The deteriorated degradation resistance of Mg alloy microtubes for vascular stent under the coupling effect of radial compressive stress and dynamic medium

The degradation of Mg alloys relates to the service performance of Mg alloy biodegradable implants.In order to investigate the degradation behavior of Mg alloys as vascular stent materials in the near service environment,the hot-extruded fine-grained Mg-Zn-Y-Nd alloy microtubes,which are employed to manufacture vascular stents,were tested under radial compressive stress in the dynamic Hanks'Balanced Salt Solution(HBSS).The results revealed that the high flow rate accelerates the degradation of Mg alloy microtubes and its degradation is sensitive to radial compressive stress.These results contribute to understanding the service performance of Mg alloys as vascular stent materials.

Large-scale particle trapping by acoustic vortices with a continuously variable topological charge

Strengthened directivity with higher-order side lobes can be generated by the transducer with a larger radius at a higher frequency. The multi-annular pressure distributions are displayed in the cross-section of the acoustic vortices(AVs)which are formed by side lobes. In the near field, particles can be trapped in the valley region between the two annuli of the pressure peak, and cannot be moved to the vortex center. In this paper, a trapping method based on a sector transducer array is proposed, which is characterized by the continuously variable topological charge(CVTC). This acoustic field can not only enlarge the range of particle trapping but also improve the aggregation degree of the trapped particles. In the experiments, polyethylene particles with a diameter of 0.2 mm are trapped into the multi-annular valleys by the AV with a fixed topological charge. Nevertheless, by applying the CVTC, particles outside the radius of the AV can cross the pressure peak successfully and move to the vortex center. Theoretical studies are also verified by the experimental particles trapping using the AV with the continuous variation of three topological charges, and suggest the potential application of large-scale particle trapping in biomedical engineering.

来那度胺治疗淋巴瘤中国专家共识(2024年版)

来那度胺作为一种免疫调节性药物,在惰性B细胞淋巴瘤治疗中具有显著活性。基于淋巴瘤病理类型复杂、疾病分子遗传学异常和临床表现异质性强的特点,来那度胺在其他类型尤其是侵袭性淋巴瘤中的应用尚存争议。中国抗癌协会淋巴瘤专业委员会结合多项前瞻性临床研究及真实世界的数据制订了本共识,详细介绍了来那度胺在常见惰性和侵袭性淋巴瘤治疗中的疗效、用药方法、不良反应和特殊人群的剂量调整以及注意事项等,旨在为临床医生规范合理使用来那度胺治疗淋巴瘤患者提供指导和帮助。

HOXD3在乳腺癌细胞干性和化疗耐药性中的作用及机制研究

目的:探讨HOXD3表达对乳腺癌细胞干性的影响,并研究HOXD3表达与乳腺癌细胞化疗耐药的关系。方法:收集2006年1月至2008年12月哈尔滨医科大学附属肿瘤医院87例乳腺癌患者组织标本。采用免疫组织化学染色法检测乳腺癌细胞和组织中HOXD3表达;采用RT-PCR、Western blot和免疫荧光染色法检测HOXD3在顺铂或阿霉素耐药细胞系MDA-MB-231和MDA-MB-435中的表达水平,分析HOXD3过表达对乳腺癌细胞系MDA-MB-231和MDA-MB-435的干细胞生物标志物表达水平的影响;采用MTT法和集落形成实验分析HOXD3在乳腺癌细胞化疗耐药中的作用。结果:乳腺癌组织中HOXD3 m RNA相对表达量显著高于癌旁正常组织,乳腺癌细胞系MDA-MB-231、MDA-MB-435和MCF-7的HOXD3 m RNA相对表达量均高于正常乳腺上皮细胞系MCF-10A(均P<0.05)。顺铂或阿霉素耐药的细胞系MDA-MB-231和MDA-MB-435的半抑制浓度(half maximal inhibi-tory concentration,IC50)分别为(20.82±0.05)μmol/L和(19.69±0.47)μmol/L,或(32.26±0.23)mmol/L和(26.08±0.55)mmol/L,均高于对应原始细胞系(均P<0.05);耐药倍数分别为2.47和3.10倍,或1.86和2.08倍。HOXD3过表达MDA-MB-231、MDA-MB-435的肿瘤球体数目、干细胞生物标志物的表达水平均明显增加(均P<0.05)。结论:HOXD3过表达对乳腺癌细胞干性的维持及化疗耐药性的发生发挥重要的作用,为制定针对肿瘤干细胞的分子靶向治疗提供理论参考。

