CSCO guidelines for metastatic colorectal cancer:personalized medicine in clinical practice

Colorectal cancer(CRC)is the second most common cancer in China,the morbidity and mortality rates of which are rapidly increasing1,2.Among newly-diagnosed CRC patients,20%have metastatic disease at the time of presentation and an additional 25%present with localized disease and will subsequently develop metastases3.The treatment of metastatic colorectal cancer(mCRC)is gradually moving towards the era of precision therapy,which involves guided treatment based on individual genetic characteristics4.Since the first edition of the Chinese Society of Clinical Oncology(CSCO)guidelines was published in 2017,the guidelines have been updated annually according to the latest clinical trial findings5-9.Herein we summarize how the CSCO guidelines enable tailor-made treatments of mCRC with different molecular characteristics(Figure 1).

Cancer immunotherapy in clinical practice—the past,present,and future

Considerable progress has been made in the field of cancer immunotherapy in recent years. This has been made possible in large part by the identification of new immune-based cellular targets and the development of novel approaches aimed at stimulating the immune system. The role played by the immunosuppressive microenvironment in the development of tumors has been established. The success of checkpoint-inhibiting antibodies and cancer vaccines has marked the beginning of a new era in cancer treatment. This review highlights the clinically relevant principles of cancer immunology and various immunotherapeutic approaches that have either already entered mainstream oncologic practice or are currently in the process of being evaluated in clinical trials. Furthermore, the current barriers to the development of effective immunotherapies and the potential strategies of overcoming them are also discussed.

Gastric cancer： current and evolving treatment landscape

Gastric(including gastroesophageal junction) cancer is the third leading cause of cancer-related death in the world.In China,an estimated 420,000 patients were diagnosed with gastric cancer in 2011,ranking this malignancy the second most prevalent cancer type and resulting in near 300,000 deaths.The treatment landscape of gastric cancer has evolved in recent years.Although systemic chemotherapy is still the mainstay treatment of metastatic disease,the introduction of agents targeting human epidermal growth factor receptor 2 and vascular endothelial growth factor/vascular endothelia growth factor receptor has brought this disease into the molecular and personalized medicine era.The preliminary yet encouraging clinical efficacy observed with immune checkpoint inhibitors,e.g.,anti-programmed cell death protein 1/programmed death-ligand 1,will further shape the treatment landscape for gastric cancer.Molecular characterization of patients will play a critical role in developing new agents,as well as in implementing new treatment options for this disease.

Immunotherapy for Gastrointestinal Malignancies

Gastrointestinal (GI) malignancies (esophageal, gastric, pancreatic, intra- and extra-biliary ductal, hepatocellular, and colorectal cancers) are an important cause of cancer incidence and mortality in the US and globally. GI cancers account for 15.4% and 23.8% of incident cancers and cancer-related deaths respectively in the US alone. Although earlier diagnosis and treatment advances have improved outcomes for some GI malignancies, the need for improved therapies in all disease phases (adjuvant, neoadjuvant and advanced) is paramount. Utilization of monoclonal antibodies targeting against vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) has shown the success in selected colorectal carcinoma patients. More investigations of immunotherapy are on going in the treatment of GI malignances with different mechanisms and methods. In this article, we review data for established and evolving immunotherapy-related treatment options in GI malignancies.

Molecular subtypes of colorectal cancer:Evaluation of outcomes and treatment

Colorectal cancer(CRC) is a biologically heterogeneous disease with diverse clinical outcomes and responses to treatment. In the past two to three decades, a major effort has focused on classifying colorectal cancer subtypes based on causation, etiology, gene expression profiles, different pathways, and translational data from clinical trials. The goal is to uncover prognostic and predictive factors for outcomes in patients with colorectal cancer and to guide therapeutic approaches and management for the improvement of overall survival. Significant advances have been achieved in this area. However, tremendous work is still needed to accomplish the goal of better understanding intratumoral heterogeneity and the influence of the colonic environment, among other facets of colorectal cancer.

互联网数据中心如何“智”冷

自1996年“Internet Data Center”概念被提出以来,我国IDC行业从无到有,先后经过PC门户网站、移动互联网、云计算阶段,互联网数据中心(以下简称“数据中心”)特性也随之不断演进,“简单机房+粗糙运营”不复存在,“专业设备+规范运维”的传统数据中心也逐渐无法满足当前需求。