler terms, BLOCK-ID allows scientists to:
- Create stress in a cancer cell’s DNA on purpose.
- They then watch how cancer cells respond to that stress.
- This helps researchers see which proteins cancer cells use to survive.
This Emory technique solves a long-standing challenge in cancer research. Until now, it has been extremely difficult to identify which proteins are involved at replication forks during stress. BLOCK-ID provides a detailed and precise way to map the protein networks cancer cells rely on to survive.
A key discovery: TRIM24 and other proteins
Using BLOCK-ID, researchers identified multiple proteins that appear at stressed replication forks. One protein, called TRIM24, stood out as particularly important.
The team then applied this discovery to a specific cancer survival mechanism known as Alternative Lengthening of Telomeres (ALT).
Telomeres are protective caps at the ends of chromosomes. In normal cells, telomeres shorten each time a cell divides, which eventually limits how long a cell can continue reproducing. Cancer cells must overcome this limit to survive.
Some cancers — estimated at 10–15% — use the ALT pathway to maintain their telomeres without relying on the more common enzyme-based method. ALT is often seen in aggressive or difficult-to-treat cancers, including:
- Osteosarcoma
- Glioblastoma
- Pancreatic neuroendocrine tumors
The research showed that TRIM24 helps cancer cells protect their chromosome ends so they can keep dividing.
Why this is hopeful: four potential treatment targets
In addition to TRIM24, the researchers identified three other proteins involved in the ALT pathway. Together, these findings highlight four potential treatment targets in ALT-driven cancers.
Identifying targets is one of the most important early steps in cancer drug development. While it can take time to move from discovery to therapy, knowing which proteins are essential to cancer survival gives researchers a clearer path forward.
The next phase of research will focus on determining whether these targets can be safely disrupted — and whether doing so can slow or stop cancer growth.
What this could mean for patients
BLOCK-ID is not a new treatment, but it represents meaningful progress in understanding cancer biology. Research like this helps explain why some cancers behave aggressively and why they may stop responding to standard treatments.
For patients living with advanced or hard-to-treat cancers, this work supports a growing shift toward precision oncology — matching treatment strategies to the specific biological features of a tumor. Discoveries like this strengthen the importance of:
- Testing the cancer to learn what makes it grow
- Understanding how the cancer survives
- Looking into clinical trials when needed
As researchers uncover new weaknesses in cancer cells, new treatment options may become possible, even for patients who have been told there are few options left.
You’re Not Alone—Connect with the Stage 4 Hope Community
Whether you’re navigating treatment options, looking for emotional support, or trying to keep up with promising research, Stage 4 Hope is here for you. Join our community to stay connected to trusted resources, new updates, online training, and encouragement from others who understand this journey.
References:
https://winshipcancer.emory.edu/newsroom/articles/2025/new-technique-identifies-potential-new-treatment-targets.php?
https://pubmed.ncbi.nlm.nih.gov/40614724/
Theranostics for Cancer
Theranostics: A Powerful Diagnostic Tool and Cancer Treatment in One
Radiation therapy has been used to fight cancer for more than a century. But when cancer has spread to multiple areas of the body, traditional radiation can be limited—because it’s usually aimed at one location at a time and can affect healthy tissue nearby. Memorial Sloan Kettering (MSK) highlights a newer approach that is changing what’s possible for advanced and metastatic cancers: theranostics.
What Is Theranostics?
Theranostics combines the words therapy and diagnostics. It’s a treatment strategy that uses radioactive medicines to first find cancer cells and then treat them—using the same target. MSK’s theranostics motto captures the concept simply: “We see what we treat, and we treat what we see.”
How Theranostics Works
Theranostics typically happens in two steps:
- Find the cancer (“see it”)
Doctors infuse a patient with a radioactive drug containing a diagnostic isotope that binds to a specific target on cancer cells. Then a PET scan “lights up” where the drug has attached, revealing cancer sites that may be hard to see on standard imaging. - Treat the cancer (“treat it”)
If the target is confirmed, doctors give a treatment version of the same approach—this time loaded with a therapeutic isotope. The radiation works like a highly precise “smart bomb,” damaging cancer cell DNA while helping protect surrounding healthy tissue.