滤泡淋巴瘤的分子靶向及免疫治疗新进展

滤泡淋巴瘤(follicular lymphoma,FL)为最常见的惰性非霍奇金淋巴瘤(non-Hodgkin lymphoma,NHL),其5年生存率较高,但多数患者最终会发展成为复发/难治性淋巴瘤。其特点为进展缓慢,且晚期较难治愈。因此,治疗策略目标为高疗效及低毒性。基于各种新型药物的不断出现,FL患者的预后得到改善。目前的临床研究结果中,具有良好活性的分子靶向药物包括BTK抑制剂、PI3K抑制剂、Bcl-2抑制剂、EZH2抑制剂等。此外,免疫调节药物,如来那度胺、GA101、CAR-T、PD-1、抗体-药物结合物以及双特异性抗体等均显示出较好的治疗效果,为改善FL患者的预后提供新的可能。免疫治疗需考虑药物不良反应,以选择合适方式减轻毒性。本文就FL免疫治疗及分子靶向治疗的新进展进行综述。

Application of next-generation sequencing technology to precision medicine in cancer: joint consensus of the Tumor Biomarker Committee of the Chinese Society of Clinical Oncology

Next-generation sequencing(NGS) technology is capable of sequencing millions or billions of DNA molecules simultaneously.Therefore, it represents a promising tool for the analysis of molecular targets for the initial diagnosis of disease, monitoring of disease progression, and identifying the mechanism of drug resistance. On behalf of the Tumor Biomarker Committee of the Chinese Society of Clinical Oncology(CSCO) and the China Actionable Genome Consortium(CAGC), the present expert group hereby proposes advisory guidelines on clinical applications of NGS technology for the analysis of cancer driver genes for precision cancer therapy. This group comprises an assembly of laboratory cancer geneticists, clinical oncologists, bioinformaticians,pathologists, and other professionals. After multiple rounds of discussions and revisions, the expert group has reached a preliminary consensus on the need of NGS in clinical diagnosis, its regulation, and compliance standards in clinical sample collection. Moreover, it has prepared NGS criteria, the sequencing standard operation procedure(SOP), data analysis, report, and NGS platform certification and validation.

Chinese Society of Clinical Oncology(CSCO) diagnosis and treatment guidelines for malignant lymphoma 2021(English version)

1. General guidelines2. Diagnosis3. Staging4. Treatment4.1 Diffuse large B-cell lymphoma(DLBCL)4.2 Follicular lymphoma(FL)4.3 Mantle cell lymphoma(MCL)4.4 Marginal zone lymphoma(MZL)4.5 Burkitt lymphoma(BL)4.6 CLL/Small lymphocytic lymphoma(SLL)4.7 Extra-nodal natural killer/T-cell lymphoma(ENKTCL), nasal type4.8 Peripheral T-cell lymphoma(PTCL)4.9 HL4.10 Primary central nervous system lymphoma5. Prognosis Lymphomas are a group of heterogeneous diseases.

Current management of chemotherapy-induced neutropenia in adults:key points and new challenges

Chemotherapy-induced neutropenia(CIN)is a potentially fatal and common complication in myelosuppressive chemotherapy.The timing and grade of CIN may play prognostic and predictive roles in cancer therapy.CIN is associated with older age,poor functional and nutritional status,the presence of significant comorbidities,the type of cancer,previous chemotherapy cycles,the stage of the disease,specific chemotherapy regimens,and combined therapies.There are many key points and new challenges in the management of CIN in adults including:(1)Genetic risk factors to evaluate the patient’s risk for CIN remain unclear.However,these risk factors urgently need to be identified.(2)Febrile neutropenia(FN)remains one of the most common reasons for oncological emergency.No consensus nomogram for FN risk assessment has been established.(3)Different assessment tools[e.g.,Multinational Association for Supportive Care in Cancer(MASCC),the Clinical Index of Stable Febrile Neutropenia(CISNE)score model,and other tools]have been suggested to help stratify the risk of complications in patients with FN.However,current tools have limitations.The CISNE score model is useful to support decision-making,especially for patients with stable FN.(4)There are still some challenges,including the benefits of granulocyte colony stimulating factor treatment and the optimal antibiotic regimen in emergency management of FN.In view of the current reports,our group discusses the key points,new challenges,and management of CIN.

