"An Zhi You Dao" 2021 POST-ESMO-Master discusses the Dao and talks about the recent progress of gastrointestinal tumors

*For reference only for medical professionals.
Focus on ESMO 2021.
Well-known experts in the field of gastrointestinal tumors will take you a quick overview of the research hotspots in the field and talk about the cutting-edge progress of diagnosis and treatment
.

The 2021 European Society of Medical Oncology (ESMO) annual meeting ended brilliantly.
At the meeting, many domestic and foreign cancer experts gathered to share the latest research results and cutting-edge diagnosis and treatment progress
.

At this ESMO conference, the field of gastrointestinal tumors can be described as "multiple blooms, colorful
.
"
Immunotherapy, targeted therapy shines, and a number of latest research results in esophageal cancer, gastric cancer and colorectal cancer related fields have been announced
.

In order to further interpret and share the world-class academic research results, and to learn the cutting-edge progress and development direction of the field with colleagues in the field of digestive tumor diagnosis and treatment in China, CP Tianqing "Safety in Peace" 2021 POST-ESMO Digestive Tumor Special Conference will be held on October 8, 2021 Grandly held in online mode
.

The meeting joined hands with many domestic experts in the treatment of gastrointestinal tumors to jointly interpret the latest research results and discuss new strategies for diagnosis and treatment
.

Based on the present and looking to the future-The conference on new breakthroughs in treatment strategies for gastrointestinal malignant tumors invited Professor Li Jin from Dongfang Hospital of Tongji University and Professor Feng Jifeng from Jiangsu Cancer Hospital as the chairpersons of the conference
.

First of all, Professor Li Jin and Professor Feng Jifeng delivered wonderful conference speeches
.

Professor Li Jin pointed out that gastrointestinal tumors have become a global disease that seriously threatens human life and health
.

At the same time, gastrointestinal tumors have a particularly prominent impact in China.
For example, the number of gastric cancer patients in China accounts for 48% of the global number of patients.

.

Diagnosis and treatment of gastrointestinal tumors in China is a long way to go
.

In recent years, malignant tumors have entered the age of immunotherapy.
With the advancement and development of medical technology, the treatment of gastrointestinal malignant tumors is breaking through the bottleneck of "chemotherapy only", and leapfrogging towards low-toxic, efficient and safe treatment methods.
This is undoubtedly Can well improve the survival status of cancer patients
.

“At this year’s ESMO annual meeting, many major researches in the field of gastrointestinal tumors were announced.
Among them, the research led by some domestic experts and medical teams was particularly eye-catching
.

Today we are gathered here to better share and learn about digestion.
The latest research results in the field of gastrointestinal tumors can better serve clinical patients
.

” Professor Feng Jifeng also said: “The just-concluded ESMO annual meeting has brought us rich academic research results.
We are here to listen to you digestive tract tumors.
The wonderful sharing of famous professors in the field
.

We will definitely be able to learn more and return with a rewarding experience
.

" Dr.
Xu Wen from CP Tianqing Pharmaceutical Group Co.
, Ltd.
gave a speech.
First of all, I would like to thank all the professors who attended the meeting
.

He said that as a national pharmaceutical company, CP Tianqing has experienced the rapid development of China's pharmaceutical industry since the reform and opening up.
It has always adhered to the unremitting exploration of life sciences, and has also been committed to the research and development of innovative tumor drugs.
Rich product pipeline
.

At this ESMO annual meeting, a number of studies were selected for posters and oral reports
.

CP Tianqing will work with experts to further develop gastrointestinal tumor drugs and benefit more clinical patients
.

Figure 1 Speech by Professor Li Jin from Dongfang Hospital of Tongji University Figure 2 Speech by Professor Feng Jifeng from Jiangsu Cancer HospitalFigure 3 Speech by Dr.
Xu Wen from CP Tianqing Pharmaceutical Group Co.
, Ltd.
2021 POST-ESMO Hotspot Express-Frontiers and Prospects of Colorectal Cancer Diagnosis and Treatment The conference officially started.
First, Professor Yuan Ying from the Second Affiliated Hospital of Zhejiang University School of Medicine brought relevant research and sharing in the field of colorectal cancer (CRC) diagnosis and treatment at the ESMO Annual Conference
.

Professor Yuan Ying said that the 2021 ESMO Annual Conference has a rich content of research related to CRC treatment.
This time, the important research content related to the first-line and maintenance treatment of advanced CRC will be shared
.

Figure 4 Professor Yuan Ying of the Second Affiliated Hospital of Zhejiang University School of Medicine interprets the study first in the field of first-line treatment of metastatic colorectal cancer (mCRC), sharing a topic about FOLFOXIRI + bevacizumab (Bev) ± atelizumab Anti (Atezo) AtezoTRIBE study for the first-line treatment of unresectable mCRC
.

