Safer Cancer Drug Dosing Ahead
Safer Cancer Drug Dosing: ASCO and FDA Push for Optimal, Not Maximum, Doses
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)
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New Clues on How Cancer Spreads
New Clues on Cancer Metastasis: How “Shape-Shifting” Cells Spread and Survive
For decades, doctors have known that cancer’s deadliest threat comes not from the original tumor but from metastasis — when cancer spreads to other parts of the body. Up to 90% of cancer deaths are linked to this process. Now, researchers led by Dr. Joan Massagué at Memorial Sloan Kettering are uncovering important insights into how metastatic cells survive, hide, and return to grow new tumors years later. These “shape-shifting” cells act like stem cells, traveling back in time to earlier, more flexible states that allow them to adapt and resist treatment. They can also slip into dormancy, hiding from the immune system until the conditions are right to awaken and spread again.
Scientists are learning that metastatic cells use different strategies depending on the type of cancer and the organ they invade. They can even change their physical shape to avoid being destroyed by the immune system. These discoveries open new possibilities for treatment — from targeting the hidden “time traveler” state, to waking dormant cells so the immune system can attack them, to blocking proteins that allow cancer cells to evade detection. While challenges remain, Dr. Massagué emphasizes that metastasis is no longer an automatic death sentence. With advances in immunotherapy and targeted research, controlling — and in some cases curing — stage 4 cancer is becoming more possible than ever before. (Source: Memorial Sloan Kettering)
Future of Cancer Screening Shows Hope
Future of Cancer Screening: Multi-Cancer Early Detection Brings New Hope
Most cancers are still found late because only five types—colon, cervical, breast, lung, and prostate—have routine screening. A new direction called multi-cancer early detection (MCED) aims to spot cancers with a single test. Instead of hunting for tiny, hard-to-find tumor DNA fragments in the blood, researchers are building tiny “sensors” that circulate in the body and switch on when they meet enzymes made by early cancer cells. These sensors release a synthetic marker that shows up clearly in samples like urine, creating a much stronger, earlier signal than traditional tests in preclinical studies.
Why it matters: this approach could make screening simpler, more accurate, and more accessible—potentially even via low-cost strips for clinics with limited resources—and may help catch hard-to-find cancers (including lung cancer) sooner, when treatment works best. Logic-based sensor designs (think an “AND” gate requiring multiple cancer signals) may reduce false alarms, and early clinical use could include tracking treatment response or watching for recurrence. Safety testing is still ahead, but progress is rapid. If successful, MCED could shift many diagnoses from late-stage to early-stage—and offer hope and options for people living with or at risk for advanced disease. (Source: MIT Technology Review)
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Boosting Cancer Immunity Through Fasting
Fasting and Cancer Immunity Explained
How Fasting May Supercharge the Immune System to Better Fight Cancer…
More than a dozen types of cancer are sensitive to obesity, which can cause inflammation that damages cells, increased hormone levels, and other changes. So it makes sense for researchers to explore whether fasting to slow body fat and improve metabolic health might improve outcomes.
Now laboratory researchers at Memorial Sloan Kettering Cancer Center (MSK) and their collaborators have found that fasting can SUPERCHARGE the immune system’s “natural killer” cells. (Natural killer cells, or NK cells, for short, are a type of white blood cell that can kill abnormal or damaged cells, such as cancer cells.)
Fasting can reprogram the metabolism of natural killer cells, the team found in a study of mice. Those reprogrammed cells are better able to survive in the harsh environment in and around tumors. Their cancer-fighting ability is stronger, too.
The research, which was published in Immunity — one of the top immunology journals — explains how natural killer cells get reprogrammed during periods of fasting. The researchers are optimistic that what they’re learning in animal models could help make human immunotherapies more effective in people.
“Tumors are very hungry,” says immunologist Joseph Sun, PhD, the study’s senior author. “They use up the essential nutrients flowing to normal tissue. In that nutrient-starved environment, it is harder for natural killer cells to survive, so their function is impaired. Fasting reprograms these natural killer cells to better survive in this suppressive environment.”
