Multi-party Collaboration Facilitates the Release of “Current State of Breast Cancer Treatment in China” The latest release of the “Current State of Breast Cancer Treatment in China” is most gratifying to me because many colleagues and scholars, many well-known academic centers and specialty centers have participated together to provide real cases to share with you. This is a gratifying sign that various disciplines in the southeast and northwest of China are moving toward joint collaboration. No matter what the data is, it is great that all scholars can come together to share their results and experiences. I believe that through the study of nearly 2,000 cases, every scholar who participated in the study and everyone who heard this report will understand the basic patterns of advanced breast cancer treatment in China, including where the norms are and where there is room for improvement. There are problems, but I believe that the interpretation of several experts will indicate how to better handle similar patients in the future. This is one of the basic purposes of this study that we initiated in the first place. Reviewing the history of maintenance therapy and discussing the original intention of maintenance therapy The first time we took sequential monotherapy maintenance therapy was in 2001, in a case of docetaxel combined with capecitabine. I had just returned from working in the United States and was dealing with a patient with liver metastases and was given an effective regimen of docetaxel in combination with capecitabine. After six cycles, some people proposed to continue the combination therapy and others proposed to switch to endocrine therapy. My thinking was that since both drugs were more effective and this patient was going back to Xiamen for Chinese New Year, he could be put on oral monotherapy maintenance therapy. As a result, the patient was maintained for more than two years, during which time he was reviewed about once every 3-4 months, ensuring that the patient was able to spend most of his time with his family. For retaining single-drug maintenance therapy after combination therapy is easy to say, but some confusion did exist before. Some people insist that life does not stop with combination chemotherapy, and always want to use combination chemotherapy until the disease progresses and until it is not tolerated. Others believe that if chemotherapy is maintained for 4 or 6 months, they can switch to another treatment regimen. I would like to caution that if you stop the treatment regimen that was working and switch to another one, it may not be effective. And if the original very effective treatment regimen is used in combination all the time, it may become toxic before the disease progresses, and then the effective regimen may be scrapped. More than a decade ago, I have been thinking that we should keep the effective single-drug maintenance therapy. This regimen has the advantage that the combination of A+B is effective, and if A is not effective after a period of maintenance, B is still effective. Then the doctor does not need to change the regimen once or twice a month when developing the treatment plan. We have also encountered patients who have used ten treatment regimens in a year, and the results may not be very good. Now after adopting a treatment regimen of combination therapy followed by maintenance with one of the single drugs and then switching to another single drug for maintenance after failure, some patients may only change to one treatment regimen for 3-5 years. We want doctors to have many treatment options in mind, but the one that is really used for the patient should be the best, which was one of the first reasons we proposed the combination effective followed by single-drug maintenance regimen. It is now reassuring to know that many of our peers and fellow specialists in China are very receptive to such a treatment concept, and in practice they are using such treatment regimens. In addition, our predecessors also understand and recognize such a treatment concept and protocol very well. This treatment plan allows for a better prolongation of the treatment period and really fulfills what I have been advocating before: if it is difficult to cure a relapsed patient, at least we should adopt a long-lasting and life-prolonging treatment strategy. ”The whole management of breast cancer is not only the maintenance treatment for advanced stage patients, but also how to optimize the diagnosis process and the treatment mode after the diagnosis is clear. For example, whether surgery or drug therapy is preferred, and if surgery is chosen, the prognosis of the patient should be evaluated after surgery to decide the best adjuvant therapy, and after the success of adjuvant therapy towards recovery, and after the failure of adjuvant therapy, the reasons for the failure should be evaluated. We should evaluate the lesion, biological indicators and physical condition to determine whether the patient should be optimally treated with local or systemic therapy after relapse and metastasis, and whether systemic therapy should be chemotherapy combined with chemotherapy or chemotherapy combined with targeted or endocrine therapy, which is what we need to pay attention to in the whole management. We hope that through systematic management of the whole process, the same patient can receive relatively consistent responses from different specialists, so that the patient can feel more secure and the medical professionals can be closer to the treatment concept in the whole process management treatment model. We hope to continue to move from concept to practice, from practice to data summary, and from the data to generalize some clinical evidence-based medical evidence to promote new concepts. In the cycle from practice to theory and from theory to practice, we will continue to improve our diagnosis and management. When we are faced with many treatment options to choose from, it is especially important to tailor a good treatment plan for the patient, which is the whole management. The most suitable treatment strategy can be chosen according to the patient’s disease characteristics and physical condition, which may be combination chemotherapy, single drug, endocrine therapy, local treatment, or even rest. There was once a patient whose disease was relatively stable after one or two years of continuous treatment, but the treatment was hard and close to the New Year, so I arranged for the patient to stop the medication for two months. After the two-month break the patient was in good health and the tumor was only slightly enlarged, and the next round of treatment was started at the right time. Such patients are fortunate if every doctor, when facing a patient, can consider the patient’s situation comprehensively at the beginning and tailor a long-term treatment plan. Doctors are lucky to have a group of patients who cooperate with their treatment, and patients are lucky to have a group of doctors who understand very well. This is the gain and experience of the whole management treatment concept that I have always advocated and am actively trying to achieve.