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*Only for medical professionals to read for reference in the era of immunotherapy, the innovative drug Carrelizumab provides more choices for patients with esophageal cancer in my country, and combined immunotherapy with radiotherapy can further improve the therapeutic effect.
Esophageal cancer is one of the most common gastrointestinal tumors in the world.
In my country, the number of new occurrences and deaths each year accounts for more than half of the world, and it is the hardest hit area for esophageal cancer.
In recent years, immunotherapy has continued to make breakthroughs, and it also plays an increasingly important role in the treatment of esophageal cancer.
The "medical community" has the honor to invite Professor Li Baosheng from Shandong Cancer Hospital to personally share the progress of immunotherapy for esophageal cancer.
The original innovative drug carrelizumab brings more options to patients with esophageal cancer.
In the past 30 years, chemotherapy has been the first-line standard treatment for advanced esophageal cancer, but the effective rate is low and the adverse reactions above grade 3 are relatively high.
Although targeted drugs are constantly being tried, the existing targeted therapies can only be used for esophageal adenocarcinoma and are ineffective for the main pathological types of esophageal squamous cell carcinoma in my country.
The emergence of immunotherapy has broken the bottleneck of esophageal cancer treatment and opened a new era of immunotherapy.
Carrelizumab is a PD-1 inhibitor independently developed in my country.
It has a wide range of research and development, focusing on a number of high-incidence cancers in my country, bringing more choices and hopes to Chinese cancer patients.
In the field of esophageal cancer, the ESCORT study [1] showed that carrelizumab as a single-agent second-line treatment of advanced esophageal squamous cell carcinoma has a good effect, with a median overall survival (OS) of more than 8 months, breaking through the traditional chemotherapy Treat bottlenecks.
Professor Li Baosheng pointed out: “Although the improvement of OS in patients treated with carrelizumab is not particularly prominent compared with chemotherapy, the results obtained by carrelizumab are very rare for second-line, refractory patients.
Importantly, the therapeutic benefits of carrelizumab in the field of esophageal cancer have brought confidence to our industry's exploration in this field, and also provided ideas for the future development of immunotherapy combined with traditional therapies.
In addition, in December 2020, Carrelizumab successfully entered the National Medical Insurance Catalog for the treatment of advanced lung cancer, liver cancer, esophageal cancer and Hodgkin’s lymphoma, which greatly relieved the financial pressure on patients with related tumors and provided patients with access to Timely and effective treatment.
Professor Li Baosheng said: “Although the price of carrelizumab is far lower than that of imported immunotherapy drugs, there are still many patients who cannot use it due to economic reasons.
Even with the support of aid projects, there is still a part of the economy.
Patients who are particularly difficult cannot afford it and miss out on opportunities for innovative drug treatment.
The entry of Carrelizumab into the National Medical Insurance Catalogue has greatly improved the accessibility of the drug and provided protection for patients in the clinic to "dare to use drugs and afford drugs".
At the same time, the clinical application of carrelizumab is more extensive, which also helps clinicians to accumulate more application experience.
"Radiotherapy works hand in hand with immunity to bring 1+1>2 anti-cancer effects to patients.
Professor Li Baosheng said: "Radiotherapy is a means of tumor treatment.
In the traditional treatment era, radiotherapy can reach 40% effective rate, which can be used in tumor treatment.
Important role.
With the advent of immunotherapy, radiotherapy combined with immunotherapy has achieved very promising results in recent years.
As a local treatment method, radiotherapy can release more new antigens while controlling the tumor, improve the tumor microenvironment, and improve the effect of immunotherapy.
Conversely, immunotherapy can also increase the sensitivity of radiotherapy, prompting radiotherapy to better control tumors.
"In the field of non-small cell lung cancer (NSCLC), the PACIFIC study [2] showed that unresectable stage III (locally advanced) NSCLC patients received concurrent radiotherapy and chemotherapy, and then treated with immunologic drugs PD-L1 inhibitors for consolidation therapy, which can significantly Improve the survival effect of patients, the 4-year survival rate is close to 50%, and the median OS is close to 4 years.
In the field of esophageal cancer, a number of clinical studies in my country have shown that patients with locally advanced esophageal cancer using radiotherapy + immunization or concurrent radiotherapy and chemotherapy + immunization have achieved good short-term effects, and the 1-year overall survival rate exceeds 80%.
In addition, the team of Professor Li Baosheng also explored the effect of radiotherapy + immune neoadjuvant therapy for operable esophageal cancer.
The results showed that 6 of 11 patients who completed surgery achieved complete pathological remission (CR) of the primary tumor and lymph nodes.
I also look forward to a more optimized and better combination model of radiotherapy + immunization in the future, which will benefit more patients with esophageal cancer.
In order to further standardize the application of radiotherapy and comprehensive treatment with radiotherapy as the core in esophageal cancer, in 2020, Professor Li Baosheng took the lead in formulating the "Chinese Guidelines for Radiotherapy of Esophageal Cancer".