What Are Natural Killer Cells?
Natural killer cells get their name because they can destroy a threat without having to recognize that threat — unlike other immune cells, called T cells, which require exposure to a specific threat in order to target it.
In general, the more NK cells that are present within a tumor, the better the prognosis is for the patient.
How Fasting Reprograms and Redistributes NK Cells
For the study, mice with cancer were fasted for 24 hours twice a week and then allowed to eat freely in between fasts. While the mice did not lose weight, the fasting had a profound effect on their natural killer immune cells.
Just as happens in humans, fasted mice saw a drop in their glucose levels and a rise in free fatty acids, which are lipids released by fat cells.
“During each of these fasting cycles, NK cells learned to use these fatty acids as an alternative fuel source to glucose,” says study first author Rebecca Delconte, PhD, a postdoctoral fellow in the Sun Lab. “This really improves their response against cancer and helps them survive in the harsh environment around the tumor.”
Fasting also led NK cells to travel to and interact with different parts of the body in big numbers. Many of the NK cells travel into the bone marrow, where they are programmed to develop a more powerful response against cancer. Meanwhile, NK cells that travel to the spleen undergo a separate reprogramming, making them better able to use lipids as a fuel source.
“With both of these mechanisms put together, we find that NK cells will move to the tumor and be primed to better kill the cancer cells,” Dr. Delconte says. “They’re more able to survive in this harsh environment, and their power is strengthened against cancer cells.”
Potential To Improve Cancer Treatments
There are several potential opportunities to advance the mouse-model research toward treating patients in the clinic, the researchers say.
First, clinical trials are already beginning to study the safety and effectiveness of fasting in combination with standard treatments. Another avenue would be to identify drugs that could mimic the underlying mechanisms without requiring patients to fast. Third, small molecules might be able to be put into a pill and taken outside of the body and then administered back to patients to improve treatment effects.
Right now, however, more clinical data is still needed about the effects of fasting for people with cancer, MSK researchers say.
There are many different types of fasting, and some might be helpful while others might be harmful. Patients should speak with their doctors about what’s safe and healthy for their individual situation. (Source: Memorial Sloan Kettering News- 2025, Issue 1)
Resources for Living With Stage 4 Cancer
Learn more about topics like fasting and cancer immunity, along with other important aspects of living with Stage 4 cancer. Become a member of our community to receive inspiring stories, helpful resources, and updates on how we support individuals and families facing advanced-stage cancer. Stay informed with the latest research and gain early access to educational content.
A New Cancer Therapy: Exercise
How Exercise and Cancer Treatment Outcomes
New Cancer patients may be surprised to learn they share something in common with astronauts in outer space.
It turns out that lying in bed and floating in zero gravity take a similar toll on the body, says Jessica Scott, PhD. She knows because she was a NASA scientist before joining the Exercise Oncology Program at Memorial Sloan Kettering Cancer Center (MSK).
“Astronauts have a lot of the same symptoms as cancer patients — being inactive and weightless can hurt fitness in a way similar to receiving a cancer treatment like chemotherapy,” Dr. Scott says. “Astronauts even get something called ‘space fog,’ which is similar to what people with cancer call ‘chemo brain.'”
When Dr. Scott saw how exercise can counteract the damage in space to the heart, brain, and muscles, she wanted to apply those lessons to benefit the millions of people with cancer.
Reducing the Toll of Cancer and Its Treatment
Contrary to popular belief, the best way for patients feeling depleted to recover is not necessarily to stay in bed.
“It’s now clear that exercise has major benefits for people being treated for cancer as well as for cancer survivors,” says MSK exercise physiologist Kylie Rowed. “In addition to improving physical and mental health, it can help minimize the long-term effects of cancer treatments such as chemotherapy and radiation.”
The benefits can be dramatic. For example, MSK research showed that people who endure three months of chemotherapy had a 15% decline in fitness levels within three to six months of treatment — equal to a decade of aging. But exercising just three times a week significantly reduced that steep decline.
