Overview
Stage 4 Non-Small Cell Lung Cancer (NSCLC) is the most advanced stage of Lung Cancer and is divided into Stage 4A and Stage 4B.
Tap “Watch Now” for an easy-to-understand overview of a Stage 4 Non-Small Cell Lung Cancer diagnosis including the most common biomarkers.; then compare treatment options side-by-side.
- Stage 4A Lung Cancer
- Stage 4B Lung Cancer
- KRAS, EGFR, MET, ALK, BRAF, PD-L1..
Overview
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Stage 4A Non-Small Cell Lung Cancer diagnosis is when the tumor is any size and one or more of the following has happened:
- There are tumors in the opposite lung.
- There are tumors in the inner lining of the lungs or the heart.
- There are cancer cells found in liquid in your lungs or heart (pleural or pericardial effusion).
- There is one tumor outside your chest in one other organ, such as bone, liver, brain, etc.
What Tests Will I Need and Why?
Blood and Imaging tests are done to understand your general health, confirm your diagnosis and determine your cancer stage.
Tissue analysis is also typically done to determine if the cancer cells have any specific biomarkers which are critical to finding the best treatment option for you.
In Stage 4 NSCLC, doctors look for many different biomarkers, including: ALK, EGFR, KRAS, ROS1, BRAF, NTRK, MET, RET and PD-L1. Identifying a specific biomarkers can help determine which treatment option will be more effective against the cancer and get better results.
Nearly 50% of NSCLC patients will test positive for one type of biomarker. If your treatment team has not already performed tests to determine your cancer’s features, please ask your doctor when these tests will be performed.
Re-read this summary as needed and then tap, “Compare My Treatment Options Now“. Our unique Comparison Page will help you understand your FDA-approved treatment options including, who can help you pay for your treatment, where and how each is given and what side-effects you may experience.
National Institute of Health/ treatment-lung
Overview
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Stage 4B Non-Small Cell Lung Cancer diagnosis is when the lung cancer has spread from your lung to multiple organs in your body that are not near your lungs.
The other organs often affected by Stage 4B Non-Small Cell Lung Cancer are the kidney, adrenal gland, brain, liver, or bones as shown here. Please ask your doctor where exactly the cancer has been found in your body.
What Tests Will I Need and Why?
Blood and Imaging tests are done to understand your general health, confirm your diagnosis and determine your cancer stage.
Tissue analysis is also typically done to determine if the cancer cells have any specific biomarkers which are critical to finding the best treatment option for you.
In Stage 4 NSCLC, doctors look for many different biomarkers, including KRAS, EGFR, ALK, ROS1, BRAF, NTRK, MET and PD-L1. Identifying a specific biomarkers can help determine which treatment option will be more effective against the cancer and get better results.
Nearly 50% of NSCLC patients will test positive for one type of biomarker. If your treatment team has not already performed tests to determine your cancer’s features, please ask your doctor when these tests will be performed.
National Institute of Health/ treatment-lung
Identifying your biomarker is critical to determining the best treatment option for you
In addition to the size and cancer stage, your treatment options are guided by biomarkers that can be identified in patients with NSCLC. Below is a summary of the most common biomarkers.
KRAS-positive
KRAS is a protein found in your normal cells helps with your body’s cell growth. When there is a mutation (an abnormal change in your cell’s DNA) in KRAS, it causes excessive cell division and cancer.
20-25% of NSCLC patients have a KRAS mutation.
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EGFR-positive
EGFR (Epidermal Growth Factor Receptor) is a protein that helps your body with healthy cell growth. A mutation or abnormal change in your body’s EGFR gene can cause excessive cell growth and cancer.
10-15% of NSCLC patients have an EGFR mutation.
There are different types of EGFR mutations that doctors look for including EGFR 19 deletion, EGFR L858R and EGFR exon 20 insertion. EGFR L858R is the most common type.
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MET-positive
MET is both a protein and a gene. There can be mutations (errors) found in the MET protein or extra copies of the MET gene called amplification, which would cause excessive cell division and tumor growth.
~5% of NSCLC patients are MET-positive. MET exon 14 skipping is the most common MET error found.
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ALK-positive
ALK (Anaplastic Lymphoma Kinase) gene is found in your cells before you are born and should automatically be turned off before birth. In some people, it turns back on and joins another gene, this change is called ALK fusion or ALK rearrangement and can cause cancer.
