2. [Chinese clinical practice guideline for genetic testing in advanced breast cancer (2025 edition)].
Breast cancer is one of the most common malignancies among women in China. According to GLOBOCAN 2022, more than 350,000 new breast cancer cases were diagnosed in China, ranking second among all newly diagnosed cancers in women. Although breast cancer has entered an era of chronic disease management and overall survival has improved substantially, the prognosis of metastatic breast cancer (MBC) remains unsatisfactory. The genome of MBC is characterized by spatiotemporal heterogeneity and may undergo dynamic evolution. With the continuous identification of actionable alterations, targeted therapies guided by genomic testing have emerged as an important approach to improving patient outcomes. Therefore, the implementation of standardized genomic testing in clinical practice has become an urgent priority. While several international and domestic guidelines have recommended genomic testing for MBC, China still lacks detailed technical specifications and clinical pathways tailored to advanced disease in the local healthcare context. Accordingly, it is imperative to establish a guideline for genomic testing in advanced breast cancer that reflects national realities, ensures strong clinical operability, unifies testing standards, and optimizes workflows, thereby expanding access to precision therapy and improving patient prognosis. Against this background, the Breast Cancer Committee of the Chinese Anti-Cancer Association convened a multidisciplinary working group experts. Following predefined methodological procedures-including clinical question prioritization, systematic evidence retrieval, graded evaluation, and formulation of recommendations-the guideline was developed. It integrates the latest evidence with multidisciplinary expert consensus, providing specific recommendations on key aspects of genomic testing for MBC, including patient eligibility, specimen selection, testing methodologies, and prioritization of target genes. In addition, the guideline systematically summarizes available targeted therapeutic strategies for different genomic alterations, and provides graded recommendations based on both levels of evidence and drug accessibility, thereby ensuring clarity and facilitating clinical implementation. This guideline is closely aligned with the realities of clinical practice and drug accessibility in China, with a strong emphasis on the feasibility of testing and the actionability of results. It establishes a multidisciplinary consensus on standardized pathways for genomic testing in patients with MBC, aiming to bridge precision diagnostics and individualized targeted therapy, and to provide practical guidance for improving the standardization of advanced breast cancer care nationwide.
4. [Guideline for diagnosis and comprehensive treatment of colorectal liver metastases (version 2025)].
The liver is the main target organ for hematogenous metastases from colorectal cancer, and colorectal liver metastasis is one of the most difficult and challenging situations in the treatment. In order to improve the diagnosis and comprehensive treatment in China, the Guidelines have been edited and revised for seven times since 2008, including the overall evaluation, personalized treatment goals and comprehensive treatments, to prevent the occurrence of liver metastases, increase the local damage rate of liver metastases, prolong long-term survival, and improve quality of life. The revised Guideline version 2025 includes the diagnosis and follow-up, prevention, multidisciplinary team (MDT), surgery and local ablative treatment, neoadjuvant and adjuvant therapy, comprehensive treatment. The revised Guideline emphasizes precision treatment based on genetic molecular typing, especially recommending immune checkpoint inhibitors for dMMR/MSI-H patients, and enriched local treatment methods, such as liver transplantation, yttrium-90 microsphere selective internal radiotherapy, etc. The revised Guideline includes state-of-the-art experience and findings, detailed content, and strong operability.
7. [Clinical Practice Guidelines for the Management of Brain Metastases from Non-small Cell Lung Cancer with Actionable Gene Alterations in China (2025 Edition)].
