Interviews with gastrointestinal tumor experts Professor Qiu Wensheng talks about the development of advanced gastric cancer in the past 20 years. Immunotherapy brings a new therapeutic weapon!

*Only for medical professionals to read and reference Odivo (Navulimab), approved as a first-line immunotherapy for advanced gastric cancer, achieving benefits for the entire population.
The results of the CheckMate-649 study show that combined immune chemotherapy has achieved both OS and PFS benefits, and Good security! When the doctor does not have a weapon to fight against the disease, the patient and the doctor can only explore in the dark and cast new hope in the "hopeless"
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The diagnosis and treatment of patients with advanced gastric cancer has gone through 20 years of long exploration.
From “crossing the river by feeling the stones” to “there are medicines available for treatment”, one patient's condition has been alleviated, the survival period has been prolonged, and the diagnosis and treatment of advanced gastric cancer has finally entered.
The "fast track" of development
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On August 25, 2021, the chemotherapy regimen of nivolumab combined with fluorouracil and platinum drugs was approved by the National Medical Products Administration (NMPA) for the first-line treatment of advanced or metastatic gastric cancer, gastroesophageal junction cancer or esophagus Adenocarcinoma patients
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Immunotherapy, represented by PD-1 inhibitors, has been approved for the first-line indication for advanced gastric cancer for the first time in China! The Medical Oncology Channel invited Professor Qiu Wensheng from the Affiliated Hospital of Qingdao University to share the difficult exploration of advanced gastric cancer in the past 20 years and the real cases of benefiting from immunotherapy
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Professor Qiu Wensheng’s wonderful video "Cross the River by Feeling the Stones", in the past two decades, the diagnosis and treatment of advanced gastric cancer in China has been difficult.
Month
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Most patients with gastric cancer were diagnosed with Crohn's disease (ACG) ten years ago.
Only when the symptoms are very severe, the examination for gastric cancer will be considered, and the situation of early diagnosis is severe
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In the past ten years, the clinical diagnosis and treatment strategies for gastric cancer have mainly been chemotherapy and targeted therapy
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Patients who cannot benefit from targeted therapy often face the dilemma of "no medicines available" after the end of conventional chemotherapy
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In view of the above difficulties in diagnosis and treatment, medical oncologists across the country are looking for ways to break the situation.
The gastrointestinal tumor specialist in China is still in its infancy, and there is a big difference between the diagnosis and treatment of gastric cancer in European and American countries.
Cross the river"
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Breaking the dilemma of "no medicines available", nivolumab has advanced to the front line of advanced gastric cancer for nearly five years, and the development of domestic advanced gastric cancer diagnosis and treatment has entered the "fast lane"
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Professor Qiu Wensheng said: Beginning in 2017, foreign immunotherapy drugs have gradually emerged
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Nivolumab was launched in 2018.
In the past four years, the release of multiple major clinical research results in the multi-line treatment of advanced gastric cancer, such as double immune combination, immune combined targeting, and immune combined chemotherapy, has brought about the diagnosis and treatment of advanced gastric cancer.
A huge breakthrough
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The combined application of nivolumab and chemotherapy has rewritten the first-line treatment recommendation of the "Chinese Society of Clinical Oncology (CSCO) Guidelines".
On August 25, 2021, the program was approved by the National Medical Products Administration (NMPA) of China , Used for the first-line treatment of advanced gastric cancer
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The approval of the first-line treatment of nivolumab combined with chemotherapy is based on the CheckMate-649 study that has attracted much attention in recent years [1].
This global multi-center, randomized, open-label study aims to explore the basis of nivolumab Compared with standard chemotherapy, the combined therapy is used in the first-line treatment of patients with advanced or metastatic gastric cancer, gastroesophageal junction cancer, and esophageal adenocarcinoma
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The results of this study were updated at the American Association for Cancer Research (AACR) annual meeting in 2021.
The preset Chinese subgroup data in the CheckMate-649 study was announced.
A total of 208 Chinese patients were included in this analysis.
The results showed that Navulio With monoclonal antibody combined with chemotherapy, the median overall survival (OS) of patients was 14.
3 months, which was better than 10.
