The CGOG conference ended successfully, listening to Professor Shen Lin sharing the progress of the diagnosis and treatment of advanced pancreatic cancer, and the second -tier treatment is about to usher in the listing of new drugs

*For medical professionals for reading reference

New progress in the diagnosis and treatment of advanced pancreatic cancer is clear!

Last week, the Beijing Gastrointestinal International Summit Forum and China Gastrointestinal Tumor Clinical Research Cooperation Group (CGOG) annual meeting was successfully held and came to an end, bringing the latest research progress of gastrointestinal tumors at home and abroad to tumor doctors.

At this time, in order to further convey the latest research progress in the field of pancreatic cancer to the majority of clinic workers, Li Chenchen, head of Stea (China) oncology, interviewed Professor Shen Lin, affiliated to Beijing University, to treat the current status of the treatment of advanced pancreatic cancer. Share in progress.

Chemotherapy and targeted therapy synchronization,

Selection of advanced pancreatic cancer treatment is expected to gradually enrich

Li Chenchen, the head of the tumor medicine at Shi Weiya (China) Oncology: The treatment of advanced pancreatic cancer reported in the CGOG conference just ended has made new progress in targeting, immunity, chemotherapy, etc. The highlights in progress?

Professor Shen Lin: There are indeed some breakthrough research progress in the field of advanced pancreatic cancer:

Targeted combined chemotherapy

The Research on the Notable III led by Professor Qin Shuyi of Nanjing Jinling Hospital was scattered in the oral report of the ASCO conference this year. Studies have shown that Nichuzumab combined with Giscitabin can significantly improve the general survival period (OS, 10.9M vs 8.5m) and no progressive survival period (PFS, 4.2M VS 3.6M) of patients with KRAS wild type or metastatic pancreatic cancer patients. This study is also a new era of accurate treatment of pancreatic cancer, and it will become a new choice for the first -line treatment of KRAS wild -type or metastatic pancreatic cancer patients [1].

Sequential chemotherapy

A phase II Sequence test initiated by Spain TTD analyzes the treatment effect of NAB-P/GEM comparison NAB-P/GEM's treatment effect on unprecedented metastatic pancreatic cancer patients. The OS rate of the main end of the 12 -month end confirmed the significant improvement of sequential therapy. The efficacy therapy such as ORR and PFS also showed good clinical benefits, which also provided new ideas for clinical treatment [2].

Inductive chemotherapy sequence of chemotherapy

The combination of chemotherapy and chemotherapy is also the existing treatment option of patients with advanced pancreatic cancer. A phase III study named Conko-007 evaluates the efficacy and safety of sequential chemotherapy and individual chemotherapy treatment. Essence The results showed that for surgical patients who induced chemotherapy after induction of therapy, which can significantly increase the R0 resection rate and ring -cut (CRM) negative rate. In this study The 5 -year survival rate of patients with resection was 27.3%, and the long -term survival rate of the sub -operation of surgical patients receiving the Folfirinox scheme was as high as 26.9%[3]. Generally speaking, after inducing chemotherapy, the schematic and surgery scheme is feasible. "

Breakthrough of pancreatic cancer research,

Related new medicines are worth looking forward to

Li Chenchen, the head of Schimia (China) Oncology Medicine: In addition to the new progress of these traditional therapies you just introduced, what new therapy is worthy of attention in CGOG this year?

Professor Shen Lin: Cell immunotherapy and new targets are worth looking forward to.

CAR-T also preliminarily demonstrated the prospects of use in pancreatic cancer. Dr. Qi Changsong, which is mainly responsible for Claudin18.2 targets, is systematically responsible for the systematic I Study IIII of Claudin18.2. The results of the phase are published in Nature Medicine. Studies incorporated 37 patients (including 5 patients with pancreatic cancer) Claudin18.2 positive advanced digestive system tumor patients. The results showed that the ORR of the therapy in all patients was 48.6%and the DCR was 73%[4]. Although the effect of pancreatic cancer patients is not as good as gastric cancer, it is still very exciting compared to traditional treatment.

This time CGOG also brought the latest progress of pancreatic cancer transformation, including the outlook of KRAS/FBW7/C-MYC and other channels as the target of therapeutic targets. It is believed that more new pancreatic cancer drugs will come out in the future and enrich the clinical treatment options. "

There are still difficulties: poor prognosis, limited treatment methods,

Patients with pancreatic cancer urgently need new treatment options

The latest research results brought more hope to patients with pancreatic cancer, but it still takes a certain amount of time to implement the results of the new research results.