Why Theranostics Is Such a Big Deal
MSK notes several practical advantages of theranostics, especially for cancers that have spread:
- It can reveal the exact location of cancer cells that might be missed on conventional scans.
- It can help doctors evaluate whether treatment is working sooner.
- It can help clinical trials move more efficiently from imaging to treatment phases.
- It can treat multiple sites of disease throughout the body, not just one spot at a time.
- Even when it isn’t a cure, theranostics can be meaningful because it may offer effective control with good tolerability—supporting quality of life and daily living for many patients.
A Real Example: Theranostics for Metastatic Prostate Cancer (Pluvicto)
MSK shares the story of a patient with metastatic (stage 4) prostate cancer who joined a clinical trial using lutetium-177 PSMA-targeted therapy (Pluvicto). The treatment targets PSMA, a protein on prostate cancer cells, delivering radiation directly to those cells.
MSK also notes that the FDA approval expanded in 2025 to include more patients—specifically, people who had not yet received chemotherapy, increasing who may be eligible for this type of treatment.
Theranostics Beyond Prostate Cancer
Theranostics is also being developed for other cancers. MSK describes ongoing work to identify new targets, including efforts in neuroendocrine cancers and research into targets like DLL3. MSK researchers are also working toward theranostics applications in cancers such as breast cancer, brain tumors, melanoma, and pancreatic cancer.
What’s Next: A More Powerful Next Wave (Alpha Particles)
MSK highlights a “next wave” of theranostics using alpha-emitting radiopharmaceuticals—described as the most powerful form yet—and notes they opened a facility dedicated to producing these agents for clinical trials.
Questions to Ask Your Care Team
If you or a loved one is living with advanced cancer, you might consider asking:
- Do I have a target (biomarker) that could make me eligible for theranostics?
- Would a PET scan help identify targets or sites of disease more clearly?
- Are there clinical trials involving targeted radionuclide therapy that fit my diagnosis?
- What side effects are typical, and how might this compare to other options?
(This is informational only—your oncology team can help you understand what’s appropriate for your specific diagnosis.)
You’re Not Alone—Connect with the Stage 4 Hope Community
Whether you’re exploring treatment options, seeking emotional support, or trying to make sense of a new diagnosis, Stage 4 Hope is here for you. Join our community to access trusted resources, education, and encouragement from others who understand the stage 4 journey.
Reference:
https://www.mskcc.org/news/theranostics-powerful-diagnostic-tool-and-cancer-treatment-in-one
MSK vs MD Anderson: Choosing the Best Cancer Center for You
Comparing MSK vs MD Anderson Using the 2025–2026 Rankings for Advanced Cancer Care
When facing an advanced or complex cancer diagnosis, patients and families are often told they need care at a top cancer center — but that advice can feel overwhelming without clear guidance. Two names that consistently rise to the top are Memorial Sloan Kettering Cancer Center (MSK) in New York City and MD Anderson Cancer Center (MD Anderson) in Houston, Texas. Both are widely recognized as leaders in advanced cancer treatment options, research, and cancer clinical trials, especially when standard treatments are no longer enough.
According to the 2025–2026 U.S. News & World Report, MD Anderson and MSK are ranked as the top two cancer hospitals in the United States, with MD Anderson at #1 and MSK at #2. On a global level, Newsweek’s World’s Best Specialized Oncology Hospitals list also places MD Anderson first and MSK second worldwide. For patients considering where to seek care or a second opinion at a top cancer center, these rankings reinforce the strength and credibility of both institutions.
While MSK and MD Anderson share the same level of excellence, they each bring distinct strengths. Understanding those differences can help patients and caregivers decide which center may be the best fit for their specific cancer and treatment goals.
MSK: Precision Oncology and Targeted Trials
MSK is especially known for its leadership in precision oncology, an approach that tailors treatment based on the specific genetic changes driving a patient’s cancer. Rather than relying on a one-size-fits-all strategy, MSK places strong emphasis on detailed molecular testing to guide care.
