Youyoung good medical voice | Speech of the full management case of advanced colorectal cancer -the hot opening of the North China Regional Station

*For medical professionals for reading reference

Youyoung good medical voice -The full management case of advanced colorectal cancer speeches in the North China Regional Station. Experts in the field discussed the new progress of advanced CRC diagnosis and treatment, and talked about new strategies for targeting joint treatment.

In order to further build a platform for young physicians in the field of digestive tract tumors, promote the interoperability of disease diagnosis and treatment, cultivate clinicians' scientific and standardized diagnosis and treatment thinking, improve the management level of patients with advanced CRC patients, help my country's CRC diagnosis and treatment level overall improvement. The colorectal cancer special committee and Huang Medicine's "You Young Good Medical Sound -Speech Speech for the Management of Given Colorectal Cancer" project on the basis of last year, optimized and upgraded, reinstalled and reinstalled.

Since April 2022, a total of 51 cities and 19 regional stations have been launched nationwide. The 43 teams will compete for the national finals to advance through the fierce competition of 7 large district stations. The first North China Regional Station was grandly opened online on August 6. Professor Bai Li, Professor Bai Li, First Medical Center of the General Hospital of the PLA and Professor Xing Baocai of Peking University Cancer Hospital as the chairman of the conference.

Figure 1 Professor Bai Li, the First Medical Center of the General Hospital of the PLA General Hospital, opened his speech at the opening

Figure 2 Professor Xing Baocai of Peking University Cancer Hospital opened his speech at the beginning

01

New strategies for big coffee to talk about colorectal cancer liver metastasis treatment

The academic express session was chaired by Professor Wang Haitao of the Second Hospital of Tianjin Medical University. Professor Jin Yan from the First Hospital of Peking University issued an academic report entitled "Selection of Colorectal Cancer Hyplateral Treatment Plan" as the theme.

Figure 3 Professor Jin Yan of Peking University First Hospital made a keynote speech

Professor Jin Yan said that colorectal cancer has a high incidence and poor prognosis with patients with liver metastases. Surgical resection is still the best treatment for its long -term survival [1]. Patients need multi -line drug treatment [2,3]. In the "2022 China Clinical Oncology Society (CSCO) CRC Diagnosis and Treatment Guide" [4], antiovascular generic drugs have occupied an important position during the drug treatment stage of CRC liver metastasis, and 呋喹itinib is recommended to accept Osarbalie Platinum Platinum Platinum Platinum Platinum Platinum Platinum Platinum The treatment of advanced CRCs treated with Ilidon (class Ⅰ recommendation, class 1) [4].

The results of the Asian group analysis of Phase III clinical research on the FRESCO III clinical research show that 呋喹inib can significantly prolong the median OS and no progressive survival (PFS) of CRC with liver metastasis patients. For people who have not used targeted drugs in the past, the median OS extension of Setinib is particularly significant (10.4 vs 6.9 months; HR = 0.63); for people who have used targeted drugs in the past The bit OS is also significantly extended (7.7 VS 6.0 months; HR = 0.63). In addition, due to the local treatment (radiotherapy) for the metastatic lesion, the immune microe environment can be changed, and the response rate of immunotherapy may be improved [5]. Patients with local treatment of liver metastases have a combined treatment plan for pyrinib+PD-1 monoclonal anti-resistance, which may bring more significant benefits.

Professor Li Hongli, Tianjin Medical University Cancer Hospital, Professor Li Zhanlin, First Affiliated Hospital of Hebei North College, Professor Song Xiaowen, Datong Second People's Hospital, Professor Wang Li, Beijing Luohe Hospital, Beijing Medical University, Professor Wei Yaning of Hebei University Affiliated Hospital, and Shaanxi Provincial People's Hospital Professor Yu Min shared the insights of hotspots such as CRC liver metastasis diagnosis and treatment strategies, 呋喹 oghinib combined with immunotherapy CRC, and other related hotspots: 呋喹ntinib has now become a "standard scheme" for advanced CRC three -line therapy recommended by the guide. Here comes more choices; in the future, it is expected that the relevant research and exploration of chimotinib in the field of joint treatment will be successful, and it will be among the entire process of CRC treatment and will benefit more patients.

