How Cancer Spreads and Survives
Why Understanding Cancer Spread Matters
For patients facing Stage 4 cancer, one of the most difficult parts of the diagnosis is understanding how cancer spreads—and what can be done to stop it.
Cancer spread, also called metastasis, happens when cancer moves from its original location to other parts of the body. In fact, the vast majority of cancer deaths are caused not by the original tumor, but by the effects of metastatic cancer.
While that can feel overwhelming, researchers are learning much more about how metastatic cancer cells survive, hide, and eventually grow in other parts of the body. These discoveries could point toward new Stage 4 cancer treatments and more personalized approaches to care.
New Discoveries About How Cancer Spreads
Researchers at Memorial Sloan Kettering Cancer Center (MSK), led by metastasis researcher Joan Massagué, PhD, are uncovering important insights into how cancer spreads.
One discovery is that metastatic cancer cells can become unusually flexible. They can access cellular programs normally associated with much earlier stages of development, giving them the ability to adapt to different environments and potentially resist treatment.
Researchers have also found that some cancer cells can enter a dormant state. Instead of actively growing, these cells can remain hidden from the immune system until conditions allow them to become active again. This may help explain why cancer can sometimes return long after initial treatment.
MSK scientists identified a signaling pathway called STING that may be important during this process. As dormant cells begin growing again, increased STING activity can make them more visible—and potentially more vulnerable—to the immune system. Researchers are studying whether this window could eventually be used to help immune defenses destroy metastatic cells.
Scientists are also learning that different cancers can use different strategies to spread to the same organ. Understanding those differences could eventually help doctors target the specific vulnerabilities of each cancer more precisely.
Can Genetics Predict Where Cancer Spreads?
Additional MSK research adds another important piece to the metastasis puzzle. Scientists analyzed genomic information from approximately 25,000 patients across 50 cancer types to investigate whether a tumor’s genetic mutations could predict whether—and where—it would spread.
Researchers found associations between certain genetic changes and patterns of metastasis, but genetics alone could not reliably predict exactly where an individual patient’s cancer would spread.
The findings suggest that metastasis is more complex than a single mutation. How genes are regulated, how cancer cells interact with their surrounding environment, and how tumors continue to change as they progress may all influence cancer’s ability to spread.
For patients, this research could eventually contribute to more personalized cancer treatment, monitoring, and assessment of metastatic risk as scientists combine genomic information with increasingly detailed clinical data.
What This Means for Patients
For people living with Stage 4 cancer, understanding metastasis is about much more than understanding why cancer spreads. It is about finding new vulnerabilities that researchers may eventually be able to target.
These discoveries could contribute to:
- New Stage 4 cancer treatment options
- Better strategies for preventing or controlling metastasis
- More personalized treatments based on tumor biology
- Improved use of immunotherapy and clinical trials
- Better ways to identify and target dormant cancer cells
Importantly, researchers emphasize that metastatic cancer is no longer universally viewed as an automatic death sentence. For some cancers, immunotherapy and other advances have made metastasis more treatable, while other advanced cancers are increasingly becoming diseases that can be controlled for longer periods.
How Stage4Hope Helps Turn Research Into Access
New discoveries are creating more options for patients with Stage 4 cancer—but access remains critical.
Stage4Hope helps bridge that gap by:
- Connecting patients to leading cancer centers
- Helping them explore clinical trials and treatment options
- Supporting the logistics of getting there
- Providing virtual retreats and support groups for emotional and spiritual support
👉 Learn more about our work: https://stage4hope.org
If you or someone you love is facing Stage 4 cancer, faster access to care can open new possibilities.
👉 Explore resources: https://stage4hope.org/resources
Healthcare providers can refer patients directly to help accelerate care:
👉 Refer a patient: https://stage4hope.org
References
https://www.mskcc.org/news/how-cancer-spreads-four-emerging-insights
What Cancer Cells Eat to Grow
What Cancer Cells Eat to Grow (Stage 4 Cancer Explained)
Why This Research Matters
For patients facing Stage 4 cancer, new treatments often begin with one important question: What is helping cancer grow—and how can it be stopped?
