Advanced hepatocellular carcinoma(HCC)is a severe malignancy that poses a serious threat to human health.Owing to challenges in early diagnosis,most patients lose the opportunity for radical treatment when diagnosed.N...Advanced hepatocellular carcinoma(HCC)is a severe malignancy that poses a serious threat to human health.Owing to challenges in early diagnosis,most patients lose the opportunity for radical treatment when diagnosed.Nonetheless,recent advancements in cancer immunotherapy provide new directions for the treatment of HCC.For instance,monoclonal antibodies against immune check-point inhibitors(ICIs)such as programmed cell death protein 1/death ligand-1 inhibitors and cytotoxic t-lymphocyte associated antigen-4 significantly improved the prognosis of patients with HCC.However,tumor cells can evade the immune system through various mechanisms.With the rapid development of genetic engineering and molecular biology,various new immunotherapies have been used to treat HCC,including ICIs,chimeric antigen receptor T cells,engineered cytokines,and certain cancer vaccines.This review summarizes the current status,research progress,and future directions of different immunotherapy strategies in the treatment of HCC.展开更多
Medulloblastoma(MB)is considered the commonest malignant brain tumor in children.Multimodal treatments consisting of surgery,radiation,and chemotherapy have improved patients’survival.Nevertheless,the recurrence occu...Medulloblastoma(MB)is considered the commonest malignant brain tumor in children.Multimodal treatments consisting of surgery,radiation,and chemotherapy have improved patients’survival.Nevertheless,the recurrence occurs in 30%of cases.The persistent mortality rates,the failure of current therapies to extend life expectancy,and the serious complications of non-targeted cytotoxic treatment indicate the need for more refined therapeutic approaches.Most MBs originating from the neurons of external granular layer line the outer surface of neocerebellum and responsible for the afferent and efferent connections.Recently,MBs have been segregated into four molecular subgroups:Wingless-activated(WNT-MB)(Group 1);Sonichedgehog-activated(SHH-MB)(Group 2);Group 3 and 4 MBs.These molecular alterations follow specific gene mutations and disease-risk stratifications.The current treatment protocols and ongoing clinical trials against these molecular subgroups are still using common chemotherapeutic agents by which their efficacy have improved the progression-free survival but did not change the overall survival.However,the need to explore new therapies targeting specific receptors in MB microenvironment became essential.The immune microenvironment of MBs consists of distinctive cellular heterogeneities including immune cells and none-immune cells.Tumour associate macrophage and tumour infiltrating lymphocyte are considered the main principal cells in tumour microenvironment,and their role are still under investigation.In this review,we discuss the mechanism of interaction between MB cells and immune cells in the microenvironment,with an overview of the recent investigations and clinical trials.展开更多
Lung cancer is the leading cause of cancer-related death worldwide.Despite advances in diagnosis and treatment of lung cancer,the overall survival remains poor.Evidence indicates that lung cancer development is a comp...Lung cancer is the leading cause of cancer-related death worldwide.Despite advances in diagnosis and treatment of lung cancer,the overall survival remains poor.Evidence indicates that lung cancer development is a complex and dynamic process that involves interactions between tumor cells and their microenvironments,including immune cells.Exosomes are small extracellular vesicles secreted by most cell types;they contain functional molecules that allow intercellular communication.Tumor-derived exosomes(TEXs)carry both immunosuppressive and immunostimulatory mediators and may be involved in various immunomodulatory effects.TEXs,which partially mimic profiles of the parent cells,are a potential source of cancer biomarkers for prognosis,diagnosis,and prediction of response to therapy.In addition,TEXs may interfere with immunotherapies,but they also could be used as adjuvants and antigenic components in vaccines against lung cancer.In the context of lung cancer,identifying TEXs and understanding their contribution to tumorigenesis and the response to immunotherapies represents a challenging research area.展开更多
