[ China Pharmaceutical Network Technology News ] Lung cancer is currently the world's most high-risk malignant tumor, and is the "killer" of human beings. Fifteen years ago, when the global medical field used burning and killing for advanced lung cancer, the survival rate of end-stage lung cancer was at most 8 months. After 15 years, about half of non-smoking female adenocarcinoma patients survive for an average of 40 months even in the terminal phase, and the drug side effects during survival are small and do not affect normal life. A series of new treatments have been adopted by 15 countries and 25 international guides. All of this came from a research and exploration by a lung cancer research team from the People's Hospital of Guangdong Province. At the just-concluded “China Medical Science and Technology Awards Conferenceâ€, Wu Yilong, a professor of the Guangdong Provincial People's Hospital, won the first prize of the highest award for his project “Building and Popularizing and Applying the Targeted Precision Treatment Model for Lung Cancerâ€.
(Lung cancer gene "password" is broken and the patient's survival will be extended. Image Source: Baidu Pictures)
Patients with advanced lung cancer live for a year
Lung cancer is currently the most common malignant tumor in the world, with about 1.6 million people dying each year. But for a long period of time, modern medicine has few ways to treat lung cancer, especially advanced lung cancer. "Since the oncology, a global feature has been found, that is, lung cancer patients are mostly in the middle and late stages, accounting for more than 50% of all lung cancer. Taking the data of China in recent years as an example, among the 720,000 lung cancer patients every year, There are 360,000 patients who are advanced patients, which has gradually become a very serious social problem." Wu Yilong said that for such patients, even in the early 21st century, there were not many methods on a global scale. Taking indiscriminate and high-dose radiotherapy and chemotherapy, under the guiding ideology of "have a mistake," the advanced lung cancer treatment at that time was inefficient, and the overall efficiency was as low as 20%-30%. That is, about one-third of patients are effective with this therapy, while other 2/3 patients with advanced lung cancer have no effect after suffering enormous treatment pain.
Even if one-third of the patients are effective, the cost is very huge. Radioactive pneumonia caused by high-dose radiotherapy, hair loss caused by high-dose toxic chemotherapy substances, poor appetite, white blood cells dropped to dangerous, extremely low level... "In the treatment, most patients will appear more than 3 Degree, seriously affecting the lives of patients, need side effects of hospitalization control." Wu Yilong said that for a long time, medical experts who specialize in lung cancer research often did not have friends with advanced lung cancer for more than one year, because in that era, the median survival of patients with advanced lung cancer was only about 8-12 months.
Gene sequencing boosts lung cancer treatment
The situation changed a little after the introduction of the world's first targeted drug for lung cancer in 2002.
The medical field continues the simple and rude out of the past – no matter what advanced lung cancer patients, they are treated with such expensive drugs. "Because it is a targeted drug for oral administration, the side effects of patients are much less and much smaller. 15% of people will have certain side effects, 15% of patients will be effective with this treatment, and the patient's median survival time will be able to The effect of not less than high-dose chemotherapy is achieved, and the survival period is still about 8 months." With more advanced drugs, why is it difficult to get better? Wu Yilong began to think about whether the one-size-fits-all plan that has been used all the time has been accurate. After the new treatment weapon, is there any room for improvement in the treatment plan?
The gene sequencing technology at that time was not promoted, and it was impossible to classify existing patients more accurately. Wu Yilong took the lead in distinguishing and classifying lung cancer patients worldwide. For the first time, he distinguished patients according to their gender, whether they smoked, whether the cancer was adenocarcinoma or squamous cell carcinoma. "The results are still very gratifying. First, the treatment response of men and women to targeted drugs is different, especially those who do not smoke, the treatment effect of this population has suddenly increased to more than 40%." A significant proportion of patients with advanced lung cancer can receive a less painful and better treatment.
A simple and rude drug cures all lung cancer patients until the popularization and application of gene sequencing technology in 2004, which has fundamentally changed. The medical field is beginning to be able to apply genotyping techniques to molecularly analyze lung cancer patients by molecular typing.
“We are the earliest treatment team in the country to apply this technology. We have established our own laboratory in China and have a number of patents.†Wu Yilong said that with patented technology, the team can carry out a large number of genetic screening, one sequencing can 40-50 gene mutations were detected. Being able to study lung cancer from a more microscopic layer, the research team began to sequence more than 500 confirmed lung cancer patients one by one, the results found a significant difference between smoking and non-smoking patients, but also found Chinese cancer patients and European and American white lung cancer patients The clear difference.
The EGFR mutations in non-smokers are very high. The EGFR mutation rate in Chinese, especially Chinese women, is very high. More than 40% of these patients have this point mutation clearly, while the European and American whites have a mutation rate lower than 10 %.