This focus makes MSK a strong option for patients seeking the best cancer center for clinical trials that are highly targeted or mutation-driven. MSK runs one of the largest early-phase (Phase I) clinical trials programs in the country, including first-in-human studies that may offer new options for patients whose cancer has resisted multiple treatments.
In addition, MSK researchers have played a key role in developing immunotherapy for cancer and targeted drugs that are now widely used in oncology care, helping translate scientific discoveries into real treatment options more quickly.
MD Anderson: Broad Expertise and Immunotherapy Leadership
MD Anderson’s strength lies in its size, scope, and multidisciplinary depth. As one of the world’s largest cancer centers, it offers specialized teams across nearly every cancer type, allowing for highly coordinated care.
The center is a recognized leader in immunotherapy for cancer, including combination immunotherapy strategies and immune-based treatments. MD Anderson continues to help refine how these therapies are used — improving effectiveness, managing side effects, and expanding which patients may benefit.
MD Anderson also offers the largest total number of cancer clinical trials in the United States, giving patients access to a wide range of research studies across many treatment approaches, including immunotherapy, cellular therapy, surgery, and combination care.
Clinical Trials: Depth vs. Volume
Both centers offer exceptional access to clinical trials, but their focus differs:
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MSK excels in early-phase, precision-driven trials tied to tumor genetics
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MD Anderson offers broad trial volume across many cancer types and treatment strategies
The right choice often depends on whether a patient’s cancer is driven by a specific mutation or whether they need access to a wide range of treatment options.
Patient Experience and Access
Care experience can also differ between the two centers:
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MSK is a more compact, integrated system, often allowing for faster molecular testing and targeted trial matching
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MD Anderson is a very large institution with extensive resources, which can be ideal for complex cases but may involve longer wait times
Neither approach is better overall — the best fit depends on the patient’s diagnosis, urgency, and treatment needs.
Patient Summary: Which Center May Be Right for You?
MSK may be a strong fit if your cancer:
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Is driven by a rare or complex genetic mutation
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Has stopped responding to multiple treatments
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May benefit from precision oncology or early-phase trials
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Requires rapid molecular-based trial matching
MD Anderson may be a strong fit if your cancer:
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May respond to immunotherapy or cellular therapy
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Requires complex, multidisciplinary care
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Involves high tumor burden or complex anatomy
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Needs access to a wide range of cancer clinical trials
Bottom Line
Both MSK and MD Anderson are among the world’s leading cancer centers, each offering exceptional care and access to breakthrough clinical trials. The most important question is not which center is best, but which center is the best fit for this cancer, this biology, and this moment.
You’re Not Alone—Connect with the Stage 4 Hope Community
Stage4Hope helps patients and families navigate this decision — guiding them to the right cancer center, the right clinical trial options, and the right next steps without delay, especially when time matters most. We are here for you! Join our community to access trusted resources, education, and encouragement from others who understand the stage 4 journey.
Reference:
1. https://health.usnews.com/best-hospitals/rankings/cancer
2. https://www.newsweek.com/rankings/worlds-best-specialized-hospitals-2025/oncology
3.https://www.mskcc.org/cancer-care/clinical-trials
https://www.mskcc.org/cancer-care/diagnosis-treatment/cancer-treatments/targeted-therapy
4.https://www.mdanderson.org/patients-family/diagnosis-treatment.html
https://www.mdanderson.org/treatment-options/immunotherapy.html
Given 2 Years, Living 13 Strong
Living 13 Years Strong: Debbie’s Stage 4 Lung Cancer Journey of Hope and Persistence
Debbie was given two years after a stage 4 lung cancer diagnosis. Thirteen years later, she’s thriving—proof that hope and targeted therapy can change lives on a stage 4 lung cancer journey.
When Debbie was first diagnosed with stage 4 lung cancer, doctors told her she might only have one to two years left. Like many patients, she felt overwhelmed and afraid. But instead of giving up, she sought a second opinion and learned that her cancer carried the BRAF mutation. This discovery opened the door to targeted therapy through a clinical trial—something that gave her options beyond traditional chemotherapy and radiation.