BACKGROUND Pregnancy in the setting of systemic lupus erythematosus can worsen thecondition from the stable to active stage, with quality of life and fertility desirebeing particular concerns. Pregnancy in the active ...BACKGROUND Pregnancy in the setting of systemic lupus erythematosus can worsen thecondition from the stable to active stage, with quality of life and fertility desirebeing particular concerns. Pregnancy in the active stage of systemic lupuserythematosus (ASLE), although rare and complicated to manage, can be treatedfavorably with immunotherapies ifs used properly. Here we report such a successcase.CASE SUMMARY A 31-year-old primigravida patient, diagnosed with SLE seven years ago, wasinduced ASLE after a cold at 21 + weeks. The patient’s vital signs on presentationwere normal. Her laboratory exam was remarkable for significant proteinuria,liver and renal dysfunction, and low C3 and C4 levels. Infectious work-up wasnegative. The patient was diagnosed with ASLE. She was given immunosuppressiveagents (methylprednisolone, gamma globulin and azathioprine etc.)and plasma adsorption therapy, monitoring blood pressure every 8 h, fetal heartrate twice a day, and liver and renal function at least twice a week. Successfulmaternal and fetal outcomes are presented here.CONCLUSION Child-bearing in ASLE has become more promising, even for this difficult case ofASLE with multiple organ damage. Thorough antepartum counseling, cautiousmaternal-fetal monitoring, and multi-organ function monitoring bymultidisciplinary specialties are keys to favorable pregnancy outcomes.展开更多
Current advances of immunotherapy have greatly changed the way of cancer treatment.At the same time,a great number of nanoparticle-based cancer immunotherapies(NBCIs)have also been explored to elicit potent immune res...Current advances of immunotherapy have greatly changed the way of cancer treatment.At the same time,a great number of nanoparticle-based cancer immunotherapies(NBCIs)have also been explored to elicit potent immune responses against tumors.However,few NBCIs are nearly in the clinical trial which is mainly ascribed to a lack understanding of in vivo fate of nanoparticles(NPs)for cancer immunotherapy.NPs for cancer immunotherapy mainly target the immune organs or immune cells to enable effcient antitumor immune responses.The physicochemical properties of NPs including size,shape,elasticity and surface properties directly affect their interaction with immune systems as well as their in vivo fate and therapeutic effect.Hence,systematic analysis of the physicochemical properties and their effect on in vivo fate is urgently needed.In this review,we frst recapitulate the fundamentals for the in vivo fate of NBCIs including physio-anatomical features of lymphatic system and strategies to modulate immune responses.Moreover,we highlight the effect of physicochemical properties on their in vivo fate including lymph nodes(LNs)drainage,cellular uptake and intracellular transfer.Challenges and opportunities for rational design of NPs for cancer immunotherapy are also discussed in detail.展开更多
Hepatocellular carcinoma(HCC)is the most common primary liver tumor,which stands fourth in rank of cancer-related deaths worldwide.The incidence of HCC is constantly increasing in correlation with the epidemic in diab...Hepatocellular carcinoma(HCC)is the most common primary liver tumor,which stands fourth in rank of cancer-related deaths worldwide.The incidence of HCC is constantly increasing in correlation with the epidemic in diabetes and obesity,arguing for an urgent need for new treatments for this lethal cancer refractory to conventional treatments.HCC is the paradigm of inflammation-associated cancer,since more than 80% of HCC emerge consecutively to cirrhosis associated with a vast remodeling of liver microenvironment.In the recent decade,immunomodulatory drugs have been developed and have given impressive results in melanoma and later in several other cancers.In the present review,we will discuss the recent advancements concerning the use of immunotherapies in HCC,in particular those targeting immune checkpoints,used alone or in combination with other anticancers agents.We will address why these drugs demonstrate unsatisfactory results in a high proportion of liver cancers and the mechanisms of resistance developed by HCC to evade immune response with a focus on the epigeneticrelated mechanisms.展开更多