Brain metastasis has emerged as a significant challenge in the comprehensive management of patients with non-small cell lung cancer (NSCLC), particularly in those harboring driver gene mutations. Traditional treatments such as radiotherapy and surgery offer limited clinical benefits and are often accompanied by cognitive dysfunction and a decline in quality of life. In recent years, novel small molecule tyrosine kinase inhibitors targeting epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), and other pathways have been developed, effectively penetrating the blood-brain barrier while enhancing intracranial drug concentrations and improving patient outcomes. This advancement has transformed the treatment landscape for brain metastases in NSCLC. Consequently, the Lung Cancer Medical Education Committee of the Chinese Medical Education Association and the Brain Metastasis Collaboration Group of the Lung Cancer Youth Expert Committee of the Beijing Medical Reward Foundation have jointly initiated and formulated the Clinical Practice Guidelines for the Management of Brain Metastases from Non-small Cell Lung Cancer with Actionable Gene Alterations in China (2025 Edition). This guideline integrates the latest research findings with clinical experience, adhering to multidisciplinary treatment principles, and encompasses aspects such as diagnosis, timing of intervention, and systemic and local treatment options for driver gene positive NSCLC brain metastases. Additionally, it proposes individualized treatment strategies tailored to different driver gene types, aiming to provide clinicians with a reference to enhance the overall diagnostic and therapeutic standards for NSCLC brain metastases in China.
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8. [Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer (2024 edition)].
To further standardize lung cancer prevention and treatment measures in China, enhance the quality of diagnosis and treatment, improve patient prognosis, and provide evidence-based medical guidance for clinicians at all levels, the Chinese Medical Association convened experts from respiratory medicine, oncology, thoracic surgery, radiotherapy, imaging, and pathology to develop the Chinese Medical Association's Clinical Diagnosis and Treatment Guidelines for Lung Cancer (2024 edition). This consensus resulted in several updates from the 2023 version. The 2024 guidelines highlight that the risk of lung cancer in smokers remains higher than that of non-smokers even 15 years after quitting. Additionally, a new lung cancer incidence risk model is expected to become a critical tool for screening high-risk groups. In pathology, the guidelines now include pathological evaluation of surgically resected lung cancer specimens following neoadjuvant therapy and suggest that immunohistochemical staining of certain transcription factors may aid in the classification of small cell lung cancer (SCLC). In molecular detection, the guidelines propose simultaneous detection of driver gene variations based on both RNA and DNA from specimens. The new edition also provides detailed descriptions of patient selection and surgical requirements for thoracic sub-lobectomy, aligned with the 9th TNM staging. Moreover, the guidelines expand treatment options, approving more therapies for immunoadjuvant and EGFR-TKI resistant lung cancer patients, as well as additional drug options for advanced non-small cell lung cancer (NSCLC) patients with EGFR mutations, EGFR 20 insertions, ALK fusions, and MET exon 14 skipping. These recommendations are based on state-approved drug applications, international guidelines, and current clinical practices in China, integrating the latest evidence-based medical research in screening, diagnosis, pathology, genetic testing, immune molecular marker detection, treatment methods, and follow-up care. The goal is to provide comprehensive and reasonable recommendations for clinicians, imaging specialists, laboratory technicians, rehabilitation professionals, and other medical staff at all levels.
9. [China clinical practice guideline for stage Ⅳ primary lung cancer (2024 edition)].
Primary lung cancer (abbreviated as lung cancer) stands as the most prevalent malignant disease and the leading cause of cancer-related death in China, with an estimated 106.06×104 incident cases and 73.33×104 deaths in 2022. Due to the absence of effective early screening methods, most patients with lung cancer in China are in stage Ⅳ when diagnosed. Multi-disciplinary treatment based on systemic therapy is the treatment principle for patients with stage Ⅳ lung cancer. Chemotherapy remains the cornerstone, but its effectiveness is still unsatisfactory. In recent years, with the rapid development of molecular targeted therapy and immunotherapy, the treatment concept for stage Ⅳ lung cancer has been continually evolving, leading to significant improvements in patient treatment outcomes. To ensure timely updates on the global progress in the treatment of stage Ⅳ lung cancer and further improve the level of standardized diagnosis and treatment of stage Ⅳ lung cancer in China, Medical Oncology Branch of China International Exchange and Promotive Association for Medical and Health Care and Chinese Association for Clinical Oncologists organized experts to compile "China clinical practice guideline for stage Ⅳ primary lung cancer (2024 edition)". This guideline systematically and comprehensively updates epidemiological data, TNM staging, new drugs, treatment regimens, and new indications approved by China National Medical Products Administration before June 30, 2024, etc. Based on the " Clinical practice guideline for stage Ⅳ primary lung cancer in China(2021 version)" and the " Clinical practice guideline for stage Ⅳ lung cancer in China (2023 edition)." This guideline incorporates recommendation levels for therapeutic drugs and treatment flowcharts for stage Ⅳ lung cancer. The guideline covers common clinical issues and corresponding guidance in the diagnosis and treatment process of stage Ⅳ lung cancer. The guideline aims to guide the clinical practice of stage Ⅳ lung cancer, comprehensively improve the standardized diagnosis and treatment level in China, prolong the survival time of patients with stage Ⅳ lung cancer, and improve patients' quality of life.
