Financial Media Reporter Wang Lina
On September 25-29, 2021, the 24th National Conference on Clinical Oncology and the 2021 Chinese Society of Clinical Oncology (CSCO) academic annual meeting was held, the theme was "Focus Innovative research, leading the original future".
On September 28, the "Anti-tumor Vascular Targeted Therapy Special" organized by CSCO Vascular Targeted Therapy Committee and exclusively sponsored by Zhengda Tianqing was held in the cloud. Prof. and Prof. Li Kai led heavy efforts, and brought experts in various fields online to link up, comprehensively, systematically and in-depthly introduced the theory and mechanism of anti-angiogenic drugs, updated iterations, and anti-angiogenic drugs represented by Anlotinib The latest research data and progress in panneoplastic tumors provide new forms and ideas for the development of my country's anti-tumor cause.
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Yu Jinming Academician | Jumping out of tumor anti-tumor: Pay attention to the therapy for tumor microenvironment
CSCO Chairman-designate, 2span Tumor Hospital of Shandong Province Tumor Hospital_span At the beginning of history, the concept of precise tumor treatment was vividly explained. He said that the past tumor treatment methods, radiotherapy, chemotherapy, targeting are all targeted at tumor cells, and the hottest research in the field of tumor research is anti-vascular therapy and immunotherapy, which are all targeted at the treatment of tumor microenvironment. . Therefore, it is necessary to look beyond the tumor to look at the tumor and combine the two to improve the effect of anti-tumor treatment and overcome drug resistance.
In addition, academician Yu pointed out that the purpose of immune combination therapy is to expand the window of immune efficacy, and the combination of immunotherapy with chemotherapy, anti-angiogenic drugs, radiotherapy and other treatment methods can expand the window of immune efficacy.Thereby increasing the effect of tumor treatment.
Professor Han Baohui|The Chinese Road of Vascular Targeted Therapy
Shanghai Jiaotong University Chest Hospital Professor Han Baohui introduced the theory, combination therapy, biomarkers, and the future from four aspects "China's R&D Road for Blood Vessel Targeting Therapy". He said that clinically commonly used anti-angiogenic drugs include three categories: single-target (bevacizumab, for VEGFR), multi-target (anlotinib, for multi-target) and pan-target. In malignant solid tumors, anti-tumor angiogenesis drugs have a wide range of clinical indications, and improved efficacy can be seen in combined chemotherapy, targeted, and immunotherapy. In the choice of drugs, combined therapy is needed to maximize strengths and avoid weaknesses.
Professor Han emphatically introduced the new strategy of small molecule multi-target combined therapy based on single target. For example, Anlotinib + chemotherapy has been tried in the treatment of first-line and second-line NSCLC patients, and achieved good results.
Professor Han pointed out that in the treatment of advanced lung cancer, as a vascular targeted drug originally developed in China, Anlotinib innovatively breaks through the pattern of the third-line treatment of advanced lung cancer and has become an indispensable and important joint strategy in the treatment of advanced lung cancer, providing patients with A treatment option that takes into account both efficacy and safety. At the same time, Anlotinib is full of potential in different indications and pan-cancer combined treatment options, and is moving to the center of the world stage.
Professor Li Kai|Replacement of new drugs-where is the best way?
Tianjin Cancer Hospital Professor Li Kai explained in detail the mechanism of action of new and old blood vessel targeting drugs. He said that with the increase in clinical applications, the first-generation single-target vascular targeted drugs are facing the common shortcoming of drug resistance.
Professor Li Kai pointed out that a new generation of blood vessel-targeted drug Anlotinib can inhibit multiple targets and take into account the tumor and the "peripheral" environment. Studies have shown that Anlotinib can reduce tumor vascular leakage, improve local circulation, reduce abnormal vascular regeneration, and inhibit tumor growth and metastasis. Secondly, Anlotinib can significantly improve the ratio of lymphocytes to granulocyte in peripheral blood.And by significantly down-regulating PD-1 on vascular endothelial cells , the immune barrier is lifted, so that immunocompetent cells quickly enter the tumor, prompting the immunocompetent cells to secrete a large amount of interferon and window hormone, forming an anti-tumor effect.
Therefore, Anlotinib can be said to make up for the shortcomings of the first generation of single-target vascular targeted drugs. It can undertake the important task of upgrading vascular targeted therapy drugs and become a Chinese contribution to anti-tumor. The gift of the world.