Immune checkpoint inhibitors represent revolutionary anti-cancer agents, being rapidly approved in different malignancies and settings. Gastrointestinal(GI) cancers represent a wide variety of tumors with specific cha...Immune checkpoint inhibitors represent revolutionary anti-cancer agents, being rapidly approved in different malignancies and settings. Gastrointestinal(GI) cancers represent a wide variety of tumors with specific characteristics and different responses to various therapeutic alternatives; while some are chemosensitive others are chemo-resistant and only respond to more aggressive cytotoxic regimens, targeted therapies or a combination of both. Preliminary results of immune checkpoint inhibitors in some GI cancers are promising, namely in hepatocellular carcinoma, anal cancers and microsatellite instability high colorectal cancers. An impressive instead of a impressive number of immune checkpoint inhibitors are being evaluated in different indications in GI cancers as single agents or in combination with other agents. We reported in this paper ongoing and published trials evaluating immune checkpoint inhibitors in hepatocellular carcinoma and biliary tract cancers, esophageal, gastric, pancreatic, colorectal and anal cancers and we discussed the future perspectives of these agents in GI cancers.展开更多
As an essential part of adaptive immunity,T cells coordinate the immune responses against pathogens and cancer cells.Lipid metabolism has emerged as a key regulator for the activation,differentiation,and effector func...As an essential part of adaptive immunity,T cells coordinate the immune responses against pathogens and cancer cells.Lipid metabolism has emerged as a key regulator for the activation,differentiation,and effector functions of T cells.Therefore,uncovering the molecular mechanisms by which lipid metabolism dictates T cell biology is of vital importance.The tumor microenvironment is a hostile milieu,i.e.often characterized by nutrient restriction.In this environment,various cells,such as T cells and cancer cells,reprogram their metabolism,including their lipid metabolism,to meet their energy and functional needs.Here,we review the participation of fatty acid and cholesterol metabolism homeostasis in orchestrating T cell biology.We demonstrate how the tumor microenvironment reshapes the lipid metabolism in T cells.Importantly,we highlight the current cancer therapeutic interventions that target fatty acid and cholesterol metabolism of T cells.By offering a holistic understanding of how lipid metabolic adaption by T cells facilitates their immunosurveillance in the tumor microenvironment,we believe this review and the future studies might inspire the next-generation immunotherapies.展开更多
Because of enhanced e cacy and lower side e ects,cancer immunotherapies have recently been extensively investigated in clinical trials to overcome the limitations of conventional cancer monotherapies.Although engineer...Because of enhanced e cacy and lower side e ects,cancer immunotherapies have recently been extensively investigated in clinical trials to overcome the limitations of conventional cancer monotherapies.Although engineering attempts have been made to build nanosystems even including stimulus nanomaterials for the e cient delivery of antigens,adjuvants,or anticancer drugs to improve immunogenic cancer cell death,this requires huge R&D e orts and investment for clinically relevant findings to be approved for translation of the nanosystems.To this end,in this study,an air–liquid two-phase electrospray was developed for stable bubble pressing under a balance between mechanical and electrical parameters of the spray to continuously produce biomimetic nanosystems consisting of only clinically relevant compounds[paclitaxel-loaded fake blood cell Eudragit particle(Eu-FBCP/PTX)]to provide a conceptual leap for the timely development of translatable chemo-immunotherapeutic nanosystems.This was pursued as the e cacy of systems for delivering anticancer agents that has been mainly influenced by nanosystem shape because of its relevance to transporting behavior to organs,blood circulation,and cell–membrane interactions.The resulting Eu-FBCP/PTX nanosystems exhibiting phagocytic and micropinocytic uptake behaviors can confer better e cacy in chemo-immunotherapeutics in the absence and presence of anti-PD-L1 antibodies than similar sized PTX-loaded spherical Eu particles(Eu-s/PTX).展开更多