Exploratory clinical study of chidamide,an oral subtype-selective histone deacetylase inhibitor,in combination with exemestane in hormone receptor-positive advanced breast cancer

Objective: The recurrence or progression under endocrine therapy in hormone receptor-positive(HR+)advanced breast cancer(ABC) remained a critical clinical challenge.Chidamide is an oral subtype-selective histone deacetylase(HDAC) inhibitor with multiple functions in tumor growth inhibition and microenvironment modulation via epigenetic reprogramming.The purpose of this study was to evaluate the safety,pharmacokinetics(PK),and preliminary efficacy of chidamide in combination with exemestane in HR+ ABC patients.Methods: Eligible patients were postmenopausal women with HR+ ABC recurrent or progressed to at least one endocrine therapy.Blood samples were obtained in the run-in period and the first day of combination treatment for PK analysis.In combination treatment,patients were given exemestane 25mg daily and chidamide 30mg twice a week(BIW) until progression of disease or intolerable toxicities.A treatment cycle was defined as 4 weeks.Safety,PK parameters,and preliminary efficacy were evaluated.Results: A total of 20 patients were enrolled between July and December,2015.The median number of treatments cycle was 5.2(20.8 weeks) with 2 patients still on treatment at the data cut-off date of October,2017.The treatment-related adverse events(AE) ≥ grade 3 in more than 2 patients were neutropenia(35%),thrombocytopenia(30%),and leucopenia(20%).The plasma exposure of exemestane was consistent in the presence or absence of chidamide.A slight increase in chidamide exposure was noted in the presence of exemestane,probably due to the inter-and intra-patient variations.The best response in 16 evaluable patients was assessed by Response Evaluation Criteria in Solid Tumors(RECIST),including 4 patients with partial response,10 patients with stable disease.The median progression-free survival(PFS) was 7.6 months.Conclusions: The combination of chidamide with exemestane was generally well tolerated with promising preliminary efficacy in HR+ ABC patients.The overall results from this study encourage further pivotal trial in this patient population.

Phase 1 studies comparing safety, tolerability, pharmacokinetics and pharmacodynamics of HLX01(a rituximab biosimilar) to reference rituximab in Chinese patients with CD20-positive B-cell lymphoma

Objective: This study aimed to compare the pharmacokinetic, pharmacodynamic and safety profiles of HLX01(a rituximab biosimilar) and reference rituximab sourced from China(Mab Thera?;rituximab-CN).Methods: Here we report the results of two phase 1 studies. In the phase 1 a, open-label, dose-escalation study(NCT03218072, CTR20140400), eligible patients received 250, 375 and 500 mg/m^(2) HLX01 sequentially at 7-day intervals, after confirming no dose-limiting toxicity(DLT). In the phase 1 b, double-blind study(NCT02584920,CTR20140764), eligible patients were given a single dose of 375 mg/m^(2) HLX01 or rituximab-CN. The primary endpoints included safety and tolerability parameters for the phase 1 a and the area under the plasma concentrationtime curve from time zero to day 91(AUC0-91 d) for the phase 1 b study. Equivalence was concluded if 90%confidence interval(90% CI) for the geometric least squares mean ratio(GLSMR) fell in the pre-specified equivalence criteria(80%-125%).Results: Between June 20, 2014 and January 5, 2015, 12 patients were enrolled in the phase 1 a study. The pharmacokinetics of HLX01 showed dose proportionality and accumulation to steady state. HLX01 was well tolerated, with no serious adverse events(AEs), discontinuations or DLTs. Between November 8, 2014 and August13, 2015, 87 eligible patients were enrolled in the phase 1 b study, including 43 who received HLX01 and 44 who were treated with rituximab-CN. The equivalence endpoint was met with GLSMR for AUC0-91 d being 89.6%(90% CI: 80.4%-99.8%). AEs, anti-drug antibodies, and CD19+ and CD20+ B lymphocyte counts were similar between the HLX01 and rituximab-CN treatment groups.Conclusions: Treatment with HLX01 was safe and well tolerated in Chinese patients with B-cell lymphoma.HLX01 and rituximab-CN have similar pharmacokinetic, pharmacodynamic and safety profiles.

