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April 7 is the 73rd World Health Day, also known as "World Health Day", which aims to raise people's awareness of the field of health and wellness
The liver is mainly responsible for metabolism, and plays an important role in removing toxins, storing glycogen (liver sugar), and synthesizing secreted proteins and bile salts
Primary liver cancer is the second leading cause of cancer death in my country
Primary liver cancer is the second leading cause of cancer death in my countryPrimary liver cancer is currently the fourth most common malignant tumor and the second leading cause of cancer death in China, which seriously threatens the life and health of the Chinese people
Figure 1: Classification of Primary Liver Cancers
HCC is the most common primary liver cancer, accounting for 75% to 85% of all liver cancers
China is a country with a high incidence of liver cancer.
Main therapeutic drugs for HCC
Main therapeutic drugs for HCCDue to the insidious onset of liver cancer, less than 30% of liver cancer patients are suitable for radical treatment at the time of first diagnosis.
With the continuous exploration of drugs and diagnosis and treatment plans by researchers, on January 10, 2022, the National Health and Medical Commission issued the "Guidelines for the Diagnosis and Treatment of Primary Liver Cancer (2022 Edition)", in the "Fourth Treatment (V) Systemic Anti-tumor Treatment" ” chapter recommends a variety of HCC therapies, including 7 first-line anti-tumor therapies and 5 second-line anti-tumor therapies
Table 1: Guidelines for the treatment of primary liver cancer (2022 edition)
Sorafenib
Sorafenib is the earliest molecularly targeted drug used in the systemic anti-tumor therapy of liver cancer
Figure 2: Sales volume/tablet of Sorafenib over the years
In July 2017, Sorafenib was included in the National Medical Insurance List for the first time
Donafinil
In June 2021, the domestic innovative targeted drug Donafenib was approved for marketing for patients with unresectable hepatocellular carcinoma who have not received systemic systemic therapy before, and it is currently the only single drug with better overall survival than Sorafil Small molecule targeted drug of Ni
The research and development and production enterprise of donafenib is Suzhou Zejing Bio-Pharmaceutical Co.
Atezolizumab in combination with bevacizumab
Although the efficacy of PD-1/L1 monoclonal antibody is not obvious, the combined drug regimen shows great potential, giving new hope to patients with advanced liver cancer
The results of the IMbrave150 global multi-center phase III study showed that the median survival time and progression-free survival of the atezolizumab combined with bevacizumab group were significantly longer than those of the sorafenib group, and the risk of death was reduced by 34%.
atezolizumab
Atezolizumab is the world's first approved PD-L1 monoclonal antibody, which can effectively bind to PD-L1 expressed on tumor cells and tumor-infiltrating immune cells, blocking its interaction with PD-1 and B7.
In May 2016, atezolizumab was approved by the US FDA for the treatment of bladder cancer.
In February 2020, atezolizumab was approved for the first time in China
Bevacizumab
Bevacizumab is a vascular-targeting drug that binds to human vascular endothelial growth factor (VEGF) and its receptor, blocks the signaling pathway of angiogenesis, and inhibits tumor cell growth
.
As one of the important drugs against tumor angiogenesis, bevacizumab has been used in the treatment of various malignant tumors
.
Bevacizumab was approved by the FDA in 2004 and is the world's first human monoclonal antibody for inhibiting tumor angiogenesis
.
In December 2019, the State Drug Administration approved the application for marketing registration of bevacizumab injection (trade name: Ankea) developed by Qilu Pharmaceutical
.
The drug is the first bevacizumab biosimilar approved in China
.
As of December 2021, 7 bevacizumab biosimilars have been approved for marketing in China, and the competition is fierce
.
Figure 3: Bevacizumab sales volume/unit over the years
At the end of 2017, as the patent protection period is approaching and domestic biosimilars are about to be launched, the bevacizumab antigen research has greatly reduced the price through medical insurance negotiation and entered the national medical insurance catalog
.
According to PDB national sample hospital drug market sales data, the sales volume of bevacizumab injection in 2018 was 505,265, a year-on-year increase of 204.
6%
.
Figure 4: Percentage of sales volume of bevacizumab companies over the years (%)
In December 2019, Qilu Pharmaceutical's bevacizumab injection was officially sold online at 1,266 yuan per bottle, a drop of about 35% compared to the latest bid price for bevacizumab research
.
With price advantages and strong marketing capabilities, Qilu Pharmaceutical will grab 34% of the in-hospital market share in 2020, and will further expand to 60% in 2021
.
In contrast, the market share of bevacizumab antigen research has dropped from 100% in 2019 to 31% in 2021, accounting for less than 1/3
.
summary
summaryAt present, domestic liver cancer drugs are still dominated by angiogenesis inhibitors, and immunotherapy represented by PD-1/L1 has begun to be used for the treatment of liver cancer
.
As more new targets are discovered, the combination of small molecule targeted drugs and immunotherapy may become the development trend of liver cancer treatment in the future
.
On World Health Day, the epidemic situation in Shanghai is still on the rise.
Although there will definitely be a day when it will fall, I just hope it will come sooner
.
Spring flowers will bloom, may the deceased be safe, and the country and the people may be safe
.
I wish you love life and love health
.