There exist differences in the epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and drug selections between gastric cancer patients from the Eastern and ...There exist differences in the epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and drug selections between gastric cancer patients from the Eastern and Western countries.The Chinese Society of Clinical Oncology(CSCO)has organized a panel of senior experts specializing in all sub-specialties of gastric cancer to compile a clinical guideline for the diagnosis and treatment of gastric cancer since 2016 and renews it annually.Taking into account regional differences,giving full consideration to the accessibility of diagnosis and treatment resources,these experts have conducted expert consensus judgment on relevant evidence and made various grades of recommendations for the clinical diagnosis and treatment of gastric cancer to reflect the value of cancer treatment and meeting health economic indexes in China.The 2021 CSCO Clinical Practice Guidelines for Gastric Cancer covers the diagnosis,treatment,follow-up,and screening of gastric cancer.Based on the 2020 version of the CSCO Chinese Gastric Cancer guidelines,this updated guideline integrates the results ofmajor clinical studies from China and overseas for the past year,focused on the inclusion of research data from the Chinese population for more personalized and clinically relevant recommendations.For the comprehensive treatment of non-metastatic gastric cancer,attentions were paid to neoadjuvant treatment.The value of perioperative chemotherapy is gradually becoming clearer and its recommendation level has been updated.For the comprehensive treatment of metastatic gastric cancer,recommendations for immunotherapy were included,and immune checkpoint inhibitors fromthird-line to the first-line of treatment for different patient groups with detailed notes are provided.展开更多
China is one of the countries with the highest incidence of gastric cancer.There are differences in epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and ...China is one of the countries with the highest incidence of gastric cancer.There are differences in epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and drug selection between gastric cancer patients from the Eastern and Western countries.Non-Chinese guidelines cannot specifically reflect the diagnosis and treatment characteristics for the Chinese gastric cancer patients.The Chinese Society of Clinical Oncology(CSCO)arranged for a panel of senior experts specializing in all sub-specialties of gastric cancer to compile,discuss,and revise the guidelines on the diagnosis and treatment of gastric cancer based on the findings of evidence-based medicine in China and abroad.By referring to the opinions of industry experts,taking into account of regional differences,giving full consideration to the accessibility of diagnosis and treatment resources,these experts have conducted experts’consensus judgement on relevant evidence and made various grades of recommendations for the clinical diagnosis and treatment of gastric cancer to reflect the value of cancer treatment and meeting health economic indexes.This guideline uses tables and is complemented by explanatory and descriptive notes covering the diagnosis,comprehensive treatment,and follow-up visits for gastric cancer.展开更多
文摘Advanced hepatocellular carcinoma(HCC)is a severe malignancy that poses a serious threat to human health.Owing to challenges in early diagnosis,most patients lose the opportunity for radical treatment when diagnosed.Nonetheless,recent advancements in cancer immunotherapy provide new directions for the treatment of HCC.For instance,monoclonal antibodies against immune check-point inhibitors(ICIs)such as programmed cell death protein 1/death ligand-1 inhibitors and cytotoxic t-lymphocyte associated antigen-4 significantly improved the prognosis of patients with HCC.However,tumor cells can evade the immune system through various mechanisms.With the rapid development of genetic engineering and molecular biology,various new immunotherapies have been used to treat HCC,including ICIs,chimeric antigen receptor T cells,engineered cytokines,and certain cancer vaccines.This review summarizes the current status,research progress,and future directions of different immunotherapy strategies in the treatment of HCC.