“The first major discovery of the research was to use our own patented technology to find the difference in the genetic variation of lung cancer among Chinese and European races. So we decided to join seven countries and regions in the Asia-Pacific region, Japan, South Korea, Hong Kong, Taiwan, Thailand. A number of international organizations have joined forces to conduct a special study on East Asian ethnic groups. For the first time, the ratio of EGFR gene mutations in East Asian ethnic groups has been clarified. It does account for a high proportion of non-smoking lung cancer patients. We finally found the drawbacks of the previous one-size-fits-all treatment. The efficiency of the first-generation molecular-targeted drugs has suddenly increased to 71%." Wu Yilong said that in order to confirm this discovery, the team has conducted three special studies to repeat the verification, and the results are equally gratifying. “Repetitive verification found that the effective rate of treatment for patients with EGFR mutant lung cancer reached 75%, and the median survival time for patients with advanced lung cancer was suddenly increased to 29 months.†The conclusion immediately caused a global sensation. International peers have identified a few milestones in the field of lung cancer treatment.
"The 25 global lung cancer guidelines have promoted our research as a standard and have set the gold standard for Chinese lung cancer treatment."
In fact, this is not the first time that Wu Yilong’s team has provided standardized medical treatment guidelines for patients with lung cancer worldwide. In the subsequent drug resistance study, the team once again provided another global treatment specification.
Extend patient survival to 40 months
However, the first-generation targeted drugs are good, and the second generation is worth mentioning. After the patients use targeted drugs, there will always be a loss of efficacy and a malignant tumor that continues to be uncontrolled. Tumors are resistant, and drug resistance can show very different symptoms.
"Some patients, part of the metastatic cancer grows fast, and some of them are well controlled. This phenomenon we call time and space heterogeneity." Wu Yilong said that in the past studies of malignant tumors, always think of all cancer cells They were all split by the same grandfather, and his team first described the state of cancer that is different from international conclusions. It is metastatic cancer of lung cancer and advanced lung cancer patients, which may be derived from other cancer cell ancestors. , or the initial cancer cells showed changes and re-variation during the process of differentiation.
With theoretical support, coupled with more targeted differentiation and treatment of drug-resistant patients, the team has also achieved good results in dealing with the drug resistance of lung cancer patients. "We found that in patients with genetic mutations, half of the patients will have a mutation in the T790M site after taking the targeted drug for a long time. After the targeted application of new drug therapy, their median survival will be repeated. It was extended by 11 months. One hour after the publication of the relevant study at the World Lung Cancer Congress, the world's leading medical journal New England immediately published this conclusion online. It has been valued and cited by the lung cancer treatment fields in various countries, and the application value of the third-generation molecular targeted drugs is clear.
"From the initial survival of only 8 months, to the subsequent survival of 29 months, and now can survive for more than 40 months, such research results undoubtedly have great effects," Wu Yilong said, in the current national new year Half of the 720,000 lung cancer patients can prolong their survival to 29 months through first- and second-generation targeted drugs, and half of them can extend their survival to 40 months through three-generation targeted drugs. Said huge. “This means that hundreds of thousands of Chinese lung cancer patients have a longer survival period and are able to wait for an updated treatment plan during treatment.â€
Lung cancer is currently the most common malignant tumor in the world, with about 1.6 million people dying each year.
Fifteen years ago, the survival rate of end-stage lung cancer was at most 8 months. Currently, approximately half of non-smoking female adenocarcinoma patients survive an average of 40 months, even in the terminal phase.
The study found that non-smoking patients have very high EGFR mutations. Chinese people, especially Chinese women, have a very high EGFR mutation rate. More than 40% of patients clearly have this point mutation, while European and American whites have a mutation rate of less than 10%. .
Fifteen years ago, when the global medical field used burning and killing for advanced lung cancer, the survival rate of end-stage lung cancer was at most 8 months. After 15 years, about half of non-smoking female adenocarcinoma patients survive for an average of 40 months even in the terminal phase, and the drug side effects during survival are small and do not affect normal life. A series of new treatments have been adopted by 15 countries and 25 international guides. All of this came from a research and exploration by a lung cancer research team from the People's Hospital of Guangdong Province. At the just-concluded “China Medical Science and Technology Awards Conferenceâ€, Wu Yilong, a professor of the Guangdong Provincial People's Hospital, won the first prize of the highest award for his project “Building and Popularizing and Applying the Targeted Precision Treatment Model for Lung Cancerâ€.
