Professor Fan Yaohua: Liver cancer with Chinese characteristics, multiple treatment methods

On May 14-16, 2021, the 5th Hangzhou Xianghu International Breast Cancer Summit (HXIBCS) and the 6th Hangzhou Xianghu Breast Cancer Forum for Young and Middle-aged People were successfully held in Hangzhou.

In the special session of the Zhejiang Medical Association Cancer Chemotherapy and Biological Therapy Annual Conference, Professor Fan Yaohua from the Second Hospital of Jiaxing City gave a speech on the progress of liver cancer treatment.

After the meeting, Yimaitong invited Professor Fan Yaohua to accept an interview to share her views on the progress of liver cancer treatment.

Expert profileProfessor Fan Yaohua, Director of Department of Oncology, Jiaxing Second Hospital, Youth Member, Chinese Anti-Cancer Association Integrated Traditional Chinese and Western Medicine Committee Youth Member, Zhejiang Anti-Cancer Association Medical Oncology Committee Youth Member, Zhejiang Anti-Cancer Association Cancer Nutrition and Palliative Support Treatment Committee Youth Committee Member, Cancer Chemotherapy and Biological Therapeutics Branch of Zhejiang Medical Association Member, Zhejiang Medical Association, Cancer Precision Treatment Professional Committee Member, Zhejiang Anti-Cancer Alliance Youth Committee Member, Zhejiang Mathematical Medicine Association Precision Diagnosis and Treatment Committee Member, Jiaxing Society of Integrated Traditional Chinese and Western Medicine Chairman of the Oncology Committee, Deputy Secretary-General of Jiaxing Anti-Cancer Association.
Diverse pathogenesis and multiple treatment options.
The pathogenesis of liver cancer in China is different from that in Europe and America.
In Europe and America, the incidence of liver cancer is mostly caused by obesity and fatty liver cirrhosis.
resulting in.

In China, viral hepatitis is one of the main factors that induce liver cancer, and "hepatitis-liver cirrhosis-liver cancer" constitutes the "trilogy" of liver cancer.

(1) Hepatitis B: China is a major hepatitis B country.
Some patients with hepatitis B will have obvious liver cirrhosis when they are younger, and the overall liver function is not good.

In addition, due to the poor status of secondary tumor prevention in my country, some patients with hepatitis B lack good antiviral treatment and follow-up, resulting in the first diagnosis of liver cancer at the advanced stage.

(2) Schistosoma: Liver cirrhosis caused by schistosome is a major "feature" in Zhejiang.

In Zhejiang, liver cancer patients over 60 years of age may have schistosomiasis liver disease more or less.

Liver cirrhosis caused by schistosomiasis liver disease is mainly caused by long-term stimulation of schistosomiasis.

In addition, liver fibrosis caused by such causes is more obvious.

(3) Obesity: With the development of my country's economy, the trend of "obesity→fatty liver→cirrhosis→liver cancer" in China has gradually moved closer to Europe and the United States.

In summary, the causes of liver cancer in my country are more complicated, so the treatment of liver cancer in my country should be more diversified and have Chinese characteristics.

Sorafenib can significantly improve the survival benefit of patients with advanced liver cancer, but previous studies have shown that the efficacy of sorafenib in patients with advanced liver cancer in China is not as good as that of European and American patients.
This is mainly due to the hepatitis B-related liver cancer in my country.

In a randomized, open, multi-center phase 2 clinical study-the TACTICS study, transarterial chemoembolization (TACE) combined with sorafenib showed a good effect in patients with hepatitis B-related liver cancer.

In addition to the combination of sorafenib, a real-world study from China proved that apatinib combined with TACE is an effective solution for advanced liver cancer.

Research data shows that the patient’s median progression-free survival (PFS) reached 7 months, and the objective response rate (ORR), disease control rate (DCR) and 6-month overall survival (OS) rates were 35.
7% and 76.
5, respectively.
% And 82.
6%.

Figure 1.
The main endpoint results of the real-world study of apatinib combined with TACE.
In addition to the above-mentioned schemes, combined immunization strategies may also bring better benefits to patients with liver cancer in my country.

The IMbrave150 study Chinese subgroup data announced at the 2021 ASCO GI Conference showed that the 12-month OS rate of the ateliiz + bevacizumab group was 71%, and the median OS was 24 months; while the sorafenib group The 12-month OS rate was 49%, and the median OS was 11.
4 months.

Figure 2.
IMbrave150 study Chinese subgroup OS update data.
Future exploration of immune combination therapy in liver cancer.
For patients with relatively advanced stage, Professor Fan hopes that patients can achieve long-term survival.

The future direction of exploration may be to reduce the adverse effects of drugs on patients or improve the quality of life of patients.

Whether it is an immune combination or an anti-vascular combination therapy mode, it may cause adverse events (AE) of grade 3 or more for the patient, resulting in a decline in the quality of life of the patient.

Therefore, while exploring the efficacy of drugs, researchers should explore more drug dosage combinations or periodic combinations to achieve a good benefit and quality of life.