文摘Medulloblastoma(MB)is considered the commonest malignant brain tumor in children.Multimodal treatments consisting of surgery,radiation,and chemotherapy have improved patients’survival.Nevertheless,the recurrence occurs in 30%of cases.The persistent mortality rates,the failure of current therapies to extend life expectancy,and the serious complications of non-targeted cytotoxic treatment indicate the need for more refined therapeutic approaches.Most MBs originating from the neurons of external granular layer line the outer surface of neocerebellum and responsible for the afferent and efferent connections.Recently,MBs have been segregated into four molecular subgroups:Wingless-activated(WNT-MB)(Group 1);Sonichedgehog-activated(SHH-MB)(Group 2);Group 3 and 4 MBs.These molecular alterations follow specific gene mutations and disease-risk stratifications.The current treatment protocols and ongoing clinical trials against these molecular subgroups are still using common chemotherapeutic agents by which their efficacy have improved the progression-free survival but did not change the overall survival.However,the need to explore new therapies targeting specific receptors in MB microenvironment became essential.The immune microenvironment of MBs consists of distinctive cellular heterogeneities including immune cells and none-immune cells.Tumour associate macrophage and tumour infiltrating lymphocyte are considered the main principal cells in tumour microenvironment,and their role are still under investigation.In this review,we discuss the mechanism of interaction between MB cells and immune cells in the microenvironment,with an overview of the recent investigations and clinical trials.
文摘Lung cancer is the leading cause of cancer-related death worldwide.Despite advances in diagnosis and treatment of lung cancer,the overall survival remains poor.Evidence indicates that lung cancer development is a complex and dynamic process that involves interactions between tumor cells and their microenvironments,including immune cells.Exosomes are small extracellular vesicles secreted by most cell types;they contain functional molecules that allow intercellular communication.Tumor-derived exosomes(TEXs)carry both immunosuppressive and immunostimulatory mediators and may be involved in various immunomodulatory effects.TEXs,which partially mimic profiles of the parent cells,are a potential source of cancer biomarkers for prognosis,diagnosis,and prediction of response to therapy.In addition,TEXs may interfere with immunotherapies,but they also could be used as adjuvants and antigenic components in vaccines against lung cancer.In the context of lung cancer,identifying TEXs and understanding their contribution to tumorigenesis and the response to immunotherapies represents a challenging research area.
文摘BACKGROUND Pregnancy in the setting of systemic lupus erythematosus can worsen thecondition from the stable to active stage, with quality of life and fertility desirebeing particular concerns. Pregnancy in the active stage of systemic lupuserythematosus (ASLE), although rare and complicated to manage, can be treatedfavorably with immunotherapies ifs used properly. Here we report such a successcase.CASE SUMMARY A 31-year-old primigravida patient, diagnosed with SLE seven years ago, wasinduced ASLE after a cold at 21 + weeks. The patient’s vital signs on presentationwere normal. Her laboratory exam was remarkable for significant proteinuria,liver and renal dysfunction, and low C3 and C4 levels. Infectious work-up wasnegative. The patient was diagnosed with ASLE. She was given immunosuppressiveagents (methylprednisolone, gamma globulin and azathioprine etc.)and plasma adsorption therapy, monitoring blood pressure every 8 h, fetal heartrate twice a day, and liver and renal function at least twice a week. Successfulmaternal and fetal outcomes are presented here.CONCLUSION Child-bearing in ASLE has become more promising, even for this difficult case ofASLE with multiple organ damage. Thorough antepartum counseling, cautiousmaternal-fetal monitoring, and multi-organ function monitoring bymultidisciplinary specialties are keys to favorable pregnancy outcomes.
基金supported by National Key Research&Development Program of China(Grant No.2018YFE0117800,China)the National Natural Science Foundation of China(NSFC)key projects(grant No.31630027,32030060,51773227 and 81701815,China)+3 种基金NSFC international collaboration key project(Grant No.51861135103,China)NSFC-German Research Foundation(DFG)project(Grant No.31761133013,China)appreciate the support by“the Beijing-Tianjin-Hebei Basic Research Cooperation Project”(19JCZDJC64100,China)the Youth Thousand-Talents Program of China。
文摘Current advances of immunotherapy have greatly changed the way of cancer treatment.At the same time,a great number of nanoparticle-based cancer immunotherapies(NBCIs)have also been explored to elicit potent immune responses against tumors.However,few NBCIs are nearly in the clinical trial which is mainly ascribed to a lack understanding of in vivo fate of nanoparticles(NPs)for cancer immunotherapy.NPs for cancer immunotherapy mainly target the immune organs or immune cells to enable effcient antitumor immune responses.The physicochemical properties of NPs including size,shape,elasticity and surface properties directly affect their interaction with immune systems as well as their in vivo fate and therapeutic effect.Hence,systematic analysis of the physicochemical properties and their effect on in vivo fate is urgently needed.In this review,we frst recapitulate the fundamentals for the in vivo fate of NBCIs including physio-anatomical features of lymphatic system and strategies to modulate immune responses.Moreover,we highlight the effect of physicochemical properties on their in vivo fate including lymph nodes(LNs)drainage,cellular uptake and intracellular transfer.Challenges and opportunities for rational design of NPs for cancer immunotherapy are also discussed in detail.
