The status of the treatment of liver cancer:

Liver cancer (liver cancer) is a malignant tumor occurring in the liver, including two kinds of primary liver cancer and metastatic liver cancer. Primary liver cancer is one of the most common malignant tumors in the clinic.

China is a big country of liver cancer, and 460 thousand people are issued every year, accounting for 55% of the world, &ldquo, and &rdquo with Chinese characteristics. Most of the liver cancer in China is caused by HBV infection, and a few of them are associated with alcohol abuse at the end of the night.

Most of the liver cancer patients in China are not found until late. For advanced liver cancer, the treatment that can be taken is very limited. Due to the insensitivity of liver cancer to chemotherapy, surgery and intervention are mainly used in clinical treatment. At present, the only FDA approved targeted drug Nexavar, Nexavar monotherapy for patients with hepatocellular carcinoma HCC can make 2% of the tumor reduced in 30% phase three clinical data show (placebo group 1%), the median survival time was 10.7 months (7.9 months in the placebo group).

Medication reaction: the effective rate of Nexavar is not high, few can shrink the tumor cases, there are indeed some patients can maintain a stable state of tumor don't grow up; in addition, the side effects of Nexavar, mainly in the hand foot skin reaction, hypertension and proteinuria, Nexavar is not cheap.

Nexavar after resistance with no standard therapy, the use of best supportive care can only prolong the survival of 7-8 months.

With the advent of PD-1 inhibitors, patients with liver cancer have come to a new, more hopeful choice.

Checkmate-040 is a clinical trial of OPDIVO for advanced liver cancer.

First, early data:

Recruitment: 51.

Patient recruitment conditions: Nexavar treatment failure, relapse or side effects of intolerance in patients with advanced liver cancer. Most of the patients had extrahepatic metastases, and most of the patients had used Sola Feeney, and the treatment failed.

Drug dose: 0.1mg/kg to 10mg/kg. (it is estimated that 3mg/kg is the best dose of curative effect)

Clinical results: of the estimated 48 patients, 7 patients had a tumor of at least 30%, of which 3 were completely disappearing. The objective remission rate of the disease was 15%.

In addition to the above 7 lucky children, there were 24 patients' tumors that were controlled and no longer developed. Patients with tumor control accounted for 50% of the total number of patients, plus those who had just been relieved objectively. In this clinical trial, the rate of disease control of opdivo for liver cancer reached 65%.

Up to now, the median survival time of patients involved in clinical trials has reached 15.1 months. The 9 month survival rate was 67%, the 12 month survival rate was 59%, and the 18 month survival rate was 48%.

In addition, the activity of opdivo against HCV was also observed in clinical trials.

Side effects: the proportion of side effects associated with treatment is 77%, mainly fatigue, diarrhea, rash, and elevated aminotransferase. The probability of 3-4 serious side effects was only 5.4%.

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Two. Clinical data update: how long is opdivo effective? When will the drug be stopped? Can the curative effect be maintained after drug withdrawal?

This year's ASCO conference, the official update of the test data:

Of the 48 patients with liver cancer, 7 of the patients reduced the tumor to at least 30%, of which 3 patients disappeared completely.

In 5 of the 7 patients, the tumor began to shrink within three months, and the other two were fourth months and fifth months, and the tumor began to shrink.

3 patients with complete disappearance of the tumor: one patient with opdivo continued to be effective. The patient used only OPDIVO4 months, and the tumor disappeared after the tumor disappeared, and the dose of opdivo was 3mg/kg. At present, the patient has maintained a non tumor state for 2 years, and continues to maintain the curative effect.

One patient stopped taking medicine 17 months later, the dose was 0.3mg/kg, 5 months after the relapse, and now continue to treat;

The last patient took the drug about 8 months later and died 24 months later, and the cause was unknown.

The duration of the median effect of these 7 patients was 17 months. Once the opdivo is valid, the 50% probability can last for 17 months without recurrence. (patient sample is too small, this data is for reference only)

Three, the clinical results suggest that using Nexavar did not affect Opdivo effect

The researchers analyzed the survival data of 37 patients who used Jimei and 11 patients who did not use many Jimei, and found that the use of multi Jimmy did not affect patients' response to opdivo.

Four. Conclusion

According to the analysis of the clinical data of the patients with hepatocellular carcinoma using opdivo is safe, side effects is relatively high transaminases; the efficiency is high, the disease control rate reached 65%; most of the available patients within 3 months can be observed in tumor size; the median survival of patients can reach 15 months. Much better than the conventional treatments currently in clinical treatment to hepatocellular carcinoma. If the economic conditions are grudgingly, 3 months can be a good choice.

At present, Opdivo has not yet been listed on the mainland of China, and patients who want to get the drug can only be purchased from the United States or Hongkong through overseas channels. Hangzhou Health Management Co., Ltd. provides an overseas medical direct train to help patients travel to cost-effective medical institutions.

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