Recently, the Exercise Oncology Program has taken the research a step further, conducting studies that shed light on whether exercise can affect cancer survival and recurrence and help new cancer drug therapies work better.
There is even tantalizing evidence that exercise might change the biology of the cancer itself, slowing its growth.
A First-of-Its-Kind Clinical Trial
In July 2024, Dr. Jones’s team published results in JAMA Oncology from a groundbreaking clinical trial suggesting that specific amounts of exercise before surgery among men with early-stage prostate cancer can meaningfully improve two key biomarkers associated with better outcomes.
“To our knowledge, this is the first clinical trial to research the optimal amount of exercise therapy for people with any kind of cancer diagnosis,” Dr. Jones says.
Previous research, including MSK’s, had shown that exercise was associated with a lower risk of prostate cancer progressing, and that men who report exercising regularly have a lower risk of dying from the cancer. But as all scientists know, correlation is not causation.
The true test is “treating” patients with controlled amounts of exercise therapy prescribed in the same way drugs are tested and prescribed — in specific “doses” administered over specific periods.
Researchers wanted to know: What is the most exercise people could reasonably be expected to do? Does the exercise have any biological effect on the tumor itself? And perhaps most important: How much exercise is enough?
To find out, the researchers studied 53 men scheduled to undergo surgery for prostate cancer at MSK. This allowed them to examine the tumor at two different points: when the tumor was biopsied at diagnosis and again at the time of surgery — usually about four weeks later. That provided a four-week window to test the effects of exercise alone, when none of the patients had undergone any treatments such as radiation or chemotherapy.
Participating in Research From Home
To make it as convenient as possible, the team found a way for most parts of the study to be done at home. They delivered a study kit that included a treadmill, an iPad loaded with apps, a smartwatch, a continuous glucose monitor, a blood pressure cuff, and a digital scale.
All exercise sessions consisted of walking on a treadmill while being monitored via Zoom by an exercise physiologist. Each participant was assigned one of the following “doses” of exercise:
- 90 minutes per week
- 150 minutes per week
- 225 minutes per week
- 300 minutes per week
- 375 minutes per week
- 450 minutes per week
The results were eye-opening. After exercise, the biomarkers either decreased or remained stable. Interestingly, there seemed to be a sweet spot: Most of the benefit was achieved with 225 minutes (3 hours and 45 minutes) of exercise a week. More than that amount had no greater impact on biomarkers.
“This was a key finding because it challenges the notion that ‘more is always better’ when it comes to exercise,” Dr. Scott says.
While encouraging, these results don’t prove exercise will improve someone’s cancer prognosis.
The researchers were looking only to see if exercise had an impact on the tumor, in the form of a biological signal over the short term. Determining if exercise leads to longer survival or better outcomes will require longer and larger clinical trials.
There is already a phase 2 clinical trial underway using the 225-minute dose level to better understand how exercise impacts prostate cancer progression. Similar trials are expected for other solid tumor cancers, including lung cancer, particularly those driven by specific mutations responding differently to exercise.
Establishing Exercise as Essential for Cancer Treatment and Prevention
“The hope is that people can be referred to an exercise physiologist who can give them a personalized prescription tailored to their physiology, tumor characteristics, and overall situation — much in the same way cancer drugs are personalized,” Dr. Scott says.
In the meantime, patients say exercising improves their overall well-being.
“I think the sense of control the exercise gave me was very important at a time when I was feeling somewhat helpless,” Robert says. “As a cancer patient, it was something 100% under my power that could help my recovery.” (Source: Memorial Sloan Kettering News- 2025, Issue 1)
Resources for Living With Stage 4 Cancer
Learn more about topics like exercise and cancer treatment, along with other important aspects of living with Stage 4 cancer. Become a member of our community to receive inspiring stories, helpful resources, and updates on how we support individuals and families facing advanced-stage cancer. Stay informed with the latest research and gain early access to educational content.