Professor Zhu Xiangzhi|Anti-angiogenic drugs are an important way to treat lung cancer brain metastases
Jiangsu Cancer Hospital Professor Zhu Xiangzhi introduced the application of anti-angiogenic drugs in the treatment of lung cancer brain metastases. Professor Zhu pointed out that anti-angiogenic drugs are an important way to treat lung cancer brain metastases. Anti-angiogenic drugs represented by anlotinib combined with radiotherapy for the treatment of lung cancer brain metastases can reduce the brain edema of by inhibiting VEGFR2; at the same time, also The tumor can be controlled by increasing radiosensitivity.
In addition, compared with placebo, anlotinib third-line monotherapy can prolong PFS and OS whether it is non-small cell lung cancer (NSCLC) brain metastasis or small cell lung cancer (SCLC) brain metastasis. In addition, the results of a phase II clinical study showed that in wild-type or mutant NSCLC patients with multiple brain metastases who were resistant to standard treatment, anlotinib combined with WBRT prolonged intracranial PFS by 11.1m. It can be seen that for NSCLC brain metastasis and SCLC brain metastasis, anlotinib single agent or combined radiotherapy is a new treatment strategy.
Professor Lu You|Progress in anti-angiogenic therapy for patients with driver-positive advanced NSCLC
West China Hospital of Sichuan University Professor Lu You introduced the progress of anti-angiogenic therapy in patients with driver-positive advanced NSCLC.
anti-angiogenic drugs combined with targeted therapy (A+T) combined therapy has a molecular basis for synergy, and theoretically can enhance anti-tumor efficacy. However, in newly treated NSCLC patients with positive driver gene, the combination therapy of macromolecular anti-angiogenic drugs + EGFR-TKI showed prolonged PFS, but OS did not benefit. The existing evidence of small molecule Anlotinib+EGFR-TKI shows that PFS is beneficial, and OS benefits need to be further verified.
Therefore, Professor Lu believes that it is not enough to change the tumor microvessels, and clinicians still need to think and explore further.
Professor Song Yong|Progress of anti-angiogenesis therapy in patients with advanced NSCLC driven by gene-negative
According to Professor Song Yong from Jinling Hospital Affiliated to Nanjing University School of Medicine, basic research confirms that anti-angiogenesis therapy combined with immunotherapy is synergistic Synergistic effect, and Anlotinib is superior to bevacizumab in improving the tumor microenvironment.
Professor Song explained the current 1-3 line treatment progress.
First-line chemotherapy±antivascular is still an important choice for first-line treatment of advanced NSCLC. Current research shows that Anlotinib has achieved good results in first-line chemotherapy or immunotherapy, but large-scale evidence-based medical evidence is still needed.
Second-line Anlotinib combined with Docetaxel chemotherapy has significantly improved the efficacy compared with chemotherapy alone. Especially in patients with failed first-line immunotherapy, the curative effect is better.
In the third-line third-line treatment, Anlotinib is the only small molecule anti-angiogenic drug recommended by the CSCO NSCLC guidelines, and it is the third-line standard treatment for NSCLC. The survival benefit of Anlotinib in the third-line is significantly better than that in the fourth-line and beyond use.
Professor Chu Tianqing|Positioning and thinking of anti-angiogenic drugs in patients with advanced NSCLC
Professor Chu Tianqing from the Chest Hospital of Shanghai Jiaotong University introduced the combination of anti-vascular drugs and chemotherapy, targeted therapy, and immunotherapy Positioning, current situation and some thoughts in use. Professor Chu said that combined chemotherapy is a classic standard treatment both abroad and at home.The combined targeted therapy (A+T) PFS has significant benefits, and OS has not yet been positive; the combined immunotherapy (A+I) mode can dually adjust the microenvironment, and the prospects are unlimited and have been recognized by multiple guidelines.
Professor Chu pointed out that among the anti-angiogenic drugs, Anlotinib is the only anti-angiogenic drug approved for single-drug 3-line treatment of NSCLC/ SCLC indications. All other drugs of this type require combined treatment. And unlike bevacizumab, Anlotinib is effective in non-squamous and squamous cell carcinomas.
Professor Wang Jing|Progress in research on the transformation of anti-angiogenic drugs for lung cancer
Professor Wang Jing from Tianjin Cancer Hospital discusses the current status of advanced lung cancer treatment, the approval status of anti-angiogenic drugs for lung cancer and future prospects Share. She said that the current anti-angiogenic drug therapy occupies an important position in the treatment of lung cancer and has become the standard regimen in the treatment of various subtypes of lung cancer. As the only anti-angiogenic drug approved for single-agent 3-line treatment of NSCLC/SCLC indications, anlotinib combined with chemotherapy for the first-line treatment of SCLC, mPFS and mOS have significant benefits; anlotinib combined with chemotherapy has good first-line treatment for advanced NSCLC The efficacy and controllable safety.
