Youyoung good medical voice | Speech of the full management case of advanced colorectal cancer -South China region is coming

*For medical professionals for reading reference

"Youyoung good medical sound -the lecture on the full management case of late colorectal cancer in the South China Region" is wonderful, exploring the management ideas of the whole period of colorectal cancer, optimizing the concept of treatment, and benefiting more patients!

Colorectal cancer is one of the common malignant tumors of digestive tract. In recent years, the incidence and mortality of colorectal cancer in my country have maintained an upward trend. Most patients are already in the middle and late stages when diagnosed. , Poor prognosis. Therefore, it is very important to pay attention to the clinical diagnosis and treatment of advanced metastatic colorectal cancer (MCRC).

On August 21, 2022, the "Excellent Young Good Medical Voice | Givey Conditional Management Speech of advanced colorectal cancer in advanced colorectal cancer in the South China Regional Stand Shengda was held, and this conference was mainly managed around the management of colorectal cancer throughout the period. A total of 6 doctors shared classic diagnosis and treatment cases. In this conference, Professor Liao Wangjun of Southern Medical University Southern Hospital and Professor Li Yuhong of Sun Yat -sen University Cancer Prevention and Control Center were the chairman of the conference.

Figure 1 Chairman of the General Assembly Speaking

First link: Academic Express -Pay attention to the sequence of the three -line line, optimize the treatment decision -making

Professor Shi Min of the South Hospital of Southern Medical University chaired the academic express delivery session. Professor Chen Dongliang from the Sun Yat -sen University Tumor Prevention Center brought the theme of the academic sharing of the theme "The Road to the Three -Line Chemotherapy of Late Colorectal Cancer".

Figure 2 Professor Chen Dongliang gave a keynote speech

Professor Chen Dongliang mentioned that in the full management of late bowel cancer, different lines have different treatment purposes: first and second -tier treatment is mainly based on chemotherapy, the purpose is to help patients achieve disease control or relieve it; and the main purpose of third -line treatment is the disease. Control and improve the quality of life of patients. In terms of third -line treatment of advanced colorectal cancer, patients with anti -vascular production treatment have benefited more.点inib focuses on the characteristics of drugs, which is more accurate and controllable [2,3]. FRESCO research shows that [4] 呋喹 呋喹ibini can significantly extend the median total survival (OS) to 9.3 months of patients, and the mid -level no progressive survival (PFS) doubles. %Of the disease control rate (DCR), the mid -level stability duration is 5.5 months.

It is worth mentioning that oginib can significantly extend OS and PFS [5] of patients with liver metastasis, and whether or not they used to use targeted therapy, the OS treated with 呋喹 替 has obviously benefited, becoming the current late ending in China, which is currently in my country. Preferred drugs for third -line treatment of rectal cancer. In terms of immune combined therapy, the preliminary results of the 1B study of the advanced colorectal cancer in the treatment of advanced colorectal cancer brought us surprise [6,7]. The rate (ORR) is 27.3%, and the disease control rate (DCR) is 95.5%; the median PFS is 6.9 months, and the median OS is 11.8 months. It is expected to bring new treatment options for patients with ≥ third -line colon cancer.

Later, Professor Gu Weiguang of the People's Hospital of Nanhai District, Foshan City, Professor Jinchuan at the Cancer Hospital of Guangzhou Medical University, and Professor Zhang Jianwei, Professor Zhang Jianwei of the Sixth Hospital of Sun Yat -sen University conducted a wonderful discussion on this topic. Participating experts agreed that the third -tier treatment of patients with advanced colorectal cancer is preferred in the current three -line treatment of cytotinib. If necessary, the patient needs to be combined with chemotherapy or immunotherapy.

The second link: competition in the competition -fierce competition, wonderful

The case speech session was chaired by Professor Zou Qingfeng, Professor Zou Qingfeng, Professor Xie Derong, Sun Yixian Memorial Hospital of Sun Yat -sen University, Professor Xie Zhong, Affiliated Hospital of Guangdong Medical University, Professor Wang Haixia, Hainan Provincial People's Hospital, Professor Xiao Liang of Shenzhen Second People's Hospital, Professor Bi Xiaoxia, Huizhou First People's Hospital, Professor Wang Wei, Foshan First People's Hospital, Professor Chen Shaojun, Fourth Affiliated Hospital of Guangxi Medical University, Professor Huang Xiaoqing, Foshan Second People's Hospital, Professor Xiao Jianjun, Zhongshan People's Hospital, and People's People's Autonomous Region Professor Cao Yuhua, Professor Zhang Jian, Zhujiang Hospital of Southern Medical University, Professor Liao Jiannan, Zencheng District Central Hospital of Foshan City, Professor Cao Xiaolong of Panyu District Central Hospital, Guangzhou, and Professor Chen Liming of the First Affiliated Hospital of Shantou University Medical College. Comment and give the score.