Innovations Bring Hope to Lung Patients
New Lung Cancer Innovations Offering Hope to Patients
At Memorial Sloan Kettering, cutting-edge lung cancer care is changing lives—especially for those with advanced disease. Take Jen Cosgrove, a mother diagnosed with stage 4 lung cancer that had spread. Thanks to precise testing, doctors found her tumor had an ALK gene mutation, which responds well to targeted therapy called alectinib. Jen saw dramatic improvements within days and has been able to share important milestones with her children she once feared missing. MSK’s expert care, innovative treatments, and thorough diagnostics give patients like Jen hope and more time with their loved ones.
New Discoveries in Lung Cancer Detection
MSK researchers are also uncovering new types of lung cancer and better ways to detect it early. For example, they identified a rare form called atypical small cell lung carcinoma in younger patients who never smoked. Early detection remains critical, and MSK is developing noninvasive tools like the “E-nose,” a device that detects cancer-related chemicals in breath, which could make screening easier and less stressful. Lab studies on lung stem cells and tumor growth help scientists understand how cancer starts and grows, leading to better treatments. For patients facing lung cancer, these advances mean earlier diagnosis, more personalized care, and brighter hope for the future. (Source: Memorial Sloan Kettering)
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Resources for Living With Stage 4 Cancer
Learn more about topics like lung cancer innovations, along with other important aspects of living with Stage 4 cancer. Become a member of our community to receive inspiring stories, helpful resources, and updates on how we support individuals and families facing advanced-stage cancer. Stay informed with the latest research and gain early access to educational content.
Hope from Metastasis Research
Metastasis is when cancer spreads from the original tumor to other parts of the body, and it’s often the toughest part to treat. Researchers at Memorial Sloan Kettering are studying how these metastatic cancer cells change and adapt to survive treatments. They found that metastatic cells can “shift” their identity to better survive, which helps explain why they become harder to stop over time.
At MSK, doctors are creating patient-based 3D models to better understand lung cancer spread and to test how different treatments work. There’s also a clinical trial exploring a drug that stops cancer cells in the brain and spine from stealing iron, which they need to grow and to avoid immune attack. This research is paving the way toward treatments that are more targeted and personalized.
For patients with late-stage or metastatic cancer, these advances offer hope for longer control of the disease and, one day, new ways to stop metastasis altogether. (Source: Memorial Sloan Kettering)
Precision Cancer Testing Brings New Hope
At Memorial Sloan Kettering’s Center for Molecular Oncology, doctors use advanced testing to find the exact changes in a person’s cancer cells. This helps them choose treatments that specifically target those changes, giving patients a better chance at controlling their cancer. Over the past decade, tests like MSK-IMPACT® have made it possible to check for hundreds of genetic changes, even through simple blood tests, helping people with advanced or rare cancers find personalized therapies. But DNA testing doesn’t show everything, so new tests that look at how cancer cells use genes (called RNA tests) and even check all of a person’s genes (whole-genome sequencing) are coming soon. These tools aim to help patients who don’t respond to current treatments and could also guide immunotherapy, which uses the body’s immune system to fight cancer.
This kind of testing can also find inherited gene changes that increase cancer risk, helping families take steps to prevent cancer early. One inspiring example is patient Michael Wolff, a jazz pianist whose rare cancer was identified through molecular testing. Doctors found a gene mutation that led to a drug treatment which quickly stopped his symptoms and shrank his tumors. His success shows how precise testing can save lives and open the door to new treatments for cancers that were once very hard to treat. For patients with stage 4 or difficult cancers, these advances mean more hope for better, tailored care—and the chance for improved quality of life. (Source: Memorial Sloan Kettering)
Cancer Vaccines Offer New Hope
Cancer vaccines, once considered a distant dream, are becoming a hopeful reality thanks to groundbreaking research inspired by the success of COVID-19 mRNA vaccines. Unlike traditional vaccines designed to prevent illnesses, therapeutic cancer vaccines teach the body’s own immune system how to recognize and attack cancer cells. Memorial Sloan Kettering (MSK) researchers, building on ideas first imagined over a century ago, have significantly advanced these vaccines. Dr. David Scheinberg, a leading researcher at MSK, explains that new technologies now allow vaccines to target multiple proteins specific to cancer cells, making treatments more effective and reducing side effects compared to chemotherapy and radiation.