New research from Memorial Sloan Kettering Cancer Center is focusing on something many people don’t think about—how cancer cells use nutrients to survive.
By understanding how cancer cells “eat,” scientists are uncovering new ways to develop better cancer treatment options and improve outcomes for patients. This type of research may shape the next generation of therapies for people facing advanced cancer.
Understanding How Cancer Cells Grow
At the center of this research is Lydia Finley, whose work focuses on cancer cell metabolism—the way cancer cells convert nutrients into energy and the building blocks they need to grow.
All cells need fuel to function, but cancer cells often depend on certain nutrients more heavily than normal cells. This creates a potential opportunity for treatment.
If researchers can identify what cancer cells rely on, they may be able to:
- Block those nutrients
- Disrupt how cancer cells produce energy
- Slow or stop tumor growth
This research is already leading to important discoveries. In some studies, scientists found that certain molecules, called metabolites, can actually change how cancer cells behave—making them less aggressive and less likely to spread.
In another example, researchers studying a rare childhood cancer identified key nutrients the cancer depended on. They then used an existing drug, methotrexate, to target that process and slow tumor growth.
This type of research may not always lead to immediate treatments, but it plays a critical role in advancing clinical trials and new cancer therapies. Many breakthroughs start with understanding how cancer works at its most basic level.
It also helps explain why some treatments stop working over time. Cancer cells can adapt and find new ways to survive. By understanding metabolism, researchers may be able to stay ahead of that resistance and develop more durable treatment options.
What This Means for Patients
For patients with Stage 4 cancer, research like this represents something important: new possibilities for treatment.
Many of today’s most effective therapies—especially targeted therapy and immunotherapy—started with this kind of foundational research. What may seem like early science today can become tomorrow’s life-saving treatment.
Understanding how cancer cells survive could lead to:
- New Stage 4 cancer treatment options
- More personalized care based on how a patient’s cancer behaves
- Better outcomes with fewer side effects
But discoveries alone are not enough.
Patients must be able to access the right care, at the right time, and at the right place. Many of the most advanced treatments and clinical trials for cancer are available at leading cancer centers—but getting there can be one of the biggest challenges patients face.
Additional Insight: Why Metabolism Research Is Expanding
Research from Dana-Farber Cancer Institute reinforces the importance of this work. Scientists are finding that cancer cells do not all use nutrients in the same way, which means treatments may need to be tailored even more precisely for each patient.
Their research highlights how cancer cells can “reprogram” the way they use energy—allowing them to survive, grow, and even resist treatment. This supports findings from MSK that understanding how cancer cells use fuel is critical to developing more effective therapies.
By identifying these metabolic differences, researchers are working toward treatments that not only target the cancer itself but also cut off the pathways it depends on to survive. This may help explain why some patients respond better to certain therapies—and how new combinations of treatments could improve outcomes.
As this field continues to grow, it is opening the door to more personalized and effective cancer treatment strategies, especially for patients with advanced or treatment-resistant disease.
How Stage4Hope Helps Patients Move Faster
At Stage4Hope, we are focused on one mission:
Helping patients with Stage 4 cancer access life-saving care—faster.
We help patients:
- Connect with leading cancer centers
- Explore clinical trials and treatment options
- Navigate complex care decisions
- Access travel support when distance is a barrier
- Join virtual retreats and support groups for emotional and spiritual support
👉 Learn more about how we support patients: https://stage4hope.org
If you or a loved one has been diagnosed with a late-stage cancer, getting to the right care quickly can make all the difference.
👉 Explore resources and patient support: https://stage4hope.org/resources
Healthcare providers and partners can also refer patients directly to help accelerate access to care:
👉 Refer a patient or partner with us: https://stage4hope.org
References:
https://www.mskcc.org/news/what-cancer-cells-eat-cancer-metabolism-may-hold-key-to-new-treatments
When Access to Care Changes a Stage 4 Cancer Story
When Options Feel Like They’re Running Out
For Nisar Hussain Khan, a diagnosis of Stage 4 lung cancer came with devastating news—there were few treatment options left.