The results of the study showed that the median PFS (mPFS) in the FOLFOXIRI+Bev+Atezo treatment group reached 13.
1 months, which was higher than the 11.
5 months in the FOLFOXIRI+Bev treatment group (HR=0.
69; P=0.
012)
.

At the same time, compared with the control group, the objective response rate (ORR) (64% vs 59%, P=0.
78) of the FOLFOXIRI+Bev+Atezo group was not statistically different from the R0 resection rate (37% vs26%, P=0.
175)
.

Another, based on the mFOLFOX6 chemotherapy regimen, a phase II clinical study (MEDETREME study) combining Durvalumab and Tremelimumab in patients with RAS mutant mCRC, the overall ORR reached 61%, and the disease control rate (DCR) was 89%.
The mPFS reached 8.
4 months, the 6-month PFS rate reached 63.
2%, and the 12-month PFS rate reached 39%
.

After that, Professor Yuan Ying focused on sharing two important research results of Anlotinib in the treatment of advanced CRC
.

The first is a single-arm, multi-center, phase II clinical study of anlotinib combined with XELOX regimen in the first-line treatment of advanced RAS/BRAF wild-type colorectal cancer (ALTER-C002 study).
The enrolled population is the initial unresectable RAS/BRAF Patients with wild-type mCRC received the XELOX regimen combined with Anlotinib for 6 cycles.
After stable disease (SD) and above were achieved, the application of Anlotinib combined with capecitabine for maintenance treatment
.

The primary study endpoint is ORR, and secondary endpoints include PFS, DCR, DoR, and safety
.

The research data of 30 patients were reported at this meeting.
The results of the study showed that: of the 30 patients, 1 patient achieved complete remission (CR), 22 cases were evaluated as partial remission (PR), and 5 cases were evaluated as SD
.

ORR was 76.
7% (95%CI, 57.
7%-90.
1%), DCR was 93.
3% (95%CI, 77.
9%-99.
2%), and the preliminary median PFS reached 11.
4 months (95%CI, 6.
9-15.
9) The results of the study are very encouraging
.

Professor Yuan Ying said: "At the beginning of the study, we were very worried about the superposition of anlotinib combined with capecitabine in the hand-foot syndrome.
However, in the actual clinical practice, no obvious exacerbation of the hand-foot syndrome was found
.

At the same time, During treatment, the incidence of grade 3-4 TEAEs (adverse events that occurred during treatment) was 76.
7%, and no grade 5 TEAEs occurred, reflecting its good safety
.

"Based on the excellent performance of Anlotinib in the above study, the study The team has begun another randomized, double-blind, multi-center phase III clinical study to evaluate the effectiveness and safety of anlotinib combined with chemotherapy in the first-line treatment of RAS/BRAF wild-type mCRC
.

I look forward to obtaining good research results in the future and bringing benefits to clinical patients
.

Figure 5 Anlotinib combined with XELOX regimen for the first-line treatment of advanced RAS/BRAF wild-type colorectal cancer in a single-arm, multi-center, phase II clinical study (ALTER-C002 study) In addition to this, there is also an anlotinib combined with XELOX Data update of the first-line and anlotinib single-agent maintenance therapy mCRC study (ALTER-C001 study)
.

This study is different from the ALTER-C002 study and did not screen patients for RAS/BRAF gene status
.

The enrolled patients were treated with anlotinib+XELOX regimen, and anlotinib single-agent maintenance treatment was given after 6 cycles
.

The primary endpoint of the study was PFS, and secondary endpoints included ORR, DCR, DoR, and safety
.

The mPFS of the current study has not yet reached.
Of the 17 mCRC patients under evaluation, 9 have achieved PR in efficacy evaluation, 6 in efficacy evaluation in SD, and 2 in PD; ORR reached 52.
9%, and DCR reached 88.
2%; Professor Yuan Ying emphasized, The above two studies have shown the excellent efficacy of anlotinib combined with XELOX regimen in the first-line treatment of mCRC patients.
It is expected that after the phase III clinical study, anlotinib can truly benefit the first-line treatment of mCRC patients
.

Figure 6 Anlotinib combined with XELOX first-line and anlotinib single-agent maintenance therapy mCRC study (ALTER-C001 study) In addition, Professor Yuan Ying shared two related studies of cetuximab for mCRC maintenance therapy (TIME -PRODIGE28 UNICANCER study)
.

The conclusions of the study show that the anti-EGFR targeting drug cetuximab combined with FOLFORI first-line treatment of RAS wild-type mCRC and maintenance therapy with cetuximab can improve PFS
.

In the field of mCRC second-line and back-line treatment, Professor Yuan Ying also shared a number of related studies
.

