China Releases First Expert Guideline on Internet-Based Management of Common Adverse Drug Reactions in Liver Cancer Patients

Recently, the first “Expert Consensus on Internet-Based Management of Common Drug-Related Adverse Reactions in Patients with Liver Cancer” (hereinafter referred to as the “Consensus”) was officially published in the Electronic Journal of Liver Cancer, a core Chinese scientific and technological journal. The Consensus was developed with the participation of the Multidisciplinary Team for Gastrointestinal Tumors at the Cancer Hospital of the Chinese Academy of Medical Sciences and Peking Union Medical College, the Liver Tumor Branch of the China International Exchange and Promotive Association for Medical and Health Care, the International Education and Training Branch of the China International Exchange and Promotive Association for Medical and Health Care, and the Health Science Popularization Branch of the China International Exchange and Promotive Association for Medical and Health Care, with support from Medlinker.

According to the latest 2020 global cancer burden data released by the International Agency for Research on Cancer (IARC) of the World Health Organization, there were 900,000 new cases of liver cancer worldwide in 2020, with China accounting for 45.6%; there were 830,000 deaths, with China accounting for 47%. Currently, clinical treatments for liver cancer mainly include surgical resection, local ablation, interventional therapy, radiotherapy, and liver transplantation, but all have certain limitations and require systemic treatment in combination with targeted drugs, immunotherapy drugs, etc. However, one or even several adverse drug reactions often occur during systemic treatment. Outside the hospital, when the attending physician is not present, it is particularly important for patients to be able to identify the manifestations of adverse reactions and receive timely diagnosis and intervention at different stages, so as to maximize the benefits of treatment.

Data indicate that various diagnostic methods and therapeutic agents used in anti-tumor treatment can cause renal impairment. Among patients with liver cancer, the incidence of acute kidney injury (AKI) is approximately 33%; however, early intervention can lead to partial or even complete recovery of renal function. The introduction of the “Guidance” has effectively alleviated the challenge of limited access to out-of-hospital interventions. The “Guidance” identifies 17 drug-related adverse reactions in liver cancer patients suitable for internet-based management, covering the gastrointestinal system, endocrine system, skin and mucous membranes and appendages, and hematopoietic system. It provides detailed descriptions of the typical manifestations, management strategies, and patient education content for each type of adverse reaction, offering physicians a reference for patient education. With a particular emphasis on precautions related to patients’ lifestyle and behavioral habits, the “Guidance” fills the gap in existing guidelines and consensus statements regarding patient education interventions.

Meanwhile, as the adverse reactions covered in the "Guidance" are easy to identify and monitor, internet-based management teams, patients, and their caregivers can also directly refer to them. This facilitates early prevention and timely intervention for corresponding symptoms, breaking the limitation that existing guidelines and consensus statements are applicable only to healthcare professionals, thereby significantly expanding the scope of application. Furthermore, although the "Guidance" initially focuses on commonly used therapeutic drugs for liver cancer, it is equally applicable to the management of adverse reactions caused by drug therapies for the majority of common tumors.

Cai Jianqiang, Vice President of the Cancer Hospital of the Chinese Academy of Medical Sciences, stated, “With advances in medicine, the clinical treatment of malignant tumors has entered a stage of systematic therapy characterized by the combination of multiple therapeutic modalities and multidisciplinary participation. The ‘Guidance’ establishes detailed and standardized out-of-hospital management processes tailored to the individual experiences and needs of liver cancer patients undergoing systemic therapy. In practice, given the nationwide imbalance in the distribution of medical resources and the overall challenges in implementing patient education, the ‘Guidance’ serves, on one hand, as a patient education tool that builds bridges to facilitate effective communication between doctors and patients; on the other hand, it helps patients and their families independently understand, manage, and even resolve some adverse reactions associated with drug therapy to a certain extent. Therefore, the development and release of the ‘Guidance’ hold significant value for all stakeholders.”

During systemic therapy, cancer patients have limited hospital stays. After discharge, with limited access to medical information, how to obtain standardized, timely, effective, and continuous care management is an urgent need for patients and their families.

Medlinker began exploring out-of-hospital management for cancer patients in December 2019 and officially launched the “Internet-Based Follow-Up Management Project for Out-of-Hospital Cancer Patients” in October 2020, covering common cancer types such as liver cancer, lung cancer, gastric cancer, breast cancer, and neuroendocrine tumors. The Guiding Opinions released herein represent the first achievement of this project. During the drafting of the Guiding Opinions, Medlinker’s management experience was integrated with clinical expertise and recommendations from advisory experts, undergoing multiple rounds of discussion and revision before finalization.

Liu Chunmei, Vice President of Medlinker, stated, “In the future, an increasing number of cancer patients will be living with their disease. How to provide these patients with convenient, timely, and standardized management outside the hospital setting, thereby improving their quality of life and extending their survival time, is the goal that Medlinker strives to achieve in its exploration of oncology. It is a great honor to have been deeply involved in the formulation of the ‘Guiding Opinions,’ sharing Medlinker’s insights and accumulated clinical experience in online cancer management, particularly in establishing processes and standards for online disease management, so as to offer practical guidance for cancer patients undergoing systemic treatment outside the hospital.”