3 months in the standard chemotherapy group; patients with PD-L1 CPS ≥ 5 and PD-L1 CPS ≥ 1 were observed to have clinical Significant OS benefits, and there is a tendency to benefit even better
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It is worth noting that regardless of the entire patient population or the Chinese subgroup, regardless of the patient's PD-L1 expression level, nivolumab combined with chemotherapy can achieve a breakthrough in curative effect, and truly realize the benefits of the "whole population"
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Young gastric cancer patients received CR after immunotherapy, and immunotherapy writes a new chapter Professor Wensheng Qiu shared a classic case of benefit from immunotherapy: male patient, 34 years old, admitted to hospital in July 2020; diagnosis: advanced gastric cancer with clavicle Upper lymph node metastasis, retroperitoneal lymph node metastasis in the abdominal cavity; treatment strategy: immune + targeting + chemotherapy; treatment result: 4 months later, the patient's imaging results showed that the tumor was significantly regressed
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Re-examination of gastroscope showed that there was no tumor lesion in the gastric cavity, and the biopsy of the gastric cavity showed negative
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PET-CT showed that the tumor lesions were inactive, but the gastric mucosa was thickened
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Pathological biopsy assessment is: pathological complete remission (pCR)
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No tumor recurrence was found in the re-examination in August 2021
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Speaking of the future of immunotherapy, Professor Qiu Wensheng said: “As a witness, participant and witness of the development of advanced gastric cancer diagnosis and treatment in China, I am full of confidence in the treatment of advanced gastric cancer
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At present, more and more patients are receiving immunotherapy.
Eight domestic immunotherapy drugs have been approved and they have been used in multiple tumor types.
The experience of domestic oncologists in the use of immunotherapy drugs is compared with that in foreign countries.
The doctor must be richer
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The recent approval of nivolumab as the first-line indication for gastric cancer will surely bring about major and revolutionary changes
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I have been working in the field of digestive tumors for more than ten years, and I have developed and grown together with this field
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I hope that the diagnosis and treatment of gastric cancer in China will have a new beginning, a new future, and new hope after the approval of nivolumab on August 25
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I also hope that more new drugs will be used clinically in the future, which will bring longer survival benefits to patients
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In addition, clinical trials of new combinations such as nivolumumab combined with ipilimumab, and nivolumab combined with LAG-3 inhibitors are also in full swing, which is expected to provide more abundant immunotherapy strategies for patients with advanced gastric cancer
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"Professor Qiu Wensheng, Deputy Dean, Chief Physician, Doctoral Tutor of Tumor Hospital of Qingdao University Affiliated Hospital; Qingdao top-notch professional and technical talent, representative of Qingdao Shibei District People’s Congress; Qingdao University Affiliated Hospital Shibei District Executive Vice President ; Director of Shandong Provincial Key Laboratory of Tumor Molecular and Translation; Director of the Second Department of Oncology, Qingdao University Affiliated Hospital; Member of the National Health Commission's Capacity Building and Continuing Education Oncology Expert Committee; Director of the Chinese Society of Clinical Oncology (CSCO); Beijing Hesco Director of the Clinical Oncology Foundation; Chairman of the Chinese Anti-Cancer Association Cancer Support Therapy Professional Committee; Vice Chairman of the Chinese Medical Doctor Association Tumor Science Professional Committee; Vice Chairman of the CSCO Immunotherapy Expert Committee; Deputy Group of the Cancer Psychological Collaboration Group of the China Cancer Foundation President; Vice Chairman of Shandong Anti-Cancer Association; Vice Chairman of Oncology Branch of Shandong Medical Association; Chairman of Shandong Branch of Chinese Colorectal Cancer MDT Alliance; Chairman of Palliative Care Branch of Shandong Anti-Cancer Association Reference materials: [1].
Shen L, Bai Y, Lin X, et al.
Abstract CT184: First-Line (1L) nivolumab (NIVO) plus chemotherapy (chemo) versus chemo in patients (pts) with advanced gastric cancer/gastroesophageal junction cancer/esophageal adenocarcinoma (GC/ GEJC/EAC): CheckMate 649 Chinese subgroup analysis[J].
Cancer Research, 2021, 81(13 Supplement): CT184.
OPDGI-DG-0047-211026-231026*This article is only used to provide scientific information to medical professionals, not On behalf of this platform’s point of view, a wonderful review of previous issues 1.
Live your life, come from the stomach! Chinese gastrointestinal oncology expert interview-immunotherapy brings longer-term survival benefits for advanced gastric cancer 2.
Interview with gastrointestinal tumor expert | Yan Professor Chao shared a real case of advanced gastric cancer with peritoneal metastasis 3.
Interview with an expert on gastrointestinal tumors | Bringing "Wo" to your heart and "Stomach", Professor Zhang Tao talks about the diagnosis and treatment value of nivolumab combination regimen