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    Home > Active Ingredient News > Digestive System Information > 2021 BOC/BOA Professor Jun Zhou: Immunotherapy changes the treatment pattern of advanced gastric cancer

    2021 BOC/BOA Professor Jun Zhou: Immunotherapy changes the treatment pattern of advanced gastric cancer

    • Last Update: 2021-08-10
    • Source: Internet
    • Author: User
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    On July 2-3, 2021, the Chinese Society of Clinical Oncology (CSCO) and Beijing Xisk Clinical Oncology Research Foundation co-sponsored the "2021 China Clinical Oncology Annual Progress Seminar (BOC) and Best of ASCO 2021 China "It was held in Chengdu, the land of abundance
    .

    At this conference, Yimaitong has the honor to invite Professor Zhou Jun from Shanghai Artemed Hospital to share with us the progress of advanced gastric cancer treatment
    .

    Expert profile Prof.
    Jun Zhou Director, Cancer Center, Shanghai Artemedian Hospital Secretary of the Chinese Society of Clinical Oncology (CSCO) Gastric Cancer Expert Committee Member of the Chinese Society of Clinical Oncology (CSCO) Biliary Tumor Expert Committee Member of CSCO Anti-tumor Drug Safety Management Expert Committee Shanghai Society of Integrated Traditional Chinese and Western Medicine Vice Chairman of the Oncology Committee Yi Maitong, Standing Committee Member of the World Federation of Chinese Medicine Societies’ Oncology Precision Medicine Committee: The monoclonal antibody Bemarituzumab (hereinafter referred to as Bema) against fibroblast growth factor receptor 2b (FGFR2b) has attracted much attention this year A new medicine for gastric cancer
    .

    What are the implications for the clinical results of the updated FIGHT research results at this ASCO annual meeting? Professor Zhou Jun: The FGFR2b receptor antagonist Bema has obtained good data in the FIGH study, which has guiding significance for the development of future phase III clinical studies and the treatment of FGFR2b-positive patients
    .

    The FIGHT study shows that the Bema combined with chemotherapy group can make the median overall survival (OS) of FGFR2b positive patients reach 19.
    2 months, while the control group is only 13.
    5 months, which is very dazzling data
    .

    At the same time, the study also showed that Bema's adverse reactions were controllable
    .

    Compared with other FGFR tyrosine kinase inhibitors (TKI), Bema reduces the incidence of adverse reactions such as hyperphosphatemia, hypercalcemia, and electrolyte imbalance by highly selective binding with FGFR2b
    .

    In addition, although corneal events in the Bema group are more common, the adverse reaction is controllable.
    Overall, the toxicity of Bema is relatively small in FGFR TKIs
    .

    Yimaitong: The advent of the immunotherapy era has brought new opportunities for HER-2 positive gastric cancer treatment.
    We hope to further explore whether immunotherapy can further improve the efficacy of targeting and chemotherapy
    .

    What breakthroughs did the KEYNOTE-811 research bring? Professor Zhou Jun: The preliminary phase II study with a small sample showed that on the basis of anti-HER-2 therapy combined with chemotherapy, the addition of PD-1 monoclonal antibody can greatly improve the benefit of HER-2 positive people
    .

    In this context, a phase III clinical study was carried out, which is the KEYNOTE-811 study
    .

    The results of the first phase analysis (IA1) announced at the 2021 ASCO conference showed that the objective response rate (ORR) of the pembrolizumab + trastuzumab + chemotherapy group reached 74.
    4%, which is surprising
    .

    In addition, the adverse reactions of the combination group were similar to the previously reported adverse reactions of pembrolizumab, and no new adverse reactions were found
    .

    Yimaitong: In the first-line treatment of advanced gastric cancer, the CheckMate-649 study has also confirmed the value of immune combined chemotherapy in the first-line treatment of gastric cancer.
    What changes will the treatment pattern of advanced gastric cancer have? Professor Zhou Jun: Gastric cancer has the characteristics of high morbidity, high mortality and high heterogeneity.
    The research field of advanced gastric cancer is very broad
    .

    In the field of gastrointestinal tumors, the research progress of liver cancer is slow, because the driver gene mutation of liver cancer has not been found.
    After the first targeted drug sorafenib appeared, after more than ten years of development, lenvatinib appeared one after another.
    , Regorafenib and other targeted drugs
    .

    Similarly, because gastric cancer has no driver genes and is highly heterogeneous, the biological characteristics of gastric body, gastric antrum, cardia, and gastroesophageal junction are different, and the research progress of gastric cancer is also very slow
    .

    In the clinical study of immunotherapy for gastric cancer and gastroesophageal junction cancer covering patients in mainland China, the CheckMate-649 study is the first first-line treatment phase III clinical study that has achieved positive results.
    For patients with advanced or metastatic gastric cancer (GC), gastroesophageal junction cancer (GEJC) or esophageal adenocarcinoma (EAC), nivolumab combined with chemotherapy has shown a significant efficacy over chemotherapy
    .

    Whether it is the CheckMate-649 study or the KEYNOTE-811 study, the addition of immunotherapy has brought tremendous changes to the treatment pattern of advanced gastric cancer
    .

    Due to the low efficacy of immune single-agent therapy, combined drugs can significantly improve the efficacy, so the application of immunotherapy in gastric cancer is mainly combined drugs
    .

    Combination medication mainly includes three aspects: immune combined anti-HER-2/other target therapy and chemotherapy
    .

    For patients with HER-2 positive gastric cancer, anti-HER-2 therapy and chemotherapy can be combined; for patients with HER-2 negative gastric cancer, other targets can be tested, such as Bema, which has a significant effect in FGFR2b-positive and HER-2-negative gastric cancer patients
    .

    HER-2 positive patients account for only 15% of patients with advanced gastric cancer, and FGFR2b positive patients account for 30% of HER-2 negative patients.
    Therefore, the emergence of Bema has increased the coverage of targeted drugs in the population
    .

    Immunization combined with anti-angiogenic drugs
    .

    In the research of anti-angiogenic drugs in the field of gastric cancer, most of the results are the results of third-line studies, and also include the results of second-line studies of small samples, some of which have obtained positive results
    .

    With the development of multi-target anti-angiogenesis drugs, it will surely bring more opportunities for breakthroughs in the efficacy of gastric cancer
    .

    Immune combined antibody conjugated drug (ADC)
    .

    The combination of ADC and PD-1 monoclonal antibody will be a development trend in the treatment of gastric cancer in the future
    .

    In addition to combined immunotherapy, many current studies of advanced gastric cancer are second-line and third-line studies, and will gradually move forward to first-line studies in the future
    .


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