Wonderful collection of Healthy China 2030-2022 inter-hospital exchange conference on standardized diagnosis and treatment of bowel cancer

In 2016, the Central Committee of the Communist Party of China and the State Council issued the "Healthy China 2030" Planning Outline, which clearly stated that It is required that the 5-year survival rate of cancer patients in China be increased by 15% by 2030, and pay attention to solving the health problems
of tumor patients.
In order to further implement the rigid requirements, the "Healthy China 2030" - "2022" of the Cancer Health Plan, sponsored by the Medical and Health Science and Technology Development Research Center of the National Health Commission The "Inter-hospital Exchange of Standardized Diagnosis and Treatment of Bowel Cancer" project was officially launched
in March.

By organizing the extensive participation of experts, scholars and clinical front-line doctors, the project actively carried out inter-hospital exchanges and summaries, and effectively improved the diagnosis and treatment level
of bowel cancer in different medical institutions in different regions.
Through academic conferences, we strive to establish and implement a more standardized bowel cancer diagnosis and treatment plan, build a whole-process treatment and management model for bowel cancer, and achieve the goal
of Healthy China 2030.
The project was undertaken by Huayi Network, and Hutchison Pharmaceutical provided public welfare support
for the project.
Affected by the epidemic, the project was carried out in a combination of online + offline, from April to June, in October across the country Experts and scholars from more than 30 hospitals in various regions have carried out inter-hospital exchange activities
for bowel cancer.
At the meeting, experts from many places had in-depth communication on the latest progress in the field of bowel cancer diagnosis and treatment and the practice of clinical standardization, and shared and exchanged views on classic colorectal cancer diagnosis and
treatment cases.

Platoon – Coordinate the benefits of mCRC patients throughout the process

On May 28, at the inter-hospital exchange led by Professor Zhang Tao of Huazhong University of Science and Technology Union Hospital, Professor Liu Hongli elaborated on the development of anti-angiogenic drugs in the treatment of digestive tract tumors Targeted therapies and targeted drugs are bringing more treatment options
to bowel cancer patients.

Figure 1 Professor Zhang Tao, Union Medical College Hospital of Huazhong University of Science and Technology, made an opening speech

Figure 2 Professor Liu Hongli of Huazhong University of Science and Technology Union Hospital gave a keynote speech

On May 23 the Cancer Hospital of the Chinese Academy of Medical Sciences Shenzhen Hospital, on May 24 the Jiangsu Provincial Cancer Hospital and in May On the 30th, Liaoning Provincial Cancer Hospital and other inter-hospital exchange meetings, experts used the "Full Management of Advanced Colorectal Cancer" to give speeches and exchange views on advanced colorectal cancer (CRC).
Different treatment line selection and focus of patients: Unlike first-line and second-line therapy to achieve deep tumor remission and tumor shrinkage, third-line therapy should focus on prolonging the survival of patients and improving
their quality of life.

Figure 3 Professor Wang Ying, Shenzhen Hospital, Cancer Hospital of Chinese Academy of Medical Sciences, gave a keynote speech

Figure 4 Professor Li Sheng of Jiangsu Cancer Hospital gave a keynote speech

Figure 5 Professor Dong Qian, Liaoning Cancer Hospital, gave a keynote speech

On June 16, at the inter-hospital exchange meeting chaired by Professor Liu Mulin of the First Affiliated Hospital of Bengbu Medical College, Professor Wang Suanhu of the hospital expressed his views on how to manage the treatment of mCRC patients under the current epidemic environment It indicates that based on the convenience, accessibility, safety and controllable adverse reactions of small molecule tyrosine kinase inhibitor (TKI) drugs, home use of oral drugs is a late CRC in the context of repeated epidemics Preferred choice
for patients.

Figure 6 Professor Liu Mulin of the First Affiliated Hospital of Bengbu Medical College made an opening speech

Figure 7 Professor Wang Suanhu, The First Affiliated Hospital of Bengbu Medical College, gave a keynote speech

At the inter-hospital exchange meeting chaired by Professor Lu Jin of Sichuan Provincial Cancer Hospital on June 30, Professor Chen Yongchang of Sichuan Provincial Cancer Hospital gave a relevant explanation
on the treatment of mCRC.
Because physical performance, bone marrow reserve, and quality of life are in a poor state, adverse reactions caused by drugs should be avoided as much as possible during treatment to ensure the quality of life
of patients.

Figure 8 Professor Lu Jin of Sichuan Cancer Hospital delivered a speech at the conference

Figure 9 Professor Chen Yongchang of Sichuan Cancer Hospital gave a keynote speech

The overall decision-making of treatment plans requires the overall situation and attention to detail, and in this process, it requires collective wisdom, and the multidisciplinary consultation (MDT) team adheres to patient-centered and multidisciplinary collaboration.
The diagnosis and treatment mode of standardized diagnosis and treatment provides patients with the best choice
possible.
At the inter-hospital exchange meeting led by Professor Yu Bin of the Fourth Hospital of Hebei Medical University on June 15, three MDTs led by Professor Bin, Professor Yang Junquan of Tangshan People's Hospital and Professor Yan Hao of Tianjin People's Hospital The team conducted in-depth exchanges on the current treatment options for patients with advanced bowel cancer and selected the optimal treatment plan
for patients.