Patients with advanced lung cancer live for a year
Lung cancer is currently the most common malignant tumor in the world, with about 1.6 million people dying each year. But for a long period of time, modern medicine has few ways to treat lung cancer, especially advanced lung cancer. "Since the oncology, a global feature has been found, that is, lung cancer patients are mostly in the middle and late stages, accounting for more than 50% of all lung cancer. Taking the data of China in recent years as an example, among the 720,000 lung cancer patients every year, There are 360,000 patients who are advanced patients, which has gradually become a very serious social problem." Wu Yilong said that for such patients, even in the early 21st century, there were not many methods on a global scale. Taking indiscriminate and high-dose radiotherapy and chemotherapy, under the guiding ideology of "have a mistake," the advanced lung cancer treatment at that time was inefficient, and the overall efficiency was as low as 20%-30%. That is, about one-third of patients are effective with this therapy, while other 2/3 patients with advanced lung cancer have no effect after suffering enormous treatment pain.
Even if one-third of the patients are effective, the cost is very huge. Radioactive pneumonia caused by high-dose radiotherapy, hair loss caused by high-dose toxic chemotherapy substances, poor appetite, white blood cells dropped to dangerous, extremely low level... "In the treatment, most patients will appear more than 3 Degree, seriously affecting the lives of patients, need side effects of hospitalization control." Wu Yilong said that for a long time, medical experts who specialize in lung cancer research often did not have friends with advanced lung cancer for more than one year, because in that era, the median survival of patients with advanced lung cancer was only about 8-12 months.
Gene sequencing boosts lung cancer treatment
The situation changed a little after the introduction of the world's first targeted drug for lung cancer in 2002.
The medical field continues the simple and rude out of the past – no matter what advanced lung cancer patients, they are treated with such expensive drugs. "Because it is a targeted drug for oral administration, the side effects of patients are much less and much smaller. 15% of people will have certain side effects, 15% of patients will be effective with this treatment, and the patient's median survival time will be able to The effect of not less than high-dose chemotherapy is achieved, and the survival period is still about 8 months." With more advanced drugs, why is it difficult to get better? Wu Yilong began to think about whether the one-size-fits-all plan that has been used all the time has been accurate. After the new treatment weapon, is there any room for improvement in the treatment plan?
The gene sequencing technology at that time was not promoted, and it was impossible to classify existing patients more accurately. Wu Yilong took the lead in distinguishing and classifying lung cancer patients worldwide. For the first time, he distinguished patients according to their gender, whether they smoked, whether the cancer was adenocarcinoma or squamous cell carcinoma. "The results are still very gratifying. First, the treatment response of men and women to targeted drugs is different, especially those who do not smoke, the treatment effect of this population has suddenly increased to more than 40%." A significant proportion of patients with advanced lung cancer can receive a less painful and better treatment.
A simple and rude drug cures all lung cancer patients until the popularization and application of gene sequencing technology in 2004, which has fundamentally changed. The medical field is beginning to be able to apply genotyping techniques to molecularly analyze lung cancer patients by molecular typing.
“We are the earliest treatment team in the country to apply this technology. We have established our own laboratory in China and have a number of patents.†Wu Yilong said that with patented technology, the team can carry out a large number of genetic screening, one sequencing can 40-50 gene mutations were detected. Being able to study lung cancer from a more microscopic layer, the research team began to sequence more than 500 confirmed lung cancer patients one by one, the results found a significant difference between smoking and non-smoking patients, but also found Chinese cancer patients and European and American white lung cancer patients The clear difference.
The EGFR mutations in non-smokers are very high. The EGFR mutation rate in Chinese, especially Chinese women, is very high. More than 40% of these patients have this point mutation clearly, while the European and American whites have a mutation rate lower than 10 %.
“The first major discovery of the research was to use our own patented technology to find the difference in the genetic variation of lung cancer among Chinese and European races. So we decided to join seven countries and regions in the Asia-Pacific region, Japan, South Korea, Hong Kong, Taiwan, Thailand. A number of international organizations have joined forces to conduct a special study on East Asian ethnic groups. For the first time, the ratio of EGFR gene mutations in East Asian ethnic groups has been clarified. It does account for a high proportion of non-smoking lung cancer patients. We finally found the drawbacks of the previous one-size-fits-all treatment. The efficiency of the first-generation molecular-targeted drugs has suddenly increased to 71%." Wu Yilong said that in order to confirm this discovery, the team has conducted three special studies to repeat the verification, and the results are equally gratifying. “Repetitive verification found that the effective rate of treatment for patients with EGFR mutant lung cancer reached 75%, and the median survival time for patients with advanced lung cancer was suddenly increased to 29 months.†The conclusion immediately caused a global sensation. International peers have identified a few milestones in the field of lung cancer treatment.