A multi-center,open-label,randomized,parallel-controlled phase II study comparing pharmacokinetic,pharmacodynamics and safety of ripertamab(SCT400)to rituximab(Mab Thera?)in patients with CD20-positive B-cell non-Hodgkin lymphoma

Objective:This multi-center,open-label,randomized,parallel-controlled phaseⅡstudy aimed to compare the pharmacokinetics(PK),pharmacodynamics(PD)and safety profile of ripertamab(SCT400),a recombinant antiCD20 monoclonal antibody,to rituximab(MabThera^(■))in patients with CD20-positive B-cell non-Hodgkin lymphoma(NHL).Methods:Patients with CD20-positive B-cell NHL who achieved complete remission or unconfirmed complete remission after standard treatment were randomly assigned at a 1:1 ratio to receive a single dose of ripertamab(375mg/m^(2))or rituximab(MabThera^(■),375 mg/m^(2)).PK was evaluated using area under the concentration-time curve(AUC)from time 0 to d 85(AUC_(0-85d)),AUC from time 0 to week 1(AUC0-1 w),AUC from time 0 to week 2(AUC_(0-2 w)),AUC from time 0 to week 3(AUC_(0-3 w)),AUC from time 0 to week 8(AUC_(0-8 w)),maximum serum concentration(C_(max)),terminal half-life(T_(1/2)),time to maximum serum concentration(T_(max))and clearance(CL).Bioequivalence was confirmed if the 90%confidence interval(90%CI)of the geometric mean ratio of ripertamab/rituximab was within the pre-defined bioequivalence range of 80.0%-125.0%.PD,immunogenicity,and safety were also evaluated.Results:From December 30,2014 to November 24,2015,a total of 84 patients were randomized(ripertamab,n=42;rituximab,n=42)and the PK analysis was performed on 76 patients(ripertamab,n=38;rituximab,n=38).The geometric mean ratios of ripertamab/rituximab for AUC_(0-85d),ATC_(0-inf),and Cmaxwere 96.1%(90%CI:87.6%-105.5%),95.9%(90%CI:86.5%-106.4%)and 97.4%(90%CI:91.6%-103.6%),respectively.All PK parameters met the pre-defined bioequivalence range of 80.0%-125.0%.For PD and safety evaluation,there was no statistical difference in peripheral CD 19-positive B-cell counts and CD20-positive B-cell counts at each visit,and no difference in the incidence of anti-drug antibodies was observed between the two groups.The incidences of treatment-emergent adverse events and treatment-related adverse events were also comparable between the two groups.Conclusions:In this study,the PK,PD,immunogenicity,and safety profile of ripertamab(SCT400)were similar to rituximab(MabThera^(■))in Chinese patients with CD20-positive B-cell NHL.

The prognostic value of programmed cell death ligand 1expression in non-Hodgkin lymphoma:a meta-analysis

Objective: Although the prognostic value of programmed cell death-ligand 1(PD-L1) expression in non-Hodgkin lymphoma(NHL) has been evaluated in many studies, the results remain controversial. To investigate the prognostic role of PD-L1 expression and the association between PD-L1 expression and clinicopathological features of NHL, we performed a meta-analysis.Methods: The Pub Med, EMBASE, and Cochrane Library databases were searched up to November 30, 2017. The hazard ratio(HR), 95% confidence interval(CI), and odds ratios(OR) with 95% CIs were combined to evaluate the association of PD-L1 expression with overall survival(OS) and clinicopathological features. Review manager 5.3 and STATA 12.0 were used in this meta-analysis.Results: A total of 2,005 patients across nine studies were enrolled in our meta-analysis, and the pooled results showed that high PD-L1 expression was associated with a poor prognosis(HR=2.04, 95% CI: 1.18–3.54, P=0.01). In the subgroup analysis according to histology types, pooled results demonstrated that an increased PD-L1 expression was an unfavorable prognostic factor for diffuse large B-cell lymphoma(HR=1.92, 95% CI: 1.06–3.48, P=0.03) but not for natural killer/T-cell lymphoma(HR=2.41, 95%CI: 0.47–12.22, P=0.29). Pooled ORs indicated that PD-L1 expression was higher in NHL with international prognostic indices of≥3. However, PD-L1 expression had no correlation with gender, age, disease stage, lactate dehydrogenase level, B symptoms, and germinal center B-cell-like lymphoma.Conclusions: High PD-L1 expression was a poor prognostic biomarker in patients with NHL. Because of our limited sample size,high-quality studies with larger sample sizes are needed to validate our results.