Professor Yuan Ying said that at this year's ESMO annual meeting, there are still many valuable studies on CRC treatment worth learning.
He hopes that the interpretation of this meeting will enable us to further understand the latest international research results and lay the foundation for clinical practice
.

Masters talk about ESMO together-research on colorectal cancer diagnosis and treatment Professor Yuan Ying finished his wonderful sharing, Professor Deng Yanhong from the Sixth Affiliated Hospital of Sun Yat-sen University, Professor Li Qi from the First People's Hospital of Shanghai Jiaotong University, and Zeng Shan from Xiangya Hospital of Central South University Professor Zhu Lingjun from Jiangsu Provincial People's Hospital had an interesting discussion on topics such as the latest research on CRC and the experience and prospects of CRC diagnosis and treatment in this ESMO annual meeting
.

Professor Deng Yanhong said that in recent years, the treatment of CRC has made rapid progress, and the results of two studies on anlotinib combined with chemotherapy are exciting
.

At the same time, related research on the application of FOLFOXIRI+Bev+Atezo treatment regimen in the treatment of mCRC has also brought important guidance to clinical practice
.

Next, Professor Zhu Lingjun said that in the related research in the field of CRC treatment, I was impressed by the related research of Anlotinib combined with chemotherapy in the first-line treatment
.

I think that for CRC treatment, the more important thing is how to change the patient’s immune microenvironment so that immunotherapy can work better.
Among them, anti-angiogenesis therapy is indispensable
.

Professor Li Qi also said that the choice of treatment strategy is very important when developing treatment plans for CRC patients
.

At the same time, how to achieve long-term survival of patients with advanced CRC through oral targeted drugs has always been a problem for our clinical work
.

The application of Anlotinib combined with chemotherapy in the first-line treatment has brought me a lot of enlightenment
.

Figure 7: Colorectal cancer diagnosis and treatment-related research discussion session 2021 POST-ESMO hotspot express-sharing the latest research on esophageal cancer and gastric cancer After a wonderful discussion, Professor Huang Jing from the Cancer Hospital of the Chinese Academy of Medical Sciences brought us this ESMO Annual Conference Gastric Cancer And related research and prospects in the field of esophageal cancer diagnosis and treatment
.

Professor Huang Jing said that in recent years, the research progress in the field of esophageal cancer and gastric cancer treatment can be described as splendid
.

In this ESMO annual meeting, many latest researches on the diagnosis and treatment of esophageal cancer and gastric cancer were announced.
This time we will share and interpret some of the wonderful researches and learn together
.

Figure 8 Professor Huang Jing from the Cancer Hospital of the Chinese Academy of Medical Sciences Interpretation of the research related to the diagnosis and treatment of esophageal cancer.
Professor Huang Jing has brought us a wonderful interpretation from two aspects of the first-line treatment related progress and the second-line treatment related progress
.

First of all, Professor Huang Jing explained to us two studies of sintilimab and teriprizumab combined chemotherapy for the first-line treatment of advanced esophageal squamous cell carcinoma, namely the ORIENT15 study and the JUPITER-06 study
.

The results of the ORIENT15 study showed that in patients with PD-L1 CPS ≥ 10 and all patients, mPFS in the sintilimab + chemotherapy group reached 8.
3 months and 7.
2 months, respectively, which was significantly higher than the 13.
6 months of the placebo + chemotherapy group And 12.
5 months
.

In terms of PFS, in patients with PD-L1 CPS ≥ 10 and all patients, the median PFS of sintilimab + chemotherapy group was 8.
3 months and 7.
2 months, which was significantly higher than the placebo + chemotherapy group of 6.
4 months and 6.
4 months 5.
7 months
.

Compared with chemotherapy, Sintilimab + chemotherapy has better benefits for OS and PFS in patients with PD-L1 CPS ≥ 10 points or in all randomized patients
.

In the JUPITER-06 study, the PFS and OS of the teriprizumab combined chemotherapy group were 5.
7 months and 17.
0 months, respectively, which were longer than the 5.
5 months and 11.
0 months of the placebo combined chemotherapy group, and the OS prolonged even more.
Obviously
.

The above two studies have confirmed the importance of immune combined chemotherapy in the treatment of esophageal squamous cell carcinoma
.

Next, Professor Huang Jing interpreted a phase II clinical study (ALTER-E002 study) on a single-arm, multi-center clinical study of anlotinib hydrochloride combined with paclitaxel + cisplatin in the first-line treatment of esophageal scales
.

The study included patients with unresectable or locally advanced recurrence and metastatic esophageal squamous cell carcinoma who were treated with anlotinib + paclitaxel + cisplatin for 4-6 cycles, after which the patients were treated with anlotinib monotherapy
.

The primary study endpoint is PFS, and the secondary study endpoints include ORR, DCR, and safety
.