The formulation of the new guidelines follows the three major principles of "standards, application, and characteristics", based on authoritative international guidelines, combining the characteristics of radiotherapy and incorporating evidence-based medicine in my country.
Professor Li Baosheng said: “Although there are multiple guidelines in the field of esophageal cancer, such as the National Comprehensive Cancer Network (NCCN) and the Chinese Society of Clinical Oncology (CSCO), most of them are comprehensive guidelines and there are no specialized guidelines for radiotherapy.
This time .
The new guidelines not only update the radiotherapy target area, radiotherapy plan, etc.
, but also make corresponding amendments to the development of immunotherapy and other related disciplines.
These updates and revisions will help to further promote the standardization and homogeneity of the treatment of esophageal cancer in China, and make radiotherapy Doctors are fully concerned about the development of tumors, highlighting the characteristics of China's tumor radiotherapy, allowing better development of the discipline and better benefits for patients.
"Expert introduction Professor Li Baosheng, doctoral supervisor, second-level professor, Vice President of Shandong Cancer Hospital, Shandong Province Taishan Scholar Post Distinguished Expert, Chinese Medical Doctor Association Chairman of the Chinese Medical Association Radiation Therapist Branch of the Chinese Medical Association Vice Chairman of the Chinese Medical Association Radiation Therapeutics Branch of China Vice Chairman of the Oncology Radiotherapy Branch of the Anti-Cancer Association, Chairman of the Multidisciplinary Joint Committee of Lung Cancer of the Shandong Medical Association, Chairman of the Oncology Branch of the Shandong Medical Association, Chairman of the Oncology Branch of the Shandong Medical Association, Chairman of the Northern Oncology Radiotherapy Cooperation Group Chairman of the International The editor-in-chief of the Journal of Oncology and the associate editor-in-chief of the Chinese Journal of Cancer Prevention and Treatment References: [1] Jing Huang, et al.
Camrelizumab versus investigator's choice of chemotherapy as second-line therapy for advanced or metastatic oesophageal squamous cell carcinoma (ESCORT): a multicentre, randomised, open-label, phase 3 study.
Lancet Oncol.
2020 Jun;21(6):832-842.
[2] Garassino MC,Paz-Ares L,Hui R,et al.
Patient-reported outcomes ( PROs) with durvalumab by PD-L1 expression in unresectable,stage Ⅲ NSCLC (PACIFIC)[R/OL].
ELCC 2019,abstract LBA2.
Esophageal cancer is one of the most common gastrointestinal tumors in the world.
In my country, the number of new occurrences and deaths each year accounts for more than half of the world, and it is the hardest hit area for esophageal cancer.
In recent years, immunotherapy has continued to make breakthroughs, and it also plays an increasingly important role in the treatment of esophageal cancer.
The "medical community" has the honor to invite Professor Li Baosheng from Shandong Cancer Hospital to personally share the progress of immunotherapy for esophageal cancer.
The original innovative drug carrelizumab brings more options to patients with esophageal cancer.
In the past 30 years, chemotherapy has been the first-line standard treatment for advanced esophageal cancer, but the effective rate is low and the adverse reactions above grade 3 are relatively high.
Although targeted drugs are constantly being tried, the existing targeted therapies can only be used for esophageal adenocarcinoma and are ineffective for the main pathological types of esophageal squamous cell carcinoma in my country.
The emergence of immunotherapy has broken the bottleneck of esophageal cancer treatment and opened a new era of immunotherapy.
Carrelizumab is a PD-1 inhibitor independently developed in my country.
It has a wide range of research and development, focusing on a number of high-incidence cancers in my country, bringing more choices and hopes to Chinese cancer patients.
In the field of esophageal cancer, the ESCORT study [1] showed that carrelizumab as a single-agent second-line treatment of advanced esophageal squamous cell carcinoma has a good effect, with a median overall survival (OS) of more than 8 months, breaking through the traditional chemotherapy Treat bottlenecks.
Professor Li Baosheng pointed out: “Although the improvement of OS in patients treated with carrelizumab is not particularly prominent compared with chemotherapy, the results obtained by carrelizumab are very rare for second-line, refractory patients.
Importantly, the therapeutic benefits of carrelizumab in the field of esophageal cancer have brought confidence to our industry's exploration in this field, and also provided ideas for the future development of immunotherapy combined with traditional therapies.
In addition, in December 2020, Carrelizumab successfully entered the National Medical Insurance Catalog for the treatment of advanced lung cancer, liver cancer, esophageal cancer and Hodgkin’s lymphoma, which greatly relieved the financial pressure on patients with related tumors and provided patients with access to Timely and effective treatment.
Professor Li Baosheng said: “Although the price of carrelizumab is far lower than that of imported immunotherapy drugs, there are still many patients who cannot use it due to economic reasons.