"The 25 global lung cancer guidelines have promoted our research as a standard and have set the gold standard for Chinese lung cancer treatment."
In fact, this is not the first time that Wu Yilong’s team has provided standardized medical treatment guidelines for patients with lung cancer worldwide. In the subsequent drug resistance study, the team once again provided another global treatment specification.
Extend patient survival to 40 months
However, the first-generation targeted drugs are good, and the second generation is worth mentioning. After the patients use targeted drugs, there will always be a loss of efficacy and a malignant tumor that continues to be uncontrolled. Tumors are resistant, and drug resistance can show very different symptoms.
"Some patients, part of the metastatic cancer grows fast, and some of them are well controlled. This phenomenon we call time and space heterogeneity." Wu Yilong said that in the past studies of malignant tumors, always think of all cancer cells They were all split by the same grandfather, and his team first described the state of cancer that is different from international conclusions. It is metastatic cancer of lung cancer and advanced lung cancer patients, which may be derived from other cancer cell ancestors. , or the initial cancer cells showed changes and re-variation during the process of differentiation.
With theoretical support, coupled with more targeted differentiation and treatment of drug-resistant patients, the team has also achieved good results in dealing with the drug resistance of lung cancer patients. "We found that in patients with genetic mutations, half of the patients will have a mutation in the T790M site after taking the targeted drug for a long time. After the targeted application of new drug therapy, their median survival will be repeated. It was extended by 11 months. One hour after the publication of the relevant study at the World Lung Cancer Congress, the world's leading medical journal New England immediately published this conclusion online. It has been valued and cited by the lung cancer treatment fields in various countries, and the application value of the third-generation molecular targeted drugs is clear.
"From the initial survival of only 8 months, to the subsequent survival of 29 months, and now can survive for more than 40 months, such research results undoubtedly have great effects," Wu Yilong said, in the current national new year Half of the 720,000 lung cancer patients can prolong their survival to 29 months through first- and second-generation targeted drugs, and half of them can extend their survival to 40 months through three-generation targeted drugs. Said huge. “This means that hundreds of thousands of Chinese lung cancer patients have a longer survival period and are able to wait for an updated treatment plan during treatment.â€
Let Chinese patients use good medicine
Targeted drugs have been widely used and incorporated into China's essential drug list. After almost every province has been included in the scope of medical insurance reimbursement drugs, the original expensive targeted drugs are also in the form of national procurement and state negotiations. A substantial price cut was obtained. "The original drug cost of more than 10,000 yuan a month, the current cost has been reduced by half, and basically the scope of medical insurance can be reimbursed." In Wu Yilong's view, recommending good drugs to the right patients is their work. The main part, but another more meaningful job is to make more patients with lung cancer affordable.
The global multi-center research of the three generations of drugs carried out by the Guangdong Provincial People's Hospital team has basically achieved global synchronization. “Only after more than 2 years of clinical research, and with solid and credible data, the State Food and Drug Administration has quickly entered the data verification stage. The third-generation targeted drugs will certainly be listed in China this year, making it domestic and foreign. The treatment of lung cancer has reached a synchronization in drug use," Wu Yilong said. In the past, China's introduction process for international drugs generally took about five years.
Targeted drugs have been widely used and incorporated into China's essential drug list. After almost every province has been included in the scope of medical insurance reimbursement drugs, the original expensive targeted drugs are also in the form of national procurement and state negotiations. A substantial price cut was obtained. "The original drug cost of more than 10,000 yuan a month, the current cost has been reduced by half, and basically the scope of medical insurance can be reimbursed." In Wu Yilong's view, recommending good drugs to the right patients is their work. The main part, but another more meaningful job is to make more patients with lung cancer affordable.
The global multi-center research of the three generations of drugs carried out by the Guangdong Provincial People's Hospital team has basically achieved global synchronization. “Only after more than 2 years of clinical research, and with solid and credible data, the State Food and Drug Administration has quickly entered the data verification stage. The third-generation targeted drugs will certainly be listed in China this year, making it domestic and foreign. The treatment of lung cancer has reached a synchronization in drug use," Wu Yilong said. In the past, China's introduction process for international drugs generally took about five years.
It is gratifying to note that the current domestic pharmaceutical manufacturers and research and development institutions have also joined the research and development team for lung cancer treatment drugs. "Whether it is a localized product of the third-generation drug, or an updated lung cancer immunotherapy drug, the research of domestic enterprises has achieved very good results in our field. In the field of lung cancer treatment, there will be more and more doctors. Effective means." Wu Yilong said.
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