The results of the study showed that of 46 patients with esophageal cancer who underwent efficacy evaluation, 1 had CR, 35 had achieved PR, and 7 had SD
.

The ORR of the study was 78.
3% (95%CI: 63.
6%~89.
1%), and the DCR was 93.
5% (95%CI: 82.
1%~98.
6%)
.

The mPFS studied was 8.
38 months (95%CI: 5.
86-10.
90)
.

At the same time, the adverse reactions are mostly grade 1-2, and most of them are related to chemotherapy, and the safety is controllable
.

Professor Huang Jing said that anlotinib combined with dual-drug chemotherapy has achieved encouraging clinical research results in advanced esophageal squamous cell carcinoma
.

Anlotinib combined with chemotherapy can provide a new option for the first-line treatment of advanced esophageal squamous cell carcinoma
.

Fig.
9 ALTER-E002 study ORR and DCR A phase II randomized controlled study of squamous cell carcinoma (UMIN000007940)
.

Research suggests that paclitaxel is more effective and safer than docetaxel in the second-line treatment of esophageal squamous cell carcinoma
.

In addition, Professor Huang Jing also shared with us the research related to the first-line and second-line treatment of gastric cancer announced at this year's ESMO annual meeting
.

Professor Huang Jing said that for HER2-negative patients, the results of Checkmate 649 long-term follow-up and ORIENT-16 showed that for patients with gastric/gastroesophageal junction cancer with different expression levels of PD-L1, Nivo/sintilimab combined chemotherapy can be carried Significant PFS and OS benefits
.

For HER2-positive patients, the combination of trastuzumab + chemotherapy and nivolumab can increase the ORR to 70%
.

In addition, the efficacy of new HER2 inhibitor ZW25 and DKK1 inhibitor DKN-01 combined with chemotherapy/immunization needs to be further confirmed
.

In the second-line and above treatment of gastric cancer, can the phosphatidylserine inhibitor (Bavituximab) combined with pembrolizumab and PD-L1/TGF-βRII (SHR-1701) program synergistically bring better benefits , Still needs further exploration
.

Masters talk about ESMO together-Professor Huang Jing's wonderful sharing of research related to the diagnosis and treatment of esophageal cancer and gastric cancer.
Professor Cao Guochun from Jiangsu Cancer Hospital, Professor Fang Weijia from the First Affiliated Hospital of Zhejiang University School of Medicine, and Professor He Yifu from Anhui Cancer Hospital, will participate in this session.
In the ESMO annual meeting, the latest research and targeting of esophageal cancer and gastric cancer, the deployment of immunotherapeutic drugs, and the application prospects of ADC drugs in gastric cancer and esophageal cancer, etc.
were discussed enthusiastically
.

Professor Cao Guochun said that in recent years, domestic experts and scholars in the field of gastrointestinal tumors have increasingly appeared in international conferences and received more recognition
.

From the sharing just now, we see the important role of immunotherapy combined with chemotherapy in the first-line treatment of esophageal cancer
.

Anlotinib, as a targeted therapy, combined with chemotherapy this time, may also provide guidance for future clinical practice
.

Next, Professor Fang Weijia said that the treatment of gastric cancer and esophageal cancer is going out of the traditional mode of chemotherapy and radiotherapy, and immunotherapy has become a very common treatment method
.

At the same time, innovative drugs emerge in endlessly.
How to make good use of the relevant advances in basic research and clinical research to make the choice of drug treatment strategies for patients is particularly important
.

Finally, Professor He Yifu said that in the first-line immune combined chemotherapy regimen for esophageal cancer, the chemotherapy regimen involved includes paclitaxel + cisplatin and 5-fluorouracil + cisplatin
.

Regarding the choice of the two chemotherapy regimens, there is currently no relevant head-to-head comparison study.
Therefore, it is difficult to compare the pros and cons of the two chemotherapy regimens.
Clinical research and practical experience are still needed
.

Regardless of the chemotherapy regimen, combined immunotherapy has achieved gratifying research results
.

Fig.
11 The discussion session of esophageal cancer and gastric cancer related research and treatment.
At the end of the meeting, Professor Feng Jifeng made a wonderful summary for the meeting
.

Professor Feng Jifeng said that at the 2021 POST-ESMO digestive tract tumor special meeting, the professors brought us a lot of research sharing and gained a lot
.

Since the treatment of malignant tumors entered the era of targeted and immunotherapy, new drugs for gastrointestinal tumors have emerged one after another, which has greatly improved our dilemma in the treatment of advanced gastrointestinal malignancies
.

It is hoped that more and better research can be carried out, and that the new drugs with excellent performance in the research can finally go to the clinic and bring more benefits to patients with gastrointestinal tumors
.

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