In situ quantification of NO synthesis in a warm air glow discharge by WMS-based Mid-IR QCL absorption spectroscopy

Nitric oxide(NO)is one of the most crucial products in the plasma-based nitrogen fixation process.In this work,in situ measurements were performed for quantifying the NO synthesis spatially in a warm air glow discharge,through the method of Mid-infrared quantum cascade laser absorption spectroscopy(QCL-AS).Two ro-vibrational transitions at 1900.076 cm^(-1) and 1900.517 cm^(-1) of the ground-state NO(X)were probed sensitively by the help of the wavelength modulation spectroscopy(WMS)approach to increase the signal/noise(S/N)level.The results show a decline trend of NO synthesis rate along the discharge channel from the cathode to the anode.However,from the point of energy efficiency,the cathode region is of significantly low energy efficiency of NO production.Severe disproportionality was found for the high energy consumption but low NO production in the region of cathode area,compared to that in the positive column zone.Further analysis demonstrates the high energy cost of NO production in the cathode region,is ascribed to the extremely high reduced electric field E/N therein not selectively preferable for the processes of vibrational excitation or dissociation of N_(2) and O_(2) molecules.This drags down the overall energy efficiency of NO synthesis by this typical warm air glow discharge,particularly for the ones with short electrode gaps.Limitations of further improving the energy cost of NO synthesis by variations of the discharge operation conditions,such as discharge current or airflow rate,imply other effective manners able to tune the energy delivery selectively to the NO formation process,are sorely needed.

Entinostat,a classⅠselective histone deacetylase inhibitor,plus exemestane for Chinese patients with hormone receptor-positive advanced breast cancer:A multicenter,randomized,double-blind,placebo-controlled,phase 3 trial

Entinostat plus exemestane in hormone receptor-positive(HR+)advanced breast cancer(ABC)previously showed encouraging outcomes.This multicenter phase 3 trial evaluated the efficacy and safety of entinostat plus exemestane in Chinese patients with HR+ABC that relapsed/progressed after≥1 endocrine therapy.Patients were randomized(2:1)to oral exemestane 25 mg/day plus entinostat(n=235)or placebo(n=119)5 mg/week in 28-day cycles.The primary endpoint was the independent radiographic committee(IRC)-assessed progression-free survival(PFS).The median age was 52(range,28—75)years and 222(62.7%)patients were postmenopausal.CDK4/6 inhibitors and fulvestrant were previously used in 23(6.5%)and 92(26.0%)patients,respectively.The baseline characteristics were comparable between the entinostat and placebo groups.The median PFS was 6.32(95%CI,5.30—9.11)and 3.72(95%CI,1.91—5.49)months in the entinostat and placebo groups(HR,0.76;95%CI,0.58—0.98;P=0.046),respectively.Grade≥3 adverse events(AEs)occurred in 154(65.5%)patients in the entinostat group versus 23(19.3%)in the placebo group,and the most common grade≥3 treatment-related AEs were neutropenia[103(43.8%)],thrombocytopenia[20(8.5%)],and leucopenia[15(6.4%)].Entinostat plus exemestane significantly improved PFS compared with exemestane,with generally manageable toxicities in HR+ABC(ClinicalTrials.gov#NCT03538171).

China Anti‑Cancer Association(CACA)guidelines for holistic integrative management of lymphoma(version 2022)Lymphoma,Guideline,Diagnosis,Treatment,Holistic integrative medicine

Purpose Lymphoma has become a major threat to human health.Fortunately,the diagnosis and treatment of lymphoma have developed rapidly,and research progress has emerged in an endless stream,with new drugs emerging one after another.These results are constantly rewriting guidelines changing clinical practice,need to be popularized and applied more widely.Methods This guideline has integrated consensuses reached by the Lymphoma Committee of China Anti-Cancer Association(CACA),based on China’s practice,tracking previous results of the most advanced clinical researches,absorbing the latest clinical evidence,and referring to domestic and international lymphoma guidelines.Results This holistic integrative guideline of lymphoma introduces the latest progress in the diagnosis and treatment of different subtypes of lymphoma,guide the clinical application of new drugs,standardized and precise management for lymphoma patients.Conclusions CACA guidelines for holistic integrative management of lymphoma(version 2022)enhance standardization and precision of the management for lymphoma patients in China.