10. [Guidelines for clinical application of platinum drugs in breast cancer (2023 edition)].
Breast cancer is the most common malignant tumor in women around the world, and it is also a common cause of death in female patients with malignant tumors in China, which seriously harms women's health. At present, with the application of comprehensive treatment approaches, breast cancer has become one of the most effective solid tumors. Platinum drugs are widely used in malignant tumors, and they are also commonly used as effective chemotherapeutic drugs for breast cancer. To regulate the application of platinum drugs in breast cancer, the experts from Breast Cancer Group, Branch of Oncologist, Chinese Medical Doctor Association, discuss and approve the "Guidelines for clinical application of platinum drugs in breast cancer (2023 edition)" . This guideline is developed from the "Expert consensus on the clinical application of platinums in advanced breast cancer (2020 version)" , which is updated from the latest evidence based on breast cancer at home and abroad, for platinum drugs in breast cancer clinical use, application scheme, efficacy analysis and treatment of adverse effects. This guideline aims to guide clinicians to use drugs rationally, and to further standardize the diagnosis and treatment.
11. [China guideline for diagnosis and comprehensive treatment of colorectal liver metastases (version 2023)].
The liver is the main target organ for hematogenous metastases of colorectal cancer, and colorectal liver metastasis is one of the most difficult and challenging situations in the treatment of colorectal cancer. In order to improve the diagnosis and comprehensive treatment of colorectal liver metastasis in China, the guidelines have been edited and revised for several times since 2008, including the overall evaluation, personalized treatment goals and comprehensive treatments, to prevent the occurrence of liver metastases, increase the local damage rate of liver metastases, prolong long-term survival, and improve quality of life. The revised guideline version 2023 includes the diagnosis and follow-up, prevention, multidisciplinary team (MDT), surgery and local ablative treatment, neoadjuvant and adjuvant therapy, and comprehensive treatment, with state-of-the-art experience and findings, detailed content, and strong operability.
13. [Chinese guideline for clinical diagnosis and treatment of thymic epithelial tumors (2021 Edition)].
Thymic tumor is a relatively rare type of thoracic cancer, which is pathologically-classified as thymic epithelial tumors by World Health Organization (WHO), including thymoma and thymic carcinoma. The incidence of thymic epithelial tumors in China is about 4.09 per million, which is slightly higher than that in European and American countries. For surgically-resectable thymic epithelial tumors, complete resection with or without postoperative radiotherapy or chemotherapy is preferred. For advanced unresectable disease, conventional radiotherapy and chemotherapy is the mainstream treatment but lack of standard first-line and second-line regimens. In recent years, targeted drugs and the immune checkpoint inhibitors have gradually exhibited certain therapeutic prospect in this subset of tumor. Since there was no guideline regarding thymic epithelial tumor released in China, Multidisciplinary Committee on Oncology, Chinese Physicians Association analyze, summarize and discuss the relevant research data for the diagnosis, treatment and prognosis of thymic epithelial tumors, and formulate the "Chinese guidelines for clinical diagnosis and treatment of thymic epithelial tumors (2021 Edition)" for clinicians' reference.