He had already spent nearly two months in the hospital. He had lost so much weight he needed a feeding tube. Even speaking was difficult because of a severe cough.
His daughter, Kay, remembers how quickly everything changed.
“We were told there wasn’t much more they could do,” she shared.
For many families facing advanced lung cancer, this is the moment when time feels like it’s slipping away.
But for some patients, clinical trials for lung cancer can offer access to advanced Stage 4 lung cancer treatment options that are not available elsewhere.
A Turning Point Through Clinical Trials
Everything changed when Nisar and his family sought care at Memorial Sloan Kettering Cancer Center.
There, they were offered something many patients never get the chance to explore—a clinical trial for Stage 4 lung cancer.
Led by Robert Daly and connected to research from Alexander Drilon, the trial focused on a targeted therapy designed to block cancer growth at the molecular level.
Within days of starting treatment, everything began to shift.
“Three days after taking the medication, I was able to talk and laugh again.”
“After a week, the terrible cough was nearly gone. I have regained over 20 pounds. I can even play ping-pong. It was a miracle.”
Living Again—Without Leaving Home
For Nisar and his family, one of the biggest concerns was the burden of travel.
Like many patients with Stage 4 lung cancer, getting to a major cancer center can be physically exhausting, emotionally overwhelming, and financially difficult.
But this clinical trial offered something different.
Through a more innovative approach, his care was coordinated remotely—allowing him to receive treatment close to home in Texas.
“It was such a huge relief for us,” Kay said. “He could stay in his own space and sleep in his own bed.”
This kind of access is changing what’s possible for patients seeking clinical trials for lung cancer.
Another Stage 4 Lung Cancer Story
Tengo Shautidze was facing a different form of aggressive lung cancer when he was offered an innovative immunotherapy treatment.
Traditionally, this type of Stage 4 lung cancer treatment requires hospitalization due to potential side effects.
But through a new “hospital at home” approach led by Dr. Daly, Tengo was able to receive treatment from his own home—with telehealth monitoring, in-home visits, and support.
“Getting medicine this way is much more convenient… it’s easier on you and your family.”
“It’s also better psychologically — you don’t feel as sick.”
For Tengo and his wife, this approach made a meaningful difference—not just physically, but emotionally.
“My husband feels so much better,” his wife shared. “And is doing so much better.”
Why These Stage 4 Lung Cancer Stories Matter
Nisar and Tengo’s experiences highlight something critical:
For patients with Stage 4 lung cancer, the right treatment—and the right access—can change everything.
Clinical trials for lung cancer are not just research. They provide access to:
- Advanced targeted therapies and immunotherapy
- New Stage 4 lung cancer treatment options
- Opportunities when standard treatments no longer work
Yet only a small percentage of patients ever participate in clinical trials.
The Reality: Access Is Still the Biggest Barrier
Many patients are not missing options—they are missing access.
Delays in referrals, lack of awareness about clinical trials for lung cancer, and the burden of travel prevent patients from reaching the care that could extend their lives.
For patients with Stage 4 cancer, time is everything.
How Stage4Hope Helps Patients Move Faster
At Stage4Hope, we are focused on one mission:
Helping patients with Stage 4 cancer access life-saving care—faster.
We help patients:
- Connect with leading cancer centers
- Explore targeted therapy and clinical trial options
- Navigate complex treatment decisions
- Access travel support when distance is a barrier
👉 Learn more about how we support patients: https://stage4hope.org
If you or a loved one has been diagnosed with Stage 4 cancer, getting to the right place quickly can make all the difference.
👉 Explore resources and patient support: https://stage4hope.org/resources
Healthcare providers and partners can also refer patients directly to help accelerate access to care:
👉 Check out our travel grants: https://stage4hope.org
References:
https://www.mskcc.org/news/msk-clinical-trials-bringing-promise-of-new-medicine-to-more-patients
A Stage 4 Lung Cancer Breakthrough Story
When a Stage 4 Diagnosis Changes Everything
When Joanne Ferrari-Mautino went in for an X-ray, she knew something wasn’t right.
