Nearly 60% of patients are terminal! How can liver cancer research be "tailored" for Chinese patients?

China is a big country
with liver cancer.
Due to the large population of liver diseases such as viral hepatitis and fatty liver, the number of people who develop liver cancer is also very large
.
Liver cancer is the fourth cancer in incidence and the second largest in mortality in China, accounting for nearly half of
the world's new cases and deaths.

This article is the original of Translational Medicine Network, please indicate the source for reprinting

Author: kope

Cancer in China has unique epidemiological characteristics, especially in the high-incidence of cancer and high-death cancer, there are significant
differences between China and the West.
In terms of liver cancer treatment drugs, immunotherapy represented by PD-1 monoclonal antibody is changing the diagnosis and treatment pattern of middle and advanced liver cancer, and bringing breakthroughs
to prolong the survival of liver cancer patients.

Patient survival is low

 01 

Hepatocellular carcinoma (HCC) is the most common type of liver cancer, which seriously threatens the life and health
of our people.
Depending on the source of occurrence, liver cancer includes primary liver cancer and secondary liver cancer
.
Among them, hepatocellular carcinoma is the most common type of liver cancer, accounting for about 75%~90%
of the total number of primary liver cancers.

Primary liver cancer in China presents the characteristics of high incidence, high mortality and low late survival rate, and the survival rate of patients is much lower than that of other digestive tract cancers and overall cancer data
.
From 2012 to 2015, the five-year survival rate of liver cancer in China was only 12.
1%, and about 55% of liver cancer patients were in stage III or IV at the time of diagnosis, while this data was only 15% and 5%
in the United States and Japan.

China's annual new cases and deaths of liver cancer account for nearly 50% of the world, and in 2020, there were 410,000 new cases of liver cancer, ranking fourth among all malignant tumors, and 391,000 deaths, second only to lung cancer, ranking second
.
Different from liver cancer in Western countries, most Chinese liver cancers have hepatitis B virus infection, which is often advanced and complex, and the survival rate is low
.
In China, 70%-80% of patients have been diagnosed with locally advanced or distant metastasis, which is difficult to treat, short survival and poor quality of life
.

Go your own way

 02 

Professor Qin Shukui, chief physician of Nanjing Jinling Hospital, said that liver cancer is a malignant tumor with high incidence in the world, and China's infection is highly heterogeneous compared with European and American countries, whether it is in the cause of the disease, disease characteristics, molecular biological behavior, clinical analysis and even treatment strategies, and the prognosis is also relatively different
.
"Therefore, China's liver cancer diagnosis research should learn from foreign advanced experience, but it cannot be rigidly applied, and it is necessary to take a path of its own in combination with
China's national conditions.
" Qin Shukui introduced
.

Although China still faces severe challenges in the prevention and treatment of liver cancer, in recent years, with the strengthening of hepatitis prevention and prevention capabilities, the continuous progress of liver cancer surgical technology, and the emergence of innovative drugs represented by immunotherapy, China's liver cancer prevention and treatment has entered a new stage
.
There are great differences
between the etiology and biological behavior of liver cancer in China and European and American countries.
Unlike non-alcoholic steatohepatitis-related liver cancer in the United States and hepatitis C-related liver cancer in Japan, hepatitis B-related liver cancer accounts for a larger
proportion in China.

Professor Fan Jia, academician of the Chinese Academy of Sciences and president of Zhongshan Hospital affiliated to Fudan University, emphasized that in recent years, with the continuous enrichment of early screening methods, the continuous development of clinical research and the continuous update of diagnosis and treatment standards, China has entered a new period, from the original incurable liver cancer to partially treatable
.
Compared with the past, not only surgical technology or other treatment techniques continue to improve, but also a large number of more effective therapeutic drugs, including targeted drugs, immune drugs, chemotherapy drugs, etc.
, under comprehensive treatment, so that patients can achieve better treatment results
.

How to "tailor"

 03 

The field of liver cancer treatment is characterized by multidisciplinary participation and the coexistence
of multiple treatments.
Common treatments include hepatectomy, liver transplantation, ablation therapy, TACE, radiotherapy, systematic anti-tumor therapy and other methods, and choosing reasonable treatment methods for patients with different stages of liver cancer can maximize
the efficacy.
Surgical resection remains the standard of care for liver cancer, but the risk of recurrence > 50%.

In addition to the 30% of patients who can undergo surgical resection, systematic therapy mainly plays a role in the diagnosis and treatment of intermediate and advanced liver cancer, with the aim of prolonging the survival time
of patients.

In terms of liver cancer treatment drugs, especially immunotherapy represented by PD-1 monoclonal antibody, it is changing the diagnosis and treatment pattern of middle and advanced liver cancer, bringing breakthroughs
to the survival of liver cancer patients.
In October 2022, China's National Medical Products Administration (NMPA) approved the PD-1 inhibitor pembrolizumab for the treatment of patients
with hepatocellular carcinoma (HCC) who had previously received chemotherapy for related drugs.
The approval of the new indication is based on data from a 7-year global phase III clinical trial, KEYNOTE-394
.
It also means that the 'long-term survival' of patients with advanced liver cancer in China will be possible
.
”

Innovative treatment options represented by immunotherapy are becoming the "mainstream" of liver cancer treatment, which is expected to change the pattern
of advanced treatment.
In recent years, with the rapid development of systemic treatment of liver cancer, targeted therapy and immunotherapy drugs have been widely used in the field of liver cancer treatment and have shown excellent efficacy
.
On this basis, strengthening the standardized treatment of liver cancer patients has become the direction
.
Implement a series of prevention and treatment measures including prevention, screening, diagnosis, treatment, etc.
, strengthen the quality control of tumors, accelerate the establishment and improvement of the national provincial, municipal and county cancer diagnosis and treatment quality control system, so as to continue to improve the 5-year survival rate of liver cancer patients in China and continuously improve the overall treatment level of liver cancer

Resources:

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for treatment options.
If you need health guidance, please go to a regular hospital
.