14. [China guideline for diagnosis and comprehensive treatment of colorectal liver metastases (version 2020)].
The liver is the most common anatomical site for hematogenous metastases of colorectal cancer, and colorectal liver metastasis is one of the most difficult and challenging situations in the treatment of colorectal cancer. In order to improve the diagnosis and comprehensive treatment in China, the Guidelines have been edited and revised for several times since 2008, including the overall evaluation, personalized treatment goals and comprehensive treatments, to prevent the occurrence of liver metastases, improve the resection rate of liver metastases and survival. The revised Guideline version 2020 includes the diagnosis and follow-up, prevention, multidisciplinary team (MDT), surgery and local ablative treatment, neoadjuvant and adjuvant therapy, and comprehensive treatment, with state-of-the-art experience and findings, detailed content, and strong operability.
15. [Essential and interpretation of Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2019 for the treatment of colorectal cancer].
The Japanese Society for Cancer of the Colon and Rectum (JSCCR) published the guidelines 2019 for the treatment of colorectal cancer in March 2019. The new edition expanded the indications of endoscopic treatment, enriched the follow-up recommendations after endoscopic resection of early colorectal cancer, supplemented the indications of ISR and added the recommendations of lymph node recurrence and peritoneal recurrence. In the new edition, the adjuvant and palliative chemotherapy schemes were revised and patients with first-line chemotherapy were divided into three categories as follows: appropriate for intensive systemic therapy (fit), inappropriate for intensive systemic therapy (vulnerable), and inappropriate for systemic therapy (frail). The new edition of guidelines can also provide references to the doctors of colorectal cancer in our country. This article intends to interpret the essentials of this new edition.
16. [Chinese expert consensus on the diagnosis and treatment for lateral lymph node metastasis of rectal cancer (2019 edition)].
Lateral lymph node metastasis represents a major cause of local pelvic recurrence after curative resection for mid-low rectal cancer. Considerable controversies over issues remain among eastern and western countries, with respect to the diagnosis of lateral lymph node metastasis, the multidisciplinary management regime, indication for lateral pelvic lymph node dissection, and the prognosis of surgical dissection. The purpose of this expert consensus is to improve the understanding of this condition among Chinese specialists, and to help standardizing the diagnosis and therapeutic strategies for lateral lymph node metastasis. Each statement and recommendation in this consensus were generated based on suggestions from at least three experts, agreed by a majority of experts from the Chinese expert panel. The evaluation criteria by U.S. Preventive Services Task Force was adopted for the grading of recommendations. In respect to the aforementioned controversies, the present consensus produced 21 statements on diagnosis and treatment for lateral lymph node metastasis. The pending issues in this consensus need further high-quality clinical practice and research.
17. [Molecular markers for the monitoring of malignant transformation of hepatocytes and early diagnosis of liver cancer].
作者: Y Yang.;M Yao.;M Fang.;W J Zheng.;Z Z Dong.;D F Yao.
来源: Zhonghua Gan Zang Bing Za Zhi. 2017年25卷5期325-328页
The monitoring of malignant transformation of hepatocytes or early diagnosis of primary hepatocellular carcinoma (PHC) remains a challenge in the medical world. Routine examinations including serum alpha-fetoprotein level and ultrasound examination have a limited value in the diagnosis of small hepatocellular carcinoma; however, the effective treatment of PHC depends on its early diagnosis. In recent years, molecular markers including important signaling molecules in PHC-related pathways, carcinoembryonic proteins, and non-coding RNA help with the monitoring of malignant transformation of hepatocytes or early diagnosis of liver cancer. This article reviews the valuable molecular markers in the monitoring of malignant transformation of hepatocytes or early diagnosis of liver cancer.
18. [Guideline for childhood Hodgkin's lymphoma]. |