One promising area is personalized mRNA cancer vaccines, custom-made for each patient based on their tumor’s unique characteristics. Early trials, particularly in pancreatic cancer, have shown encouraging results, with vaccinated patients’ immune cells remaining active for years. Additionally, MSK researchers are developing off-the-shelf vaccines targeting common cancer markers, such as WT1, found in leukemia and ovarian cancer. These vaccines could soon offer accessible, affordable options for many patients. The rapid progress in cancer vaccine development at MSK offers genuine optimism, especially for patients fighting advanced or hard-to-treat cancers. (Source: Memorial Sloan Kettering)
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Targeted Therapies Bring New Hope in Lung Cancer
Recent advancements in lung cancer treatment are offering new hope, especially for those with advanced or hard-to-treat cases. Scientists are developing highly targeted drugs that focus on the unique features of each person’s cancer. These treatments aim to attack only the cancer cells—sparing healthy ones—and may reduce side effects while helping patients live longer. New tools like antibody-drug conjugates (ADCs) and bispecific antibodies are leading the way, with some early results showing success even in cases where standard chemo and immunotherapy haven’t worked well.
Some of these new drugs target specific proteins found in certain lung cancers, including those seen in both non-small cell (NSCLC) and small cell lung cancer (SCLC). Researchers are also exploring ways to combine immune-based therapies with these new targeted drugs to overcome resistance and keep the cancer from returning. While many of these treatments are still in early testing, they represent a major step toward more personalized—and more hopeful—options for lung cancer patients. (Source: Drug Target Review)
New Lung Cancer Treatments Show Real Promise
New research shared in 2025 brings hope for people with advanced non-small cell lung cancer. Scientists presented several treatment updates that are helping patients live longer with fewer side effects. One medicine, aumolertinib, helped slow cancer growth—especially when combined with chemotherapy. Another drug, JYP0322, worked well for people with a rare type of lung cancer, even when the cancer had spread to the brain.
Other promising treatments are helping people whose cancer carries uncommon genetic changes. A pill called zongertinib helped many patients and caused fewer side effects than older drugs. Another new medicine, zoldonrasib, showed early success in shrinking tumors in patients whose cancer had stopped responding to other treatments. While one immune-based drug didn’t work as well as hoped, researchers believe it still has potential. Overall, the message is clear: more personalized and effective treatments are on the horizon. (Source: American Association for Cancer Research)
Gene Therapy Gives Stage 4 Mom More Time
When Sara Whitlock was diagnosed with stage 4 lung cancer in 2010 at just 47, she feared she wouldn’t live to see her daughters grow up. Her outlook was bleak—only a 3% chance of surviving five years. Yet more than a decade later, Sara is thriving, watching her daughters graduate and enjoying everyday life with her husband. Her journey began with traditional chemotherapy and radiation, but a major turning point came in 2017 when she joined a clinical trial for a gene-targeted therapy called selpercatinib (LOXO-292). The drug is designed for patients with a rare mutation called RET fusion-positive non-small cell lung cancer, found in only about 2% of lung cancer patients.
Sara’s story is a powerful example of how targeted therapies—drugs developed to block specific cancer-driving mutations—are transforming treatment and survival for people with advanced lung cancer. Unlike the harsh side effects of earlier treatments, this pill-based therapy has been easier to tolerate, and Sara currently has no signs of cancer. While she remains aware that her cancer could return, she’s living fully and cherishing every moment. Her story is a reminder that even with a stage 4 diagnosis, new research and personalized treatments are rewriting the possibilities for patients—and their families. (Source: Cleveland Clinic)
