Colon Cancer Treatment in China: Targeted Therapy, Surgery, and Access for International Patients
China diagnoses more than 500,000 new colorectal cancer cases annually. A guide to FOLFOX and CAPOX chemotherapy, bevacizumab, anti-EGFR cetuximab, BRAF V600E targeted therapy, MSI-H immunotherapy with pembrolizumab, China-developed fruquintinib (呋喹替尼 — now also FDA-approved globally), liver metastasis surgery, conversion therapy, and HIPEC for peritoneal disease.
Key Highlights
- 500,000+ new colorectal cancer cases annually in China — deep caseload experience across all disease stages, molecular subtypes, and treatment lines
- China-developed fruquintinib (FRESCO trial in China → FRESCO-2 global trial → FDA approval 2023) — available in China before global markets
- MSI-H/dMMR colorectal cancer: pembrolizumab first-line immunotherapy (KEYNOTE-177) available in China; MSI/MMR testing determines eligibility
- High-volume liver metastasis surgery and conversion therapy — converting initially unresectable liver metastases to resectable through MDT-driven combination treatment
Important Facts
- RAS (KRAS/NRAS), BRAF V600E, MSI/MMR, HER2, and tumour sidedness testing are all required before metastatic treatment planning — incomplete profiling leads to suboptimal decisions
- Fruquintinib (呋喹替尼) is a China-developed VEGFR inhibitor approved for refractory mCRC — available in China before receiving global FDA approval in 2023
- MSI-H/dMMR patients should receive pembrolizumab first-line rather than standard chemotherapy — a result that changes treatment completely
- Liver metastasis resectability should be assessed by a hepatobiliary surgeon, not medical oncology alone — conversion therapy is a defined treatment goal at Chinese centres