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    Home > Active Ingredient News > Antitumor Therapy > Review of the annual research progress of gastric cancer in clinical oncology in China

    Review of the annual research progress of gastric cancer in clinical oncology in China

    • Last Update: 2021-08-07
    • Source: Internet
    • Author: User
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    From July 2nd to 3rd, 2021, the "2021 China Clinical Oncology Annual Progress Seminar (BOC) and Best of ASCO®2021 China" was successfully held in Chengdu, the land of abundance
    .

    The conference invited domestic oncology experts from various fields to comment on the wonderful research in the 2021 ASCO meeting; at the same time, there is a Chinese clinical oncology annual progress report link, which is selected by CSCO for the 2020 Chinese clinical oncology annual progress and Chinese experts’ international The clinical research of the conference report was summarized and discussed
    .

    At this meeting, Professor Qiu Hong from Tongji Hospital Affiliated to Huazhong University of Science and Technology introduced the annual research progress of gastric cancer in clinical oncology in China.
    The details are as follows
    .

    Expert Profile Prof.
    Hong Qiu, Deputy Director of the Department of Digestive System Oncology, Tongji Hospital, Huazhong University of Science and Technology, Deputy Director, Chief Physician, Doctoral Supervisor, Deputy Director, Targeted Therapy Professional Youth Committee, China Anti-Cancer Association Member of CSCO Youth Committee Member of CSCO Drug Safety Committee Member of CSCO Liver Cancer Committee Member of CSCO Pancreatic Cancer Committee Member of Chinese Anti-Cancer Association Tumor Nutrition Society Member of Chinese Anti-Cancer Association Tumor Mark Professional Committee Member of China Research Hospital Association Precision Medicine and Tumor MDT Professional Committee Standing Committee World Member of the Standing Committee of the Chinese Association of Oncologists Radiotherapy Oncology Cooperation Group Executive Committee Member and Secretary of the Standing Committee of the Cancer Rehabilitation and Palliative Care Committee of the Hubei Anti-Cancer Association Member of the Radiotherapy Professional Committee of the Wuhan Medical Association January 1, 2020-December 31, 2020, by Chinese scholars mainly participated in the publication of 2,854 articles in the field of gastric cancer, a year-on-year increase of 15.
    7%, but the proportion of high-scoring articles has not changed significantly compared with previous years
    .

    There are 304 articles with an impact factor greater than 5, accounting for 10.
    7% of all published articles.
    As in previous years, a large proportion of high-scoring articles are concentrated in the field of translational research, accounting for 83.
    9% of all articles with a score of 5 or higher
    .

    Important research progress 01 Radical lymph node dissection can significantly improve the long-term survival rate and accuracy of gastric cancer patients, and the extraction of more lymph nodes has gradually become the pursuit of current surgeons
    .

    In the case of complicated vascular anatomy and lymphatic drainage around the stomach, how to dissect enough lymph nodes efficiently and accurately without increasing surgical complications is still a huge challenge
    .

    As a new surgical navigation technology, indocyanine green (ICG) near-infrared fluorescence imaging allows tissues to penetrate better, and can accurately identify lymph nodes in hypertrophic adipose tissue than other dyes in visible light
    .

    The team of Professor Huang Changming from Union Hospital of Fujian Medical University published a study in JAMA Surgery, aiming to explore the safety and effectiveness of ICG near-infrared tracer-guided imaging during laparoscopic D2 lymph node dissection in patients with gastric cancer
    .

    The results of the study show that indocyanine green can significantly increase the number of lymph node dissection in patients with D2 radical gastric cancer surgery, reduce the disqualification rate of lymph nodes, and will not increase postoperative complications
    .

    This study suggests that indocyanine green imaging can be used for routine lymphatic tracing during laparoscopic gastrectomy, especially total gastrectomy
    .

    In the 022020 CSCO Guidelines for Gastric Cancer, both nivolumab and pembrolizumab have been recommended in the third-line treatment.
    The results of CheckMate649 and ATTRATION4 have been announced, providing high-level evidence-based medical evidence for the application of first-line immunotherapy and will change the clinic.
    Practice
    .

    However, the clinical data of immune checkpoint inhibitors independently developed by China are not sufficient in the Chinese population.
    There are actual needs for finding predictive markers of immune efficacy, screening suitable populations, and exploring optimized combined treatment models
    .

    The clinical research results of tislelizumab combined with chemotherapy in the first-line treatment of esophageal squamous cell carcinoma led by Professor Xu Jianming from the Fifth Medical Center of the General Hospital of the People’s Liberation Army were published in Clinical Cancer Research
    .

    The results showed that the objective response rate (ORR) reached 46.
    7%, the disease control rate (DCR) was 80%, and the curative effect was very significant.
    It reflects that tislelizumab's attempts in the field of first-line esophageal squamous cell carcinoma will indeed bring patients Really hope and look forward to further research results
    .

    03 Immune checkpoints are valuable prognostic biomarkers of patients across different cancer types.
    However, the diversity of immune checkpoints makes it difficult to accurately predict the prognosis of patients based on a single immune checkpoint.
    Therefore, a comprehensive evaluation system needs to be established.
    Make predictions
    .