“I’ve been a nurse for 20 years,” she said. “I knew it was not a good sign.”
What started as a persistent cough quickly turned into something far more serious. Within days, Joanne was told she had Stage 4 non-small cell lung cancer—and a life expectancy of just 18 months to two years.
In that moment, everything changed.
She had a teenage son. A partner. A life she loved in her small Connecticut town. And suddenly, she was facing a diagnosis that felt overwhelming and uncertain.
Finding Answers Through Biomarker Testing
But Joanne’s story didn’t end there.
Further testing revealed something critical—a genetic mutation known as a ROS1 fusion, a rare driver of lung cancer. That one piece of information changed everything about her treatment path.
She was referred to Memorial Sloan Kettering Cancer Center, where she met Alexander Drilon, a physician who specializes in ROS1 lung cancer treatment.
Instead of standard chemotherapy, Joanne was able to begin targeted therapy for Stage 4 lung cancer—a treatment designed specifically for the genetic mutation driving her cancer.
What followed felt, in her words, like a miracle.
“I live a normal life. Sometimes people don’t even know I have cancer.”
A Second Story of Strength
Joanne’s experience is not the only one.
Anthony Valente, 63, was also diagnosed with advanced lung cancer after tumors were discovered during a routine exam. Initial treatment worked for a time—but eventually, the cancer began to grow again.
At that point, he was offered something different: a clinical trial for a next-generation ROS1 targeted therapy.
After starting treatment, he saw rapid improvement.
“The cancer shrunk and shrunk and shrunk. I actually feel better now than before I had cancer.”
For Anthony, it wasn’t just the treatment that made a difference—it was also the support around him. His wife of 40 years stood beside him through every step, and the care team helped guide him through difficult decisions.
Why These Stories Matter
Joanne and Anthony’s stories highlight something incredibly important for patients with Stage 4 lung cancer:
The right treatment can change everything.
Advances in targeted therapy for lung cancer, including newer drugs like Repotrectinib, Taletrectinib, and Zidesamtinib, are helping patients live longer with fewer side effects.
But these treatments are only possible when patients:
- Receive biomarker testing
- Get connected to the right specialists
- Access leading cancer centers and clinical trials
And for many patients, that access is the biggest challenge.
The Reality Many Patients Face
Too often, patients are not missing options—they are missing access.
Delays in referrals, lack of awareness about ROS1 lung cancer treatment, and the burden of travel can prevent patients from reaching the care that could extend their lives.
Time matters—especially with advanced cancer.
How Stage4Hope Helps Patients Like Joanne and Anthony
At Stage4Hope, we are focused on one mission:
Helping patients with Stage 4 cancer access life-saving care—faster.
We help patients:
- Connect with leading cancer centers
- Explore targeted therapy and clinical trial options
- Navigate complex treatment decisions
- Access travel support when distance is a barrier
👉 Learn more about how we support patients: https://stage4hope.org
If you or a loved one has been diagnosed with Stage 4 lung cancer, especially with a known mutation like ROS1, getting to the right place quickly can make all the difference.
👉 Explore resources and patient support: https://stage4hope.org/resources
Healthcare providers and partners can refer patients directly to Stage4Hope for travel assistance grants, helping reduce the financial burden of traveling for treatment or a second opinion.
👉 Refer a patient or partner with us: https://stage4hope.org
References:
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.
Learn how second opinions can save lives.
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.
Read our blog about the New KRAS-G12D Lung Cancer Therapy Hope.
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.
Learn about a new breakthrough: Cancer vaccines offer new hope.
References:
https://winshipcancer.emory.edu/newsroom/articles/2025/new-technique-identifies-potential-new-treatment-targets.php?
https://pubmed.ncbi.nlm.nih.gov/40614724/