Li Chenchen, the head of Schima (China) Oncology Medicine: What are the uncomfortable needs for the diagnosis and treatment of advanced pancreatic cancer in my country?

Professor Shen Lin: "In terms of treatment, chemotherapy is still the cornerstone of advanced pancreatic cancer treatment. The first -line chemotherapy scheme is mainly AG solution and the Folfirinox solution; Recommended by winning standard treatment schemes [5]. But current metastatic pancreatic cancer still has a large number of unsatisfactory treatment needs. First, poor living conditions. The existing treatment has not improved the fundamental survival status and quality of survival of pancreatic cancer. Subsequent treatment is scarce, such as second -tier and subsequent treatment options are very limited. New therapies such as targeted and immune are not obvious in the treatment of pancreatic cancer. Doctors and patients are very eager to develop new drugs for pancreatic cancer and completely improve the current dilemma. "

New dosage type pancreatic cancer chemotherapy drugs are listed in China,

Patients with advanced pancreatic cancer ushered in a new second -line treatment plan

The Ilida Development (Yitianda) produced by Shiweiya Company was approved in China on April 12, 2022, which will benefit domestic patients. The approval of Yili Tettan Guardiac is based on NAPOLI-1 research. The results of the research show that patients with metastatic pancreatic cancer received after receiving the treatment of Jesitaba were treated with Ilide Candy Lipstick+5-FU/LV. The patient's median survival It is significantly improved with no progressive survival period, and OS is 26%a year [6]; and the survival benefits of Asian people have benefited more obvious. The median OS is 8.9 months, an extension of 5.2 months; ) 4.0 months, extended 2.6 months, the objective relief rate ORR (8.8% vs 0) has improved, the CA199 response rate has increased significantly (32.0% vs 7.7%), and the adverse reactions can be controlled [7]. The listing of this drug will have the choice of substantial evidence for domestic patients with second -line treatment. Expert Introduction

Professor Shen Lin

Director of the Department of Internal Medicine of the Cancer Hospital of Peking University, Director of Phase I Clinical Test Ward

He has served as Deputy Dean of Peking University Cancer Hospital and Deputy Director of the Institute of Beijing Cancer Prevention and Control Research

Beijing scholar

Chairman of the China Anti -Cancer Association Cancer Precision Treatment Professional Committee

The first chairman of the China Anti -Cancer Association Oncology Clinical Research Committee

Chairman of the China Clinical Oncology Society Clinical Research Expert Committee

The chairman of the Stomach Cancer Committee of the China Clinical Oncology Society

Deputy Chairman of the Professional Committee of the Chinese Anti -Cancer Association

Chairman of the Rotating Chairman of the Beijing Cancer Prevention and Control Society

Reference materials:

[1].QinS,BaiY,WangZ,etal.NimotuzumabcombinedwithgemcitabineversusgemcitabineinK-RASwild-typelocallyadvancedormetastaticpancreaticcancer:Aprospective,randomized-controlled,double-blinded,multicenter,andphaseIIIclinicaltrial.ASCO2022.Abs#LBA4011.[2].CarratoA,Pazo-CidR,MacarullaT, etal.Sequentialnab-paclitaxel/gemcitabinefollowedbymodifiedFOLFOXforfirst-linemetastaticpancreaticcancer:TheSEQUENCEtrial.ASCO2022.Abs#4022.[3].FietkauR,GhadimiM,GrützmannR,etal.RandomizedphaseIIItrialofinductionchemotherapyfollowedbychemoradiotherapyorchemotherapyalonefornonresectablelocallyadvancedpancreaticcancer:FirstresultsoftheCONKO-007trial.ASCO2022.Abs#4008.[4].QiC,GongJ, LiJ,etal.Claudin18.2-specificCARTcellsingastrointestinalcancers:phase1trialinterimresults.NatMed.2022May9.[5].中国临床肿瘤学会.《中国临床肿瘤学会（CSCO）胰腺癌诊疗指南》2022版.[6].Wang-GillamA,LiCP , Bodokeyg, ETALIPOSOMALIRINOTECANWITHFLACILINICIDINMETASTASTASTASTAST l,phase3trial.Lancet2016;387:545-557.[7].BangYJ,LiCP,LeeKH,etal.LiposomalirinotecaninmetastaticpancreaticadenocarcinomainAsianpatients:SubgroupanalysisoftheNAPOLI-1study.CancerSci2019.

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