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2022 CSCO | Professor Yao Xin: Based on the international perspective and focusing on Chinese characteristics, the diagnosis and treatment of prostate cancer in China is moving to a new height

 Last Update: 2023-01-01
 Source: Internet
 Author: User

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preface

The 25th National Congress of Clinical Oncology and the 2022 CSCO Annual Conference were held
in Beijing, Jinan and Harbin from November 5 to 12 in the form of a combination of offline and online.
The theme of this year's conference is precision innovation, wisdom and humanities, and we will join hands with experts and scholars in various oncology fields across the country to carry out in-depth academic exchanges and scientific and technological cooperation, share clinical research and innovation achievements, deeply discuss precision oncology based on multidisciplinary standardized comprehensive treatment, and actively promote the development of
disciplines.
In the prostate cancer special session 2 held online on the afternoon of November 9, Professor Yao Xin of Tianjin Medical University Cancer Hospital reviewed and summarized the major breakthroughs made in the field of prostate cancer diagnosis and treatment at home and abroad in 2022, and deeply interpreted the characteristics and development trends of prostate cancer diagnosis and treatment in China.

Professor Yao Xin

Director and Professor of Department of Urology, Cancer Hospital of Tianjin Medical University

Chairman-elect of the Urogenital Oncology Professional Committee of the Chinese Anti-Cancer Association

Chairman-elect of the Kidney Cancer Committee of the Chinese Society of Clinical Oncology

Vice Chairman of the Urothelial Cancer Committee of the Chinese Society of Clinical Oncology

Chairman of the Urogenital Tumor Committee of Tianjin Anti-Cancer Association

Member of the Council of the Chinese Society of Clinical Oncology (CSCO).

Member of Urology Branch of Chinese Medical Association

Deputy Director of the Urologic Oncology Collaborative Group (UCOG) of China Cancer Hospital

Leader of the writing team of urothelial cancer guidelines of the Chinese Anti-Cancer Association

Deputy leader of the Kidney Cancer Guidelines Writing Group of the Chinese Medical Association

Editorial board member of Chinese Journal of Urology, Chinese Journal of Endocrine Surgery, Journal of Machine Surgery, Journal of Minimally Invasive Urology, etc

How to shorten the gap between prostate cancer diagnosis and treatment in China and the West? Early diagnosis and early treatment are key

In recent years, the incidence and mortality of prostate cancer in China have increased year by year, especially in developed coastal areas, prostate cancer has become the first malignant tumor
in the incidence of male reproductive system.
According to statistics, the proportion of prostate cancer patients in China who were diagnosed with advanced prostate cancer was about 68%, the proportion of patients with bone metastasis was about 54%, and most (80%) patients with metastatic castration-resistant prostate cancer (mCRPC) developed bone pain symptoms
.
There is still a big gap between the 5-year survival rate of prostate cancer patients in China and Western developed countries (especially the United States), and Professor Yao proposed that the key to solving the problem lies in early diagnosis and early treatment
.

Across China and the West, the challenges of early diagnosis and treatment of prostate cancer are different
.
At present, there is great controversy in the Western medical community about the development of early prostate cancer screening and the lowering of the screening threshold, and it is believed that prostate cancer screening will produce a series of potential negative effects, such as screening false positives, overdiagnosis, overtreatment and corresponding psychological effects
.
These controversies may have something to do with
the fact that the West has insisted on early screening for prostate cancer over the past two or three decades, resulting in lower existing detection rates.
However, the coverage rate of early screening of prostate cancer in China is low at this stage, and the benefits of improving the screening rate are far higher than the potential negative impacts
.
Therefore, screening high-risk groups, detecting early prostate cancer patients and standardizing treatment are important means
to improve the prognosis of prostate cancer patients in China.
The CSCO 2022 version of the guidelines for prostate cancer also emphasizes the importance of early diagnosis and early treatment, proposing that men aged > 50 years old, aged > 45 years old with a family history of prostate cancer and > 40 years old and carrying BRCA2 gene mutations should be routinely screened
for early prostate cancer.

The 2022 International Conference brings new ideas for the diagnosis and treatment of prostate cancer

Based on the fruitful results of various blockbuster studies, Professor Yao said that combination therapy is very distinctive in the treatment of advanced prostate cancer, and early combination therapy in patients with mCRPC may be the direction
of future development.

