2020 BOC/BOA. Annual progress in liver and bile pancreas research.

From July 3 to 4, the 2020 BOC / boa meeting was successfully held. The meeting mainly included the most important research progress in various tumor fields, the annual research progress in China and the update and interpretation of the 2020 version of the guidelines. During the meeting, Professor Fang Weijia from the First Affiliated Hospital of Medical College of Zhejiang University summarized the latest clinical research progress in the field of hepatobiliary and pancreatic tumors. The details are as follows.Chinese Study 1 neoadjuvant three-dimensional conformal radiotherapy for resectable portal vein tumor thrombi of hepatocellular carcinoma was completed by Professor Cheng shuqun, Oriental hepatobiliary surgery hospital, Naval Military Medical University. This randomized, open label, multicenter controlled study was conducted in patients with resectable hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT). Patients were randomly allocated to receive neoadjuvant RT at a ratio of 1:1, Then hepatectomy (n = 82) or hepatectomy alone (n = 82) was performed.results showed that neoadjuvant RT combined with surgery significantly improved OS and DFS rates compared with single surgery. There was no significant difference in the incidence of perioperative complications and mortality between the two groups.IL-6 can be used as a predictor of radiotherapy efficacy.2 sorafenib combined with hepatic artery infusion of oxaliplatin, fluorouracil, calcium folinate and sorafenib in the treatment of hepatocellular carcinoma with portal vein invasion was completed by Professor Shi Ming of Sun Yat sen University Cancer Hospital. A total of 247 patients with liver cancer were enrolled in 5 hospitals in China. The results showed that the median survival time of the combined group was significantly longer than that of the single drug group (13.37 vs The median progression free survival group was better (7.03 months vs 2.6 months).the remission rate of the combined group was significantly higher than that of the single drug group (40.8% vs 2.46%); 14 patients in the combined group achieved complete remission.in addition, 35 patients in the monotherapy group received follow-up treatment in the combination group, and the median survival time of these 35 patients was 9.47 months, while the median survival time of the patients who did not receive the combined treatment was 5.53 months.3 the establishment of the prognosis model of HCC suitable for TACE was completed by Professor Han Guohong, Xijing Hospital, Air Force Military Medical University. Transcatheter arterial chemoembolization (TACE) is a medium-term hepatocellular carcinoma (BCLC) recommended by EASL and AASLD guidelines B) However, due to the heterogeneity of the patients, there is a significant difference in the survival of the patients. Therefore, it is urgent to establish a tool to evaluate the clinical prognosis and risk stratification for this population.Professor Han Guohong led a national multicenter study and pioneered the "six and two" model, which used "linear prediction (LP) = tumor size (maximum tumor diameter cm) + tumor number" to realize individualized prognosis evaluation of patients. According to the two cutoff values 6 and 12 of the sum of the maximum tumor diameter and tumor number, the optimal target population for TACE treatment was divided into three risk levels."six and two" model has better prediction ability and discrimination than other known prediction models. It is the most suitable prognosis model for TACE ideal target population.the efficacy, safety and bioactivity of ASCO progress 1pd-l1 monoclonal antibody durvaluamb combined with CTLA-4 monoclonal antibody tremelimumab in the treatment of advanced HCC is a kind of tumor with high malignancy and poor prognosis. Gemcitabine combined with cisplatin is the first-line treatment for patients with metastatic cholangiocarcinoma.this is the first clinical study of durvalumab ± tremelimumab combined with chemotherapy in patients with advanced biliary system tumor without chemotherapy.121 patients with advanced cholangiocarcinoma without chemotherapy were included in the study. The results showed that the objective remission rate of the three drug combination group and the four drug combination group reached more than 70%, and the disease control rate of the three drug combination group even reached 100%, showing good curative effect, good safety and tolerance.phase II apact study albumin paclitaxel combined with gemcitabine compared with gemcitabine monotherapy in adjuvant treatment of pancreatic cancer: prognosis in different regions. In metastatic pancreatic cancer, albumin paclitaxel combined with gemcitabine (nab-p / g) showed significantly longer OS than gemcitabine alone (g).the apact study evaluated the efficacy and safety of nab-p / g versus g in the treatment of surgically resected pancreatic cancer. Although the primary endpoint was not reached, the DFS, nab-p / g of the independent evaluation committee was not significantly better than that of the group G.but the analysis of different regions showed that the OS value of nab-p + gem was superior to that of group G. although in some cases, there was an imbalance in the advantage of gemcitabine monotherapy, the OS value of nab-p + G group was still superior to that of group G. the safety results were consistent with the data of the whole study population.other important studies: 1. A randomized, multicenter, phase II study on the second-line treatment of advanced hepatocellular carcinoma (HCC) patients in China with the largest sample size (220 cases) in the world and the highest HBV infection rate (84%) in the enrolled population. compared with other PD-1 inhibitors, the baseline status of the enrolled population was worse, the proportion of hepatitis B virus (HBV) infected population was higher, and the efficacy and safety were similar. The orr was 14.7%, the OS rate at 6 months was 74.4%, and the median follow-up time was 12.5 months. Most of the patients with remission were still in continuous remission, with significant long-term survival benefits. 2pemigatinib is a selective and potent oral FGFR1 / 2 / 3 inhibitor for previously treated locally advanced or metastatic cholangiocarcinoma. a total of 146 patients were recruited in this phase II open label single arm study. According to the results of gene status test, they were divided into three groups: group A had FGFR2 gene rearrangement, group B had other FGF / FGFR gene mutations, and group C had no FGF / FGFR gene mutation. for patients with cholangiocarcinoma with FGFR2 rearrangement, the orr was 35.5%, the median PFS was 6.9 months, and the median OS was 21.1 months. secondly, for patients without FGFR2 gene rearrangement (even if there is mutation), pemigatinib is completely ineffective, which indicates that the drug should be "improved" in the selection of treatment population for intrahepatic cholangiocarcinoma. 3 a new method for the treatment of pancreatic cancer hydroxychloroquine + chemotherapy was published in nature. It was found that in pancreatic cancer cells, MHC-I entered the compartment (also known as vesicles) and was self phagocytized and degraded in cancer cells. by removing the MHC-I tag, autophagy can keep cancer cells from being noticed by the immune system and make them resistant to immunotherapy. in mice with pancreatic cancer, it has been shown that blocking autophagy with gene method or chloroquine can increase the mhc-1 molecule on the surface of tumor cells. the combination of chloroquine and two immunosuppressants can greatly increase tumor expression, far better than immunotherapy alone. clinical tests in patients with pancreatic cancer have shown that the combination of hydroxychloroquine and standard chemotherapy can increase the response of patients to chemotherapy. new studies have shown that hydroxychloroquine may improve the efficacy of immunotherapy.