Case 1: Breaking through the intestinal rules backline

This case is provided by Huizhou First People's Hospital

Instructor: Professor Bi Xiaoxia; Speech: Dr. Liao Qiaofang

The patient is a 74 -year -old man who is diagnosed with glandular cancer in colon, tumor staging: PYT4BN1M1C IVC stage. Immunohistochemical reminder: PMMR HER2 (-). After the patient's littering of colon cancer in 2018, the postoperative Folfox scheme 12 treatment aid chemotherapy was performed, and in 2019, it was used to maintain the treatment. The follow -up review in March 2020 prompts the progress of the disease. MDT discussed the use of the Byvarzab combined with the Folfiri scheme for second -line treatment, and then used the Bevarzumab United Carbie to maintain the treatment. Due to the toxicity of drug toxicity, patients stopped observation and developed diseases in February 2021. Three -line therapy applications continue to be stable during the period of 尼 间ibinib, and the PFS of patients with 呋喹itinib for more than 17 months, adverse reactions can tolerate, suggesting that 呋喹 呋喹ibinib is safe and effective for patients with previous multi -line treatment.

Figure 3 Dr. Liao Qiaofang made cases of case speeches 2: Find the whole bureau, focus on details, step by step

This case is provided by the Fourth Affiliated Hospital of Guangxi Medical University

Instructor: Professor Chen Shaojun; Speech: Gorgeous Doctor

Male patients are 49 years old. In June 2018, the diagnosis of the Division of adenocarcinoma CT3N1M1, IV in the middle of the rectum, with lymph node metastasis, and vascular violations. Synchronous chemotherapy has been performed in June 2018, and in November, it will be adjusted to assist chemotherapy. In September 2019, the follow -up review of patients prompts the progress of the disease. The second -tier use of Kubi Binbin for treatment, and performed radio frequency discharge for liver metastases. The second -line PFS reached 12 months. The review in September 2020 prompted the progress of the disease. After discussions by MDT, the third-line therapy uses the padinib combined PD-1 inhibitor solution, and the liver SBRT treatment is used for liver metastatic lesions. Under such treatment schemes, the patient has a very stunning prognosis. PFS is 23 long 23 A month, the patient had a long -term survival of 50 months. The case indicates that the 尼 尼 pd-1 inhibitor shows the possible good long-term prognosis.

Figure 4 Gorgeous doctor gives a case speech

Case 3: Cut the thorns, not afraid of the age

This case is provided by Zhongshan People's Hospital

Instructor: Professor Xiao Jianjun; Speech: Dr. Li Huifen

The patient is a 74 -year -old woman. In April 2018, the left half of the colon cancer was treated under the laparoscopy. The pathological tumor was divided in the postoperative pathological tips, and the tumor staging PT3N0M1B IVB stage. When the first -line treatment, I chose Siciestab and Folfox scheme chemotherapy. The PFS was 6 months. After the disease progressed, the second -tier treatment selected Bevarzab combined with Folfiri treatment. Unfortunately, the patient reviewed the disease again after 5.5 months. MDT discussed the choice of cosin). The patient's overall tolerance was good, and the treatment continued to benefit. PFS has reached 16 months. Prompt that 三 三 提 提 提 提 can help patients with advanced bowel cancer benefit from it.

Figure 5 Dr. Li Huifen gives a case speech

Case 4: The targeted is not limited, it can be united or united

This case is provided by the Central Hospital of Panyu District, Guangzhou

Instructor: Professor Cao Xiaolong; Speech: Dr. Jiang Yuan Xue

The patient is a 61 -year -old woman. In December 2018, the root cure was performed, and the auxiliary chemotherapy was improved after surgery. In August 2020, the patient's review prompts the progress of the disease, and the first -line therapy chose Folfiri combined with the Bevarzab. Unfortunately, the tumor has not been well controlled. After the progress of the disease, the second-tier treatment option chooses the Sicieccimab+5-FU/CF scheme for combined treatment, and the abdominal cavity metastasis stove is surgical treatment. After the disease progressed again in November 2020, the third -line treatment was started. After the patient and their families knew the consent, they chose to treat the pyrite single medicine, and the dose was adjusted according to the patient's physical condition to 3mg orally. During the treatment period, the patient tolerates good tolerance, and the patient's disease progresses in March 2022. The third -line PFS is 16 months long. The subsequent treatment is converted to a crichinini combined with Nipidi Mippitum, and nutritional support is also expressed. The patient also shows the show. Good treatment tolerance, the total OS has been 31 months since the diagnosis of patients. This case suggests that in the treatment of patients with advanced colorectal cancer, even if the treatment of ninibicist drugs is progressing, continuing to use 呋喹binib combined immunosuppressants can bring better tumor control effects to patients.