For the future, Professor Wang concluded: anti-angiogenesis drugs are effective as a single agent, and better in combination; combined with chemotherapy to promote mutual enhancement; combined with TKI to inhibit drug resistance. Combined immunization, synergy.
Professor Libo Chen|Advancement of Targeted Drug Therapy for Advanced Thyroid Cancer
Sixth People's Hospital Affiliated to Shanghai Jiaotong University Professor Libo Chen introduced the progress of targeted drug treatment for advanced thyroid cancer. He said that the incidence of thyroid cancer has increased rapidly and has increased by 4.73 times in the past 30 years. For different types of thyroid cancer, treatment strategies are different.
Professor Chen introduced the study on the efficacy and safety of anlotinib neoadjuvant treatment of locally advanced thyroid cancer reported at the ASCO meeting in 2021.It shows that out of 13 eligible patients, the overall ORR reached 76.9%, and 10 patients achieved PR, showing great prospects. The study of anlotinib sequential iodine-131 treatment of advanced DTC is expected to reduce the difficulty of treatment and achieve clinical benefits in both the number of treatment courses and the total record.
Finally, Professor Chen said that from optimizing indications for drugs to optimizing drugs for patients, targeted therapies for advanced thyroid cancer have entered a new era, requiring strict control and innovative design to enhance the value of research, improving efficacy, ensuring quality of life and Continued progress was made in expanding indications.
Professor Zhou Yuhong|The road to targeted anti-vascular TKI therapy for sarcoma patients in China
Zhongshan Hospital Affiliated to Fudan University Professor Yuhong Zhou introduced the road to anti-vascular TKI therapy for sarcoma patients in China. She said that the first-line treatment of sarcoma is still based on chemotherapy, and the long-term progression-free survival of patients has not improved significantly.
Professor Zhou pointed out that as an anti-angiogenic drug originally developed in my country, Anlotinib has achieved significant benefits in the second-line treatment of soft tissue sarcoma. The median PFS can reach 6.27 months, which significantly improves the survival of patients. It is recommended by the CSCO guideline level I, which is the standard drug for the treatment of patients with soft tissue sarcoma after anthracycline progression. Anlotinib is the only targeted drug with indications for soft tissue sarcoma in China, bringing more survival hope to Chinese patients with sarcoma.
Professor Zhiyu Chen|Professor Zhiyu Chen | Full-course management of anti-vascular therapy for advanced colorectal cancer
Tumor Hospital of Fudan University Professor Zhiyu Chen introduced the full-course management of anti-vascular therapy for advanced colorectal cancer. He said that recent studies have shown that anti-angiogenesis therapy can be used throughout the entire management of mCRC, from first-line, cross-line, second-line to end-line therapy. In the era of three-drug combination therapy, the three-drug combination (FOLFOXIRI) + bevacizumab ORR, PFS and OS are better than the two-drug combination (FOLFIRI).And the initial three drugs are significantly better than the sequential three drugs.
For patients who have failed standard treatments, the combination of anti-angiogenesis and cytotoxic drugs, as well as the potential regulation of the immune microenvironment, will play new value for the application of anti-angiogenesis therapy in the end-line treatment.
Professor Zhou Qi|The dilemma and failure of recurrent and metastatic gynecological malignancies
The Affiliated Tumor Hospital of Chongqing University Professor Zhou Qi introduced the dilemma and failure of drug treatment for recurrent and metastatic gynecological malignancies. She said that the incidence of gynecological malignancies is high, and the recurrence rate of patients is high. About 30% of patients with gynecological malignancies will experience recurrence, and the prognosis is often very poor. In addition, the chemotherapy regimens for recurrent/metastatic cervical cancer, endometrial cancer , and platinum-resistant ovarian cancer have poor efficacy, and there are a large number of unmet needs for treatment.
Professor Zhou pointed out that in recent years, the rise of anti-angiogenesis and immunotherapy has brought hope to patients with advanced recurrent gynecological tumors. Among them, Anlotinib, as a new multi-target anti-angiogenesis drug independently developed by my country, has the dual effects of anti-tumor angiogenesis and inhibiting tumor growth. It can be combined with a variety of drugs to enhance the anti-tumor efficacy. Compared with similar drugs, Anlotinib has a low incidence of adverse reactions and high safety. A number of clinical trials have verified the effectiveness and safety of Anlotinib in the treatment of gynecological tumors, providing a new clinical option and bringing more hope to patients.
With the advancement and development of medicine and the increasing influence of the international oncology community, CSCO has become an important academic platform for the display of the research results of Chinese scholars who are at the forefront of academics and have a global perspective. Nepal has also achieved world-renowned achievements. In the future, it is expected that with the hard work of fellow oncologists across the country, different joint programs can collide with new sparks and benefit more patients.
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