Figure 10 Professor Yu Bin of the Fourth College of Hebei Medical University made an opening speech

The future can be expected - anti-angiogenesis combined with immunomodulation of tumor microenvironment

It is well known that advanced CRC with intact microsatellite stabilization/mismatch repair (MSS/pMMR) does not respond to immunotherapy and has poor therapeutic effect
。 Data from a Phase Ib study of anti-angiogenic combined immunity were presented at the 2021 ASCO meeting [1], on MSS/pMMR Type late CRC for related exploration
.
For the regulation of the tumor microenvironment, from immunosuppression to immune support, that is, from "cold" to "hot" ", the treatment of antivascular combined immunity provides a follow-up research direction for the exploration of MSS/pMMR type advanced CRC Helps patients with digestive tumors to benefit from
survival.
Professor Wang Xiaoran from the Fourth Hospital of Hebei Medical University and Professor Zhang Zongbing from the First Affiliated Hospital of Bengbu Medical College discussed the significance and feasibility
of anti-vascular therapy combined with immunotherapy at the conference.

Figure 11 Professor Wang Xiaoran from the Fourth Hospital of Hebei Medical University gave a keynote speech

Figure 12 Professor Zhang Zongbing from the First Affiliated Hospital of Bengbu Medical College gave a keynote speech

Practice knowledge – real-world evidence that full-course management can benefit patients over long life

At the inter-hospital exchange meeting led by Professor Liu Zhenyang of Hunan Cancer Hospital on May 18, Professor Zhou Yan of Changde First People's Hospital shared a case of multiple ovarian and bone metastases after colon cancer surgery Patients with differentiated adenocarcinoma in the sigmoid colon (pT3N0M0, stage IIa) were diagnosed preoperatively, and XELOX was treated
postoperatively.
Ovarian and bone metastases
occur during regular follow-up.
Patients with enlarged tumors 1.
6 months after first-line treatment with FOLFIRI chemotherapy; Second-line chemotherapy + anti-VEGF treatment was combined with local radiotherapy, and PFS for 12.
7 months was obtained.
Third-line therapy is the option of antiangiogenic combined immunotherapy for partial remission (PR).

PFS has been obtained for 9 months by the time of case reporting, and the benefit is still continuing, with a total OS of 35 months
。

At the meeting chaired by Professor Tang Yong of the Affiliated Cancer Hospital of Xinjiang Medical University on June 9, Professor Liu Quanxia of the Cancer Hospital of Ningxia Medical University General Hospital also brought wonderful case sharing: A postoperative patient with differentiated adenocarcinoma of the left colon with right lower lung metastases (pT4aN0M1), MSI-H
.
During postoperative follow-up, the right lower lung nodule increased and enlarged, and the patient refused lung surgery
.
The first-line treatment was FOLFIRI + anti-EGER therapy, and the patient had a severe gastrointestinal response, and then adjusted the combination chemotherapy treatment Patients received PFS for only 3 months; Second-line monotherapy was less effective, with only 4 months of PFS; Later, antiangiogenic drugs were added to third-line therapy, and the lung lesions continued to shrink, and the time to report cases had brought PFS to patients for more than 16 months
。

At the inter-hospital exchange meeting led by Professor Li Zhiwei of the Affiliated Cancer Hospital of Harbin Medical University, Professor Wei Xiaoli of the hospital brought a patient with rectal cancer with liver metastasis, and in the case of rapid tumor progression (PD) in the first, second and third line treatment, Fourth-line antiangiogenic drugs are used for greater than −26 months, and the tumor is currently maintaining stable disease (SD) status
.

Figure 13 Professor Zhou Yan of Changde First People's Hospital shared his case

Figure 14 Professor Liu Quanxia, Cancer Hospital, General Hospital of Ningxia Medical University, gave a case sharing

Figure 15 Li Zhiwei, Cancer Hospital Affiliated to Harbin Medical University, made an opening speech

Figure 16 Professor Wei Xiaoli of the Affiliated Cancer Hospital of Harbin Medical University gave a case sharing

At present, the meeting of the project is still in full swing, and the active dialogue between the project base hospital and the grassroots hospital is going hand in hand
.
Through the collation and interpretation of the "CSCO Colorectal Cancer Diagnosis and Treatment Guidelines" by superior hospitals and experts, retrospectively analyze and summarize the specific cases displayed in primary hospitals, which will balance the differences in diagnosis and treatment between different regions to a certain extent and improve the diagnosis and treatment level of primary medical workers , Achieve the goal of Healthy China 2030 at an early date, and benefit more advanced bowel cancer patients
.

References:

Ye Guo, Weijie Zhang, Jieer Ying, et al.
Preliminary results of a phase 1b study of fruquintinib plus sintilimab in advanced colorectal cancer.
2021 ASCO Abstract 2514.