02

Speculation of advanced colorectal cancer full -process management cases

——The presence

The lecture on the competition competition case was officially opened under the auspices of Professor Wu Shikai, the First Hospital of Peking University. Professor Wen Zhenping from Inner Mongolia Medical University, Professor Wang Zhiwu of Tangshan People's Hospital, Professor Jia Yitao of Hebei Provincial People's Hospital, Professor Eli, First Affiliated Hospital of Xi'an Jiaotong University, Professor Gao Song, Peking University Cancer Hospital, and Shanxi Medical University No. 1 Professor Jia Junmei of the hospital formed a jury to comment on the performance of the speaker and give a scoring.

Case 1: Rectal cancer case sharing

This case is provided by Datong Second People's Hospital.

Instructor: Professor Song Xiaowen, speech: Dr. Jia Guoping.

This patient is a rectal cancer TXN1MX staging. The newly assisted chemotherapy before admission, and then the root cancer treatment of rectal cancer. The genetic test results show that the KRAS gene No. 12 codon mutation is shown. The first -line treatment is treated with Osarie Platinum+Koriebinhemore, and the second -line Bedarzumab+Folfiri is treated. The third -tier three -tier treatment is not tolerated by vein chemotherapy. After 6 months of treatment, the quality of life of patients has been significantly improved, and the efficacy assessment is SD. After the proteinuria was replaced with the Bervarzumab joint plan, patients again appeared hematuria and acute urine retention. The treatment plan was replaced with cadinib+Karelizab+Koriocbine and continued treatment. The third -line PFS has reached 12 months, while taking into account the efficacy and the quality of life.

Figure 4 Dr. Jia Guoping, the Second People's Hospital of Datong City, gives a case speech

Case 2: "New 生" life, "for" you created for you -the case of stage IV rectal cancer sharing this case was provided by Hebei University Affiliated Hospital.

Instructor: Professor Wei Yaning, speech: Dr. Guo Zhigui.

This patient is a stage of hypogargly rectal gonad cancer with a stages of CT4BN+M1 ⅳ, and anal fistula, perianal abscess, and rectal vaginal fistula. After admission, the perianal abscess was cut off. The genetic detection showed KRAS mutations, and the microfinee stabilized (MSS). The first -line XELOX scheme developed rapid progress after 2 cycles (PD); second -line Bearsteophard Mipoid+Xeliri followed Bedar United Kaibibin to maintain the disease after treatment again; After 8 cycle treatment for Qucei, PR is reached. Case suggesting that in the treatment of advanced CRC backline of MSS, the pyrinib+immune+chemotherapy brings a more significant tumor relief, which is expected to become a new treatment model for such patients.

Figure 5 Dr. Guo Zhigui, Affiliated Hospital of Hebei University, gives a case speech

Case 3: Case thinking of a case of intestinal cancer -Share sharing of phase III rectal cancer cases

The case was provided by Beijing Luohe Hospital affiliated to the Capital Medical University.

Instructor: Professor Wang Li, speech: Dr. Cheng Yurong.

Differentiated adenocarcinoma T3N1CM0 IIIB patients performed rectal cancer root treatment. The genetic test results were KRAS No. 2 exogenous sub-appendage mutations, PMMR, Her-2 (1+). After surgery, XELOX adjuvant chemotherapy, no disease survival (DFS) for 15 months. The first disease progress indicates that rectal cancer chest and lung metastasis and abdominal cavity metastasis. MDT discussed the patient's current tumor load and multiple metastases, formulating chest irrigation treatment (Bedar bead monoclonal) and 4 -cycle Bevarzab+Folfiri combined therapy plan. HIPEC), given Bevarzab+Folfiri and United Kapechabin after surgery. After 4 months, the illness progressed again, and then the treatment was given to SD. From September 2021 to April 2022, there was an empty necrosis of the patient's lung metastases during the treatment of Patti. Due to local fungal infections during the treatment of patients, the subsequent milotol was treated. Follow -up review tips: Tumor signs such as CEA and CA99 are continuously controlled within the normal range. The total OS of this real -world treatment of patients has reached 39 months, and the treatment of Tenni has brought better tumor control effects to patients.

Figure 6 Dr. Cheng Yurong, Beijing Luohe Hospital, Capital Medical University, speak

Case 4: ideal and reality -multiple transfers of rectal cancer sharing cases

The case was provided by the First Affiliated Hospital of Hebei North College.

Instructor: Professor Li Zhaolin, guest: Dr. Wang Yongxia.

This case is a patient with multiple transitions of liver and lungs after rectal cancer for more than 13 years after surgery. For the first time, hepatotherapy was performed after liver metastases, and Osarina Platinum+Capiobin Auxiliary Chemotherapy was performed after surgery. After the second disease progressed, the genetic test results were improved to MSS, KRAS mutations, and TP53 mutations, and gave Bevarzumab+Folfiri treatment. For a long time, the survival benefits brought by drugs are thrown on.