Over the last 13 years, Debbie has faced many treatments, side effects, and setbacks, but also many breaks from therapy where she could live life more fully. She has outlived the predictions and now encourages other patients to stay hopeful, ask questions, and keep pushing for answers. Debbie’s story shows how advances in biomarker testing and targeted therapy can turn what once felt like an “end date” into years filled with milestones and new memories.
Her journey reminds us that no one is defined by statistics. For patients with advanced lung cancer, Debbie is living proof that hope, persistence, and medical progress can lead to more time and better quality of life. (Source: GO2 for Lung Cancer)
Read the complete article here >
You’re Not Alone—Connect with the Stage 4 Hope Community
Whether you’re navigating treatment options, seeking emotional support, or trying to make sense of a new diagnosis, Stage 4 Hope is here for you. Learn more about stage 4 lung cancer and other aspects of living with late-stage cancer. Join our community to connect with others who understand your experience and gain access to resources, events, medical updates, and invitations to supportive virtual events.
Safer Cancer Drug Dosing Ahead
Safer Cancer Drug Dosing: ASCO and FDA Push for Optimal, Not Maximum, Doses
ASCO and the FDA promote safer cancer drug dosing by focusing on optimal cancer drug dosing—finding the optimal effective dose to reduce side effects and improve treatment tolerance. Learn more in this article about optimal cancer drug dosing.
Concerns are growing that cancer drugs may be given at higher doses than patients actually need, leading to unnecessary side effects and treatment interruptions. The American Society of Clinical Oncology (ASCO), working with the FDA, has issued new principles urging a shift from the old “maximum tolerated dose” approach toward finding the “optimal effective dose.” This matters for newer treatments like immunotherapies and targeted therapies, where higher doses don’t always improve results but often increase harmful side effects. Patient surveys show many people with advanced cancers struggle with severe treatment side effects, and oncologists frequently lower doses early on to help patients stay on therapy.
To fix this, ASCO recommends designing trials that test multiple dosage levels, tailoring studies to real-world patients, and improving how patient-reported side effects are tracked. These steps align with the FDA’s Project Optimus, which is pushing for better drug dosing in cancer research. For patients, this shift offers hope for treatment that works just as well—or better—while being easier to tolerate, helping people with advanced cancer focus on living fully instead of fighting side effects. (Source: Oncology News Central)
Read the complete article here >
Earlier detection and better-tolerated treatment often go hand in hand. If you’re interested in what’s on the horizon for catching cancer sooner, read Future of Cancer Screening: Multi-Cancer Early Detection Brings New Hope.
You’re Not Alone—Connect with the Stage 4 Hope Community
Whether you’re navigating treatment options, seeking emotional support, or trying to make sense of a new diagnosis, Stage 4 Hope is here for you. Learn more about topics like optimal cancer drug dosing, dosing strategy guidance from ASCO and the FDA, trial design, and initiatives like the FDA’s Project Optimus—along with other aspects of living with late-stage cancer. Join our community to connect with others who understand your experience and gain access to resources, events, medical updates, and invitations to supportive virtual events.
New Clues on How Cancer Spreads
New Clues on Cancer Metastasis: How “Shape-Shifting” Cells Spread and Survive
With new cancer metastasis research, scientists are uncovering how cancer cells spread, hide, and return, offering new hope for treatments that may stop cancer progression and improve survival.
Understanding the Biggest Challenge in Cancer
For decades, doctors have known that cancer’s deadliest threat is not the original tumor, it is metastasis, the process by which cancer spreads to other parts of the body. In fact, up to 90% of cancer-related deaths are linked to metastatic disease.
But what exactly is happening inside the body when cancer spreads?
What Is Metastatic Cancer?
Metastatic cancer is cancer that has spread from its original (primary) location to another part of the body. This process is called metastasis.
Even after spreading, cancer is still named after where it started. For example, if breast cancer spreads to the liver, it is still called metastatic breast cancer, not liver cancer.