Foreign highlights reappeared:

PEACE-1 study: Androgen deprivation therapy (ADT) + abiraterone + docetaxel prolongs metastatic hormone-sensitive prostate cancer (mHSPC) overall survival (OS).
PROpel study: olaparib + abiraterone prolongs survival in patients with mCRPC
ARASENS study: ADT + daroltamide + docetaxel prolongs overall mHSPC survival
PRESIDE study: Enzalutamide + docetaxel prolongs radiographic progression-free survival (rPFS) in patients with mCRPC
RALU study interim analysis: OS was prolonged and well tolerated in patients with mCRPC treated with ¹⁷⁷Lu-PSMA after radium-223

Draw on international experience, combine with China's actual conditions, and make a strong voice of China

With the unremitting efforts of CSCO prostate cancer committee members, urologists and scholars, the diagnosis and treatment of prostate cancer in China has made leaps and bounds in
2022.
Professor Yao pointed out that the biggest highlight in China's prostate cancer research field in 2022 is that China's self-developed drug SHR3680 (revilumide) appeared on the ASCO stage for the first time, and at the same time, Chinese mainland scholars participated in the preparation and formulation of the St.
Gallen Consensus on Prostate Cancer (APCCC) and ESMO-Asia guidelines for the first time Chinese
.

Referring to the EAU, NCCN, APCCC consensus and ESMO-Asia guidelines, the progress of ASCO GU, EAU, AUA, ASCO and other international conferences and the latest literature in the field of prostate cancer at home and abroad, the CSCO Prostate Cancer Special Committee revised and updated
the CSCO prostate cancer diagnosis and treatment guidelines in combination with the current situation of prostate cancer in China.
The updated 2022 version of the guide focuses on specific subtypes, with both precision and standardization, and Professor Yao summarized the key points as follows:

Optimize prostate cancer puncture strategy, reduce excessive puncture, and improve puncture accuracy
.
For the detection rate of clinically significant cancer, based on the latest research at home and abroad, MRI-guided precision targeted puncture and transperineal targeted puncture
are recommended.
PSMA PET/CT is used in the initial stage and prostate cancer needle biopsy is used to improve the detection rate
of clinically significant cancers.
Based on the definition of non-metastatic castration-resistant prostate cancer (nmCRPC) in the DAPOL real-world study and the guidelines of the Prostate Cancer Clinical Trials Working Group (PCWG3), the diagnostic criteria for castration-resistant prostate cancer (CRPC) were updated, CRPC treatment was initiated at a lower prostate-specific antigen (PSA) threshold (PSA>1 ng/ml), and patients benefited from early intervention
.
The diagnosis and treatment strategies of four specific subtypes of prostate cancer have been added to provide guidance and basis
for the diagnosis and treatment of intraductal prostate cancer, ductal adenocarcinoma, neuroendocrine carcinoma and mesenchymal-derived tumors that are rare clinically and have no unified diagnosis and treatment standards.
Emphasis is placed on the standardized detection of patients with homologous recombinant repair (HRR) gene mutations, and PARP inhibitors are used to improve the survival of
prostate cancer patients with HRR mutations.

epilogue

Finally, Professor Yao concluded his speech: 1.
Prostate morbidity and mortality are increasing year by year, and the 5-year survival rate of prostate cancer patients in China has increased, but there is still a gap
compared with the United States.
The coverage of early diagnosis and treatment of prostate cancer should be expanded, and clinical diagnosis and treatment should be standardized according to guidelines
.
2.
Across China and the West, brilliant achievements have been made in the development of prostate cancer diagnosis and treatment in 2022, international conferences have provided new ideas and new technologies for the diagnosis and treatment of prostate cancer in China, and Chinese urological oncologists have spoken out in the international community, adding China's strongest voice to evidence-based medicine, which is gratifying
.
3.
The 2022 version of the CSCO prostate cancer diagnosis and treatment guidelines is updated, focusing on the early diagnosis and treatment of prostate cancer, focusing on specific subtypes, and paying equal attention to accuracy and standardization, which can provide more beneficial guidance and help
for prostate cancer clinical practice in China.
4.
Combination therapy increases efficiency, combination is better than sequential, the new era of triple therapy is coming, prostate cancer patients are expected to further extend OS, and achieve long-term clinical benefits
.

In 2022, China has made great progress in the diagnosis and treatment of prostate cancer, and the development of combination therapy has also opened up a new situation
for future exploration.
We look forward to the clinical research and innovation results shared at this CSCO Annual Meeting to bring more inspiration to Chinese clinicians and further promote the comprehensive development of prostate cancer diagnosis and treatment!"

Editor: Gardenia Reviewed: Rudolf Executive: Rudolf

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