    Professor Huang Changming's team established a comprehensive immune scoring system (ISSGC) based on six immunosuppressive ligands including NECTIN2, CEACAM1, HMGB1, SIGLEC6, CD44, and CD155 to predict the prognosis of gastric cancer
    .

    The results show that ISSGC is an independent prognostic factor, which can be used as a supplement to the TNM staging of gastric cancer patients, can improve the accuracy of prognosis prediction, and can distinguish gastric cancer patients with better prognosis and gastric cancer patients with higher nutritional index scores
    .

    In gastric cancer patients who do not rely on TNM staging, MSI status, and EBV status, ISSGC can also be used as a tool to screen patients for adjuvant chemotherapy.
    The research results were published in Nature Communications
    .

    Research worthy of attention 01 The team of Professor Zhu Zhenggang from Ruijin Hospital, Shanghai Jiaotong University School of Medicine launched a new adjuvant treatment of apatinib combined with SOX[S-1 (ticgio) + oxaliplatin] scheme for locally advanced gastric glands A single-center, open, single-arm phase II clinical study of cancer (Ahead-G329), and the results were published in the European Journal of Cancer
    .

    This study preliminarily confirmed the good effectiveness and reliable safety of apatinib combined with SOX regimen in neoadjuvant treatment of resectable locally advanced gastric cancer
    .

    02 A study published by the team of Professor Ji Jiafu from Peking University Cancer Hospital in Gastric Cancer explored related inflammation and nutritional markers and their changes to evaluate the predictive effect of neoadjuvant chemotherapy in locally advanced gastric cancer
    .

    The results show that for locally advanced gastric cancer, neoadjuvant chemotherapy can significantly reduce certain inflammatory indicators
    .

    Changes in neutrophil to lymphocyte ratio (NLR) before neoadjuvant therapy, hemoglobin (Hgb) and lymphocyte to monocyte ratio (LMR) after neoadjuvant therapy, combined with factors such as age, gender, tumor burden, and clinical stage, It has a certain degree of predictive effect on survival
    .

    Elevated NLR before initial treatment, preoperative anemia, and large LMR changes are related to poor prognosis
    .

    03 The team of Professor Bai Chunmei of Peking Union Medical College Hospital led a large real-world study to evaluate the safety and effectiveness of apatinib in the treatment of advanced gastric adenocarcinoma, and the results of the AHEAD-G202 study were published in Therapeutic Advances in Medical Oncology.

    .

    The results showed that there was no significant difference in the median progression-free survival and median overall survival between the middle-dose group (425 mg~500 mg daily) and the high-dose group (675 mg~850 mg).
    This result was slightly better than that Phase III clinical study
    .

    In terms of safety, the incidence of hypertension in the middle and low-dose groups, especially the incidence of hypertension above grade three, was significantly lower than that in the high-dose group
    .

    The results of the study will provide clinicians with more evidence on the dosage of apatinib.
    At the same time, the reduction of the dose will eventually further improve the patient's drug tolerance and reduce the cost of treatment
    .

    04The team of Professor Hongbing Shen from Nanjing Medical University published a blockbuster titled "Genetic Load, Healthy Life>
    .

    Researchers constructed a polygenic genetic risk score (PRS) model for gastric cancer in the Chinese population based on the results of genetic association studies, and applied more than 100,000 subjects of the Chinese Chronic Disease Prospective Research Cohort (CKB) on this basis to prospectively evaluate PRS The relationship with the risk of gastric cancer, and the protective effect of a healthy life>
    .

    The results of the study suggest that in the Chinese population, different gene profiles are significantly associated with different risks of gastric cancer, and life>
    .

    05 A study published by Professor Wang Shouyu's team from Gulou Hospital of Nanjing University in Gut magazine revealed the carcinogenic role of METTL3 in the occurrence and development of gastric cancer
    .

    Studies have found that METL3-mediated HDGF mRNA m6A modification can promote the progression of gastric cancer and has prognostic significance.
    METL3 may be a potential predictive and therapeutic target for gastric cancer
    .

    06 A study published by Professor Huang Changming's team in Gastric Cancer analyzed the impact of the completeness of lymph node reporting after distal gastric and total gastric laparoscopic D2 resection on the prognosis
    .

    At present, the indications for laparoscopic gastric cancer surgery have expanded from early gastric cancer to advanced gastric cancer
    .

    Different from early gastric cancer, thorough lymph node dissection is necessary in the surgical treatment of advanced gastric cancer
    .

    The patient's clinical status, tumor growth degree, surgical strategy, and the meticulous degree of pathological evaluation of excised specimens may affect the rate of lymph node non-compliance
    .

    The results of the study showed that lymph node incompatibility is an independent prognostic factor for overall survival (OS).
    For patients with advanced gastric cancer with a BMI ≥ 25 kg/m2, a history of upper abdominal surgery, a tumor diameter> 60 mm and located in the upper middle position, careful selection should be made Laparoscopic total gastrectomy method
    .


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