Even with the support of aid projects, there is still a part of the economy.
Patients who are particularly difficult cannot afford it and miss out on opportunities for innovative drug treatment.
The entry of Carrelizumab into the National Medical Insurance Catalogue has greatly improved the accessibility of the drug and provided protection for patients in the clinic to "dare to use drugs and afford drugs".
At the same time, the clinical application of carrelizumab is more extensive, which also helps clinicians to accumulate more application experience.
"Radiotherapy works hand in hand with immunity to bring 1+1>2 anti-cancer effects to patients.
Professor Li Baosheng said: "Radiotherapy is a means of tumor treatment.
In the traditional treatment era, radiotherapy can reach 40% effective rate, which can be used in tumor treatment.
Important role.
With the advent of immunotherapy, radiotherapy combined with immunotherapy has achieved very promising results in recent years.
As a local treatment method, radiotherapy can release more new antigens while controlling the tumor, improve the tumor microenvironment, and improve the effect of immunotherapy.
Conversely, immunotherapy can also increase the sensitivity of radiotherapy, prompting radiotherapy to better control tumors.
"In the field of non-small cell lung cancer (NSCLC), the PACIFIC study [2] showed that unresectable stage III (locally advanced) NSCLC patients received concurrent radiotherapy and chemotherapy, and then treated with immunologic drugs PD-L1 inhibitors for consolidation therapy, which can significantly Improve the survival effect of patients, the 4-year survival rate is close to 50%, and the median OS is close to 4 years.
In the field of esophageal cancer, a number of clinical studies in my country have shown that patients with locally advanced esophageal cancer using radiotherapy + immunization or concurrent radiotherapy and chemotherapy + immunization have achieved good short-term effects, and the 1-year overall survival rate exceeds 80%.
In addition, the team of Professor Li Baosheng also explored the effect of radiotherapy + immune neoadjuvant therapy for operable esophageal cancer.
The results showed that 6 of 11 patients who completed surgery achieved complete pathological remission (CR) of the primary tumor and lymph nodes.
I also look forward to a more optimized and better combination model of radiotherapy + immunization in the future, which will benefit more patients with esophageal cancer.
In order to further standardize the application of radiotherapy and comprehensive treatment with radiotherapy as the core in esophageal cancer, in 2020, Professor Li Baosheng took the lead in formulating the "Chinese Guidelines for Radiotherapy of Esophageal Cancer".
The formulation of the new guidelines follows the three major principles of "standards, application, and characteristics", based on authoritative international guidelines, combining the characteristics of radiotherapy and incorporating evidence-based medicine in my country.
Professor Li Baosheng said: “Although there are multiple guidelines in the field of esophageal cancer, such as the National Comprehensive Cancer Network (NCCN) and the Chinese Society of Clinical Oncology (CSCO), most of them are comprehensive guidelines and there are no specialized guidelines for radiotherapy.
This time .
The new guidelines not only update the radiotherapy target area, radiotherapy plan, etc.
, but also make corresponding amendments to the development of immunotherapy and other related disciplines.
These updates and revisions will help to further promote the standardization and homogeneity of the treatment of esophageal cancer in China, and make radiotherapy Doctors are fully concerned about the development of tumors, highlighting the characteristics of China's tumor radiotherapy, allowing better development of the discipline and better benefits for patients.
"Expert introduction Professor Li Baosheng, doctoral supervisor, second-level professor, Vice President of Shandong Cancer Hospital, Shandong Province Taishan Scholar Post Distinguished Expert, Chinese Medical Doctor Association Chairman of the Chinese Medical Association Radiation Therapist Branch of the Chinese Medical Association Vice Chairman of the Chinese Medical Association Radiation Therapeutics Branch of China Vice Chairman of the Oncology Radiotherapy Branch of the Anti-Cancer Association, Chairman of the Multidisciplinary Joint Committee of Lung Cancer of the Shandong Medical Association, Chairman of the Oncology Branch of the Shandong Medical Association, Chairman of the Oncology Branch of the Shandong Medical Association, Chairman of the Northern Oncology Radiotherapy Cooperation Group Chairman of the International The editor-in-chief of the Journal of Oncology and the associate editor-in-chief of the Chinese Journal of Cancer Prevention and Treatment References: [1] Jing Huang, et al.
Camrelizumab versus investigator's choice of chemotherapy as second-line therapy for advanced or metastatic oesophageal squamous cell carcinoma (ESCORT): a multicentre, randomised, open-label, phase 3 study.
Lancet Oncol.
2020 Jun;21(6):832-842.
[2] Garassino MC,Paz-Ares L,Hui R,et al.
Patient-reported outcomes ( PROs) with durvalumab by PD-L1 expression in unresectable,stage Ⅲ NSCLC (PACIFIC)[R/OL].
ELCC 2019,abstract LBA2.