Metastasis occurs when cancer cells:
- Break away from the original tumor
- Travel through the bloodstream or lymphatic system
- Settle in a new organ or tissue
- Begin forming new tumors
This ability to spread and grow in new environments is what makes metastatic cancer more complex to treat, but ongoing research is changing what is possible.
Metastasis Definition
Metastasis is the process by which cancer cells spread from the primary tumor to distant parts of the body, forming new tumors in other organs or tissues.
New Research: How Cancer Cells “Shape-Shift” and Survive
Researchers led by Dr. Joan Massagué at Memorial Sloan Kettering are uncovering important insights into how metastatic cancer cells behave.
These cells are not static. Instead, they are incredibly adaptable.
Scientists have discovered that metastatic cells can:
- “Shape-shift” into more flexible, stem-like states
- Travel back to earlier developmental stages to survive
- Adapt to new environments in different organs
- Evade the immune system
- Enter a dormant (inactive) state for years
This means cancer cells can essentially “hide” in the body, sometimes for long periods, before reactivating and forming new tumors.
Where Can Cancer Spread in the Body?
Cancer does not spread to just one location. While some areas are more common than others, metastatic cancer can travel to multiple parts of the body.
Common sites of metastasis include:
- Liver
- Bones
- Lungs
- Brain
- Lymph nodes
- Peritoneum (abdominal lining)
Different cancers tend to spread in predictable patterns:
- Breast cancer often spreads to bones, liver, lungs, or brain
- Lung cancer may spread to the brain, liver, or bones
- Colorectal cancer commonly spreads to the liver
Understanding where cancer spreads helps guide treatment and monitoring strategies.
Metastatic Cancer Life Expectancy
Life expectancy with metastatic cancer varies widely depending on several factors, including:
- The type of cancer
- Where it has spread
- How the cancer responds to treatment
- Overall health
While metastatic cancer is considered advanced, outcomes are improving. Some individuals live for many years with ongoing treatment and supportive care.
Stage 4 Metastatic Cancer Survival Rate
Survival rates are based on large groups of people and cannot predict individual outcomes. However, they help provide general context.
Today, survival rates are improving due to:
- Immunotherapy
- Targeted therapies
- Personalized treatment approaches
Many patients are living longer and maintaining a higher quality of life than ever before.
Why These New Discoveries Matter
The research from Memorial Sloan Kettering is helping scientists understand not just that cancer spreads, but how it spreads and survives.
By uncovering how cancer cells:
- Change form
- Hide in dormant states
- Adapt to different organs
Researchers can begin to develop treatments that:
- Target hidden cancer cells
- Prevent metastasis from occurring
- Reduce the risk of recurrence
- Improve long-term survival
This represents a major shift, from simply treating tumors to interrupting the metastatic process itself.
Dr. Massagué emphasizes that metastasis is no longer automatically viewed as a final stage without options. With ongoing advances in research and treatment, controlling, and in some cases even overcoming, stage 4 cancer is becoming more possible.
Continued Progress in Cancer Treatment
As scientists learn more about metastasis, they are also rethinking how treatments are delivered.
Researchers are exploring:
- More precise drug dosing strategies
- Treatments that reduce side effects
- Therapies that patients can tolerate long-term
These advancements aim to help patients stay on treatment longer while maintaining quality of life.
Learn more about optimal cancer drug dosing and why “optimal” can matter more than “maximum.”
Read the complete article here >
As cancer screening evolves, researchers are also rethinking how cancer drugs are dosed to reduce side effects and help patients stay on therapy. Learn more about optimal cancer drug dosing and why “optimal” can matter more than “maximum.”
You’re Not Alone—Connect with the Stage 4 Hope Community
Whether you’re navigating treatment options, seeking emotional support, or trying to make sense of a new diagnosis, Stage 4 Hope is here for you. Learn more about topics like cancer metastasis research, including new findings on how metastasis works, mechanisms like dormancy and “shape-shifting” behavior—and how this research could inform future treatments. Join our community to connect with others who understand your experience and gain access to resources, events, medical updates, and invitations to supportive virtual events.