Hepatitis B virus–associated diffuse large B cell lymphoma:epidemiology,biology,clinical features and HBV reactivation

Diffuse large B cell lymphoma(DLBCL)is the most common type of lymphoma in adults with high heterogeneity.Recent studies have manifested that the occurrence and development of DLBCL is related to hepatitis B virus(HBV)infection.As a medium-to-high prevalence area of HBV infection in China,the importance and exact mechanism of HBV infection in the occurrence of DLBCL have attracted considerable attention.HBV-associated DLBCL has unique clinical characteristics,poor treatment effect and inferior prognosis.HBV reactivation caused by DLBCL treatment also needs for constant vigilance.In this review we summarize the current research progress in the epidemiology,pathogenesis,clinical characteristics,HBV reactivation and antiviral therapies of HBV-associated DLBCL,in order to provide reference for clinical diagnosis and treatment.

Efficacy and safety of obinutuzumab for the first-line treatment of follicular lymphoma:a subgroup analysis of Chinese patients enrolled in the phase III GALLIUM study

Backgrounds:GALLIUM is a global phase Ⅲ study that demonstrated significant improvements in progression-free survival(PFS)for obinutuzumab plus chemotherapy(G-chemo)vs.rituximab plus chemotherapy(R-chemo)in previously untreated patients with follicular lymphoma(FL).This study aimed to report the results of a subgroup of patients in China.Methods:Patients were randomized to G-chemo or R-chemo.Responders received maintenance therapy for 2 years or until disease progression.The primary endpoint was investigator(INV)-assessed PFS.Secondary endpoints included the overall response rate(ORR)and complete response rate(CRR)at the end of induction chemotherapy,overall survival(OS),and safety.Results:Overall,58 patients with FL were randomized to the G-chemo(n=25)and R-chemo arms(n=33).The INV-assessed PFS rate at 3 years was 81.8%in the G-chemo arm,vs.70.2%in the R-chemo arm(hazard ratio 0.35;95%confidence interval:0.09-1.34;P=0.1120).The INV-assessed CRRs(without positron emission tomography[PET])in these arms were 24.0%and 21.2%,respectively,whereas the ORRs were 80.0%and 90.9%,respectively.INV-assessed CRR-PET was 52.6%in the G-chemo,vs.60.9%in the R-chemo.Median OS was not reached in either arm.Grade 3 to 5 adverse events were more frequent in the R-chemo arm(97.0%vs.88.0%).Conclusions:The results of this subgroup analysis were consistent with those of the global population,and they suggest that G-chemo has a positive benefit-risk profile in patients from China with FL.Trial registration:ClinicalTrials.gov,No.NCT01332968.

Effect of building interface form on thermal Check foi comfort in gymnasiums in hot and humid climates

The thermal environment and thermal comfort of a building are greatly affected by the desig n of the build ing interface form. Most con temporary architectural designs con sider only the relations between architectural form and architectural beauty. Few studies on the correlati on of architectural form and thermal comfort address the in flue nee of architectural form on thermal comfort and thermal environment. These studies are particularly important for gymnasium architectures located in hot and humid areas, which have high requirements for thermal comfort. This paper presents an experimental investigati on and an an alysis of the effect of the building in terface form of gymnasiums on thermal comfort in hot and humid subtropical regions during summer. Results showed that the influence of the top interface forms on thermal comfort is mainly dominated by the mea n radiant temperature, which could be con trolled to improve thermal comfort. The in fluence of side interface forms on thermal comfort is mainly domi nated by air velocity, and thermal comfort could be improved by promoting natural ventilation on the side interface form design to reduce indoor heat. This research enhanced our understanding of the relation between the in terface form and the thermal comfort of gymnasiums. In addition, this paper provides a theoretical reference for the sustainable design of gymnasiums in hot and humid climates.

CACA Guidelines for Holistic Integrative Management of Breast Cancer

Purpose:Breast cancer is now the most common malignant tumor worldwide.About one-fourth of female cancer patients all over the world sufer from breast cancer.And about one in six female cancer deaths worldwide is caused by breast cancer.In terms of absolute numbers of cases and deaths,China ranks frst in the world.The CACA Guidelines for Holistic Integrative Management of Breast Cancer were edited to help improve the diagnosis and comprehensive treatment in China.Methods:The Grading of Recommendations Assessment,Development and Evaluation(GRADE)was used to classify evidence and consensus.Results:The CACA Guidelines for Holistic Integrative Management of Breast Cancer include the epidemiology of breast cancer,breast cancer screening,breast cancer diagnosis,early breast cancer treatment,advanced breast cancer treatment,follow-up,rehabilitation,and traditional Chinese medicine treatment of breast cancer patients.Conclusion:We to standardize the diagnosis and treatment of breast cancer in China through the formulation of the CACA Guidelines.