基金Supported by Ligue Nationale Contre le Cancer and the Agence Nationale de la Recherche,No.DLK1-EPILIV 2018-2021(to Gougelet A)Universitede Paris(to Sanceau J).
文摘Hepatocellular carcinoma(HCC)is the most common primary liver tumor,which stands fourth in rank of cancer-related deaths worldwide.The incidence of HCC is constantly increasing in correlation with the epidemic in diabetes and obesity,arguing for an urgent need for new treatments for this lethal cancer refractory to conventional treatments.HCC is the paradigm of inflammation-associated cancer,since more than 80% of HCC emerge consecutively to cirrhosis associated with a vast remodeling of liver microenvironment.In the recent decade,immunomodulatory drugs have been developed and have given impressive results in melanoma and later in several other cancers.In the present review,we will discuss the recent advancements concerning the use of immunotherapies in HCC,in particular those targeting immune checkpoints,used alone or in combination with other anticancers agents.We will address why these drugs demonstrate unsatisfactory results in a high proportion of liver cancers and the mechanisms of resistance developed by HCC to evade immune response with a focus on the epigeneticrelated mechanisms.
文摘Immune checkpoint inhibitors represent revolutionary anti-cancer agents, being rapidly approved in different malignancies and settings. Gastrointestinal(GI) cancers represent a wide variety of tumors with specific characteristics and different responses to various therapeutic alternatives; while some are chemosensitive others are chemo-resistant and only respond to more aggressive cytotoxic regimens, targeted therapies or a combination of both. Preliminary results of immune checkpoint inhibitors in some GI cancers are promising, namely in hepatocellular carcinoma, anal cancers and microsatellite instability high colorectal cancers. An impressive instead of a impressive number of immune checkpoint inhibitors are being evaluated in different indications in GI cancers as single agents or in combination with other agents. We reported in this paper ongoing and published trials evaluating immune checkpoint inhibitors in hepatocellular carcinoma and biliary tract cancers, esophageal, gastric, pancreatic, colorectal and anal cancers and we discussed the future perspectives of these agents in GI cancers.
基金C.X.is funded by National Natural Science Foundation of China(92057201,92157301).
文摘As an essential part of adaptive immunity,T cells coordinate the immune responses against pathogens and cancer cells.Lipid metabolism has emerged as a key regulator for the activation,differentiation,and effector functions of T cells.Therefore,uncovering the molecular mechanisms by which lipid metabolism dictates T cell biology is of vital importance.The tumor microenvironment is a hostile milieu,i.e.often characterized by nutrient restriction.In this environment,various cells,such as T cells and cancer cells,reprogram their metabolism,including their lipid metabolism,to meet their energy and functional needs.Here,we review the participation of fatty acid and cholesterol metabolism homeostasis in orchestrating T cell biology.We demonstrate how the tumor microenvironment reshapes the lipid metabolism in T cells.Importantly,we highlight the current cancer therapeutic interventions that target fatty acid and cholesterol metabolism of T cells.By offering a holistic understanding of how lipid metabolic adaption by T cells facilitates their immunosurveillance in the tumor microenvironment,we believe this review and the future studies might inspire the next-generation immunotherapies.