Figure 6 Doctor Jiang Yuanxue gives a case speech

Case 5: Dance with cancer, everybody everybody

This case is provided by Hainan Provincial People's Hospital

Instructor: Professor Wang Haixia; Speech: Dr. Wu Jianyong

The patient is a 73 -year -old man. In 2016, he was diagnosed with cecum cancer with liver metastasis. A variety of chemotherapy schemes were used in first -line treatment. The follow -up review still suggested that the disease progresses. After entering the Folfiri second -line treatment in December 2018, the patient's adverse reactions were more obvious, poor tolerance, refused treatment, and tumor lesions progress again. In January 2019, the patient began to treat three -tier treatment. During the treatment period, no serious adverse reactions occurred, and the patient's tolerance was good. In 3 months, the efficacy assessment reached partial relief (PR), and then maintained a stable disease (SD) state. Until July 2022, the CT reminded the lungs to occupy the position and consider tumor metastatic lesions. After communicating with patients, the treatment of 与 与 与 与 与 与 与 与 与 与 与 与 It is recommended that patients with lung puncture biopsy clearly specify the symptomatic treatment. As of now, the total OS has a total OS length of patients for 6 years, and it is prompted to be safe and effective for 呋喹 替ibinib, which can be given long -term survival benefits for patients with advanced intestinal cancer.

Figure 7 Dr. Wu Jianyong gave a case speech

Case 6: Optimize the plan, enjoy the new life

This case is provided by Zhaoqing First People's Hospital

Instructor: Professor Zhang Jian; Speech: Dr. Zhang Menglan

The patient is a 59 -year -old woman. After the emergency surgery of the foreign hospital in May 2019, the diagnosis was diagnosed with a differentiated adenocarcinoma in the lift. Tumor staging: PT4AN1CM0 IIIB stage. The diagnosis and treatment team for the first choice for the XELOX scheme for the first choice. In November 2020, after the follow -up review, the patient was diagnosed with colonic adenocarcinoma lung metastasis, and the left lower lung wedge -shaped resection of the thoracoscopy. Patients with 10 courses of treatment after surgery Folfiri combined with Bevarzumab for treatment. After the lesions are stable, oral Koribbin maintained therapy. During treatment, patients with severe hand -foot syndrome have poor tolerance. After discussions by MDT, the patients were selected for patients for treatment, and the patient's overall treatment to patients after 3 mg was adjusted to 3 mg. As of now, patients have continued to benefit for 1 year, and the treatment effect of Petinib continues. This case suggests that 尼 尼ibinib is preferred to maintain treatment as patients with advanced colorectal cancer, which is expected to bring significant survival benefits to more patients. Figure 8 Dr. Menglan made a case speech

At the meeting, the six doctors fully demonstrated the thinking and choice of the diagnosis and treatment team in the treatment of the above real world cases. In the comments and questions, doctors and professors of the judge are fully interacted. The golden sentences are frequent and colorful. In the end, after the review and judgment of the jury, Dr. Jiang Yuanxue from the Central Hospital of Panyu District, Guangzhou performed well and won the first prize. Dr. Gorgeous and Dr. Liao Qiaofang won the second prize; the third prize winner was Dr. Li Huifen, Dr. Zhang Menglan and Dr. Wu Jianyong.

Summarize

The meeting was close to the end. Professor Li Yuhong made a wonderful summary of the meeting: indicating that the meeting was carried out around the diagnosis and treatment strategy of patients with late colorectal cancer. The content was detailed and rich. The accumulation of evidence is to evaluate late colorectal cancer and clarify the purpose of treatment. The thoughts shown in the process of sharing and reviewing in cases also brought rare learning opportunities to the doctors of the participating doctors. Finally, congratulations to the doctors to achieve good results. I look forward to the development of the "Excellent Young Good Medical Spell" Speech Speech of the Global Colorectal Cancer Management Case "to effectively improve the management level of patients with advanced colorectal cancer in my country, help the development of the field, and help more patients get obtained beneficial.

references:

[1]. China colorectal cancer diagnosis and treatment specification (2020 edition) China Practical Surgery Magazine, 2020,40 (6): 600-630

[2] .Cancer Biol therapy, 15:12, 1635-1645 (2014)

[3] .sun q, et al. Cancer Biol Ther. 2014; 15 (12): 1635-45.

[4] .li j, et al. Jama. 2018 jun 26; 319 (24): 2486-2496

[5] .qin sk, et al. 2019 CSCO ORAL PRESENTATION

[6] .j Clin Oncol 39, 2021 (SUPPL 15; ABSTR 2514)

[7]. Ye Gu. Et Al. 2021 asco. Oral Presentation.

*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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