Figure 7 Dr. Wang Yongxia, the First Affiliated Hospital of Hebei North College

Case 5: BRCA2 or KRAS A146T = Optimum immunotherapy? —— Share sharing of right half colon cancer cases

This case is provided by the Shaanxi Provincial People's Hospital.

Instructor: Professor Yu Min, speech: Dr. Zhang Fan.

The patient was auxiliary chemotherapy, PT3NN2AM0 ⅢB, and KRAS A146T gene mutation after the colon cancer root treatment. After liver metastasis, the local treatment of Bayandling Mipidum+Folfiri+Lobot Lotus Learr+Popular abdominal adhesion Local treatment. After the liver metastasis lesion, liver metastase resection+abdominal adhesion and pine solution. The review found that the liver lesions were repeated, and the lungs metastasis lesions. Later, the patients chose a pupinib+Xindiley Mipide for treatment. So far, the three -line PFS has exceeded 13 months, and OS has reached 38 months. In the case of the rapid progress of the frontline chemotherapy combined with Bevar, the back line can still obtain a long -term tumor control, and the adverse reactions can be controlled.

Figure 8 Shaanxi Provincial People's Hospital Zhang Fanyi gave a case speech

Case 6: Share sharing of advanced sigmical colon cancer with liver metastasis

This case is provided by the Tumor Hospital of Tianjin Medical University.

Instructor: Professor Li Hongli, speech: Dr. Yang Yuzheng.

After the patient is sigmal cancer, the RAS/Braf wild type. After January, the review showed that the liver's multiple campaign prompts were transferred, and MFOLFIRINOX combined with Sicium Miposuke in parallel to the skin and pushing liver crickets. Review shows that the scope of the top of the hepatic tops has increased significantly compared with the previous one, and the external hospital is re -selected to selective hepatitis arterial chemotherapy twice. After the progress of the disease, it was given joint treatment of 尼 进ibo+vinsi Mippitum. The best effect assessment reached PR. The follow -up of 呋喹 ogerib was maintained. Third -line therapy PFS reached 31 months; +Civy Metarum Treatment has challenged another 5 cycles. The best efficacy assessment of treatment is SD. The fourth -line PFS has been more than 4 months. In this case, the treatment of patients with advanced PFS patients with a long time of treatment of PFS is prompted by patients with the failure of the first and second -tier treatment. Patients with liver metastases that fail to metastasize the first and second -tier treatment. Over -long survival benefits, maintenance treatment is still continuing. Figure 9 Dr. Yang Yuzheng, Tianjin Medical University Cancer Hospital, speak

The six groups of players not only shared wonderful diagnosis and treatment cases, but also in the subsequent question session. You asked me to answer and fiercely confront them; the judge group asked and reviewed the review layer by layer, and it brought full gains to the speaker and online audiences. In the end, Dr. Cheng Yurong from Luohe Hospital affiliated to the Capital Medical University was in a thorns, promoted successfully, and successfully entered the National Finals.

Figure 10 conference summary

With the end of the meeting, the chairman of the conference, Professor Bai Li and Professor Xing Baocai on behalf of the participating expert Dr. Xiang Yurong, who congratulated the participating experts, and expressed high affirmation of the preparation of the North China Station event: the theme of the meeting was prominent and rich in content. Promote the sharing and exchanges of CRC diagnosis and treatment related experience, improve the standardized diagnosis and treatment level of CRC in the late period of my country, and benefit more CRC patients.

references:

[1] Li Xingchen, Li Zhiyu, Bi Xinyu. The application of laparoscopy in the liver metastasis of colorectal cancer [J]. Chinese liver and biliary surgery magazine, 2020,26 (3): 226-229.

[2] Konda B, Shum H, Rajdev L. Anti-AGENTS in Metastatic Colorectal Cancer. World J Gastrointest Oncol. 2015; 7 (7): 71-86.

[3] Poston G, adam r, xu j, et al. Et al. Et al. The role of cetuximab in converting initially unresectable color canceter metastases for research.

[4] 2022 CSCO colorectal cancer guide

[5] Yu j, Green MD, li S, et al. Liver Metastasis RESTRIINS Immunotherapy Effical Via Macrophage-Mediated T Cell Elmination. Nat Med. 2021; 27 (1): 152-164.

*This article is only used to provide scientific information to medical people, and does not represent the viewpoint of this platform

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