基金supported by Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Science,ICT and future Planning(2018R1A2A1A05020683)supported by the NRF(2018R1A2A2A05021143)grant funded by the Korean Governmentthe Medical Research Center Program(2015R1A5A2009124)through the NRF funded by MSIP.
文摘Because of enhanced e cacy and lower side e ects,cancer immunotherapies have recently been extensively investigated in clinical trials to overcome the limitations of conventional cancer monotherapies.Although engineering attempts have been made to build nanosystems even including stimulus nanomaterials for the e cient delivery of antigens,adjuvants,or anticancer drugs to improve immunogenic cancer cell death,this requires huge R&D e orts and investment for clinically relevant findings to be approved for translation of the nanosystems.To this end,in this study,an air–liquid two-phase electrospray was developed for stable bubble pressing under a balance between mechanical and electrical parameters of the spray to continuously produce biomimetic nanosystems consisting of only clinically relevant compounds[paclitaxel-loaded fake blood cell Eudragit particle(Eu-FBCP/PTX)]to provide a conceptual leap for the timely development of translatable chemo-immunotherapeutic nanosystems.This was pursued as the e cacy of systems for delivering anticancer agents that has been mainly influenced by nanosystem shape because of its relevance to transporting behavior to organs,blood circulation,and cell–membrane interactions.The resulting Eu-FBCP/PTX nanosystems exhibiting phagocytic and micropinocytic uptake behaviors can confer better e cacy in chemo-immunotherapeutics in the absence and presence of anti-PD-L1 antibodies than similar sized PTX-loaded spherical Eu particles(Eu-s/PTX).
文摘There exist differences in the epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and drug selections between gastric cancer patients from the Eastern and Western countries.The Chinese Society of Clinical Oncology(CSCO)has organized a panel of senior experts specializing in all sub-specialties of gastric cancer to compile a clinical guideline for the diagnosis and treatment of gastric cancer since 2016 and renews it annually.Taking into account regional differences,giving full consideration to the accessibility of diagnosis and treatment resources,these experts have conducted expert consensus judgment on relevant evidence and made various grades of recommendations for the clinical diagnosis and treatment of gastric cancer to reflect the value of cancer treatment and meeting health economic indexes in China.The 2021 CSCO Clinical Practice Guidelines for Gastric Cancer covers the diagnosis,treatment,follow-up,and screening of gastric cancer.Based on the 2020 version of the CSCO Chinese Gastric Cancer guidelines,this updated guideline integrates the results ofmajor clinical studies from China and overseas for the past year,focused on the inclusion of research data from the Chinese population for more personalized and clinically relevant recommendations.For the comprehensive treatment of non-metastatic gastric cancer,attentions were paid to neoadjuvant treatment.The value of perioperative chemotherapy is gradually becoming clearer and its recommendation level has been updated.For the comprehensive treatment of metastatic gastric cancer,recommendations for immunotherapy were included,and immune checkpoint inhibitors fromthird-line to the first-line of treatment for different patient groups with detailed notes are provided.
文摘China is one of the countries with the highest incidence of gastric cancer.There are differences in epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and drug selection between gastric cancer patients from the Eastern and Western countries.Non-Chinese guidelines cannot specifically reflect the diagnosis and treatment characteristics for the Chinese gastric cancer patients.The Chinese Society of Clinical Oncology(CSCO)arranged for a panel of senior experts specializing in all sub-specialties of gastric cancer to compile,discuss,and revise the guidelines on the diagnosis and treatment of gastric cancer based on the findings of evidence-based medicine in China and abroad.By referring to the opinions of industry experts,taking into account of regional differences,giving full consideration to the accessibility of diagnosis and treatment resources,these experts have conducted experts’consensus judgement on relevant evidence and made various grades of recommendations for the clinical diagnosis and treatment of gastric cancer to reflect the value of cancer treatment and meeting health economic indexes.This guideline uses tables and is complemented by explanatory and descriptive notes covering the diagnosis,comprehensive treatment,and follow-up visits for gastric cancer.