About 4% of patients with Lung Cancer are ALK-positive.
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BRAF-positive
The BRAF protein controls how fast cells grow. When there is a mutation, an abnormal change in your cell’s DNA in the BRAF gene, it causes accelerated cell growth and cancer.
~ 4% of patients with NSCLC are BRAF-positive, and those patients tend to have a smoking history.
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HER2-positive
HER2 is a protein that is found in normal cells, it gives them a signal to grow and produce more cells. A HER2-positive NSCLC means that the tumor cells have too many HER2 proteins, causing uncontrolled tumor growth and cell division.
About 2% of patients with NSCLC are HER2-positive.
NTRK-positive
NTRK can join other genes, which would be called NTRK gene fusion. This union of genes can cause uncontrolled cell division and tumor growth.
Less than 1% of NSCLC patients test NTRK-positive.
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PD-L1 >50%
PD-L1 is a protein that is found in healthy cells and acts as a “brake” to keep your immune system from attacking your body’s non-harmful cells. Some cancer cells “trick” the immune system to not turn on and therefore avoid being attacked.
If your tests show cancer cells with a high level of PD-L1 ( > than 50% of the cells have PD-L1), you may benefit from immunotherapy, a treatment type that takes the “brakes” off your immune system so it will recognize and attack the cancer.
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RET-positive
RET is a gene that can join to other genes in patients with NSCLC. This union is called RET rearrangement or RET fusion and causes rapid cell division and tumor growth.
1-2% patients with NSCLC test RET-positive
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ROS1-positive
ROS1 is a gene that can join to other genes in patients with NSCLC. This union is called ROS1 rearrangement or ROS1 fusion and causes rapid cell division and tumor growth.
1-2% patients with NSCLC test ROS1-positive. These patients tend to be diagnosed at an earlier age and have little to no smoking history.
K.go2011, CC BY-SA 3.0
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Commonly Searched Questions
What are the symptoms of Stage 4 Lung cancer?
The symptoms of Stage 4 lung cancer are dependent on the part of the body that is affected.
These are some common symptoms that you might experience if you have Stage 4 lung cancer.
- Breathlessness
- Chronic cough
- Feeling weak
- Coughing up blood
- Weight loss
- Chest pain
- Noisy breathing
- Difficulty in swallowing
- Paraneoplastic syndrome
- Horner’s Syndrome(drooping of the eyelid and absence of sweating on one side of the face)
Source: Cancer.org
What is the treatment for Stage 4 Lung cancer?
These are some common treatment options that are available for your Stage 4 lung cancer.
- Surgery: This involves removing part of the lung or a whole lobe of the lung that is affected
- Chemotherapy: can be given before or after surgery
- Targeted Therapy: targets the changes or mutations in cancer cells that help them grow, divide and spread
- Immunotherapy: helps a person’s immune system identify and kill cancer, often in combination with or without chemotherapy.
- Radiotherapy
Now Click Here To Compare Your Latest Treatment Options.
Source: Cancer.org
What is the prognosis or survival rate of Stage 4 NSCLC?
According to SEER data, Stage 4 lung cancer falls into the distant Stage with a survival rate of 6.3%. This means that people with Stage 4 lung cancer are 7% as likely as people without lung cancer to live for 5 years after the diagnosis.
These numbers do not take into account recurrence (cancer coming back), non-small cell lung cancer subtypes and newer data so they should be used with caution.
Source: Cancer.gov
Is Stage 4 Lung cancer Curable?
Stage 4 lung cancer is not curable. However, there are treatment options available to help reduce your symptoms, improve your quality of life and increase your chances of survival as well as on-going clinical trials.
Now Click Here To Compare Your Latest Treatment Options.
Source: Cancer.org
What is the chance of your lung cancer coming back in Stage 4 NSCLC?
The chance of your Stage 4 lung cancer coming back (recurrence rate) is influenced by multiple factors such as your overall health, the type of treatment used and your genetics.
There are limited studies on the recurrence rate of Stage 4 lung cancer. Please talk to your doctor about your specific situation.
Source: PubMed.gov
How long can someone live without treatment?
There is no clear length of time someone can live without treatment for Stage 4 lung cancer. However, lung cancer can progress quickly and lead to death without treatment.
Source: Cancer.gov
