Major Liver Cancer Research from Zhongshan Hospital, Fudan University Published Again in The Lancet

At the European Society for Medical Oncology (ESMO) annual meeting on October 19, 2025, good news came again from China's liver cancer research. Under the guidance of Academician Fan Jia of Zhongshan Hospital, Fudan University, the latest results of the clinical study initiated by researchers led by Professor Zhou Jian - "Camrelizumab combined with apatinib for perioperative treatment of patients with resectable hepatocellular carcinoma with intermediate and high risk of recurrence: a multi-center, open, randomized controlled phase 2/3 study (CARES-009)" were officially released. Professor Zhou Jian was invited to give a report at the conference, interpret the results of the CARES-009 study on behalf of the team, and share China’s perioperative treatment experience for liver cancer with international colleagues. As the world's first clinical trial to achieve positive results in a phase III study of perioperative treatment of liver cancer, its blockbuster data attracted global attention once it was released.

On the day of the conference, the research results were also published online in the form of an original article in the top international journal "The Lancet". Clinical Trial (2nd Edition) Editor-in-Chief, Professor Timothy M. Pawlik of The Ohio State University Wexner Medical Center, and Professor Ahemd Kaseb of the University of Texas MD Anderson Cancer Center commented in The Lancet at the same time: Studies such as CARES-009 highlight the important progress in multimodal treatment of liver cancer, which has leading value in promoting the continued development of perioperative systemic therapy and occupying a more important position in tumor treatment.

China is the country with the heaviest burden of liver cancer in the world, and the prevention and control situation is grim. For patients with operable liver cancer, most patients face the risk of postoperative recurrence, and the recurrence and metastasis rate is as high as 60% to 70% 5 years after surgery. In clinical practice, there is an urgent need to use multidisciplinary means such as comprehensive perioperative treatment to reduce the risk of postoperative recurrence and improve the overall survival of patients. The "sandwich" treatment model of "neoadjuvant + surgery + adjuvant" has potential advantages and is expected to become an important comprehensive treatment strategy for resectable liver cancer. Therefore, the research team designed the CARES-009 study to evaluate the perioperative treatment effect of camrelizumab (Erica) combined with apatinib (Aitan) in patients with intermediate- and high-risk recurrence of resectable hepatocellular carcinoma (HCC).

The CARES-009 study is the world's first phase III clinical trial (NCT04521153) to achieve positive results in the perioperative treatment of HCC. It was carried out in 16 liver cancer diagnosis and treatment centers in China and adopted a "sandwich" treatment model based on "neoadjuvant + surgery + adjuvant" based on China's original innovative drugs. The study results show that for patients with resectable HCC with intermediate and high risk of recurrence, compared with surgical treatment alone, "sandwich" perioperative treatment of "Double Ai" neoadjuvant + surgery + "Double Ai" auxiliary can significantly prolong the patient's median event-free survival (EFS, 42.1 months vs. 19.4 months), doubling the efficacy. As a "pioneer" in perioperative immunotherapy for HCC, the CARES-009 study has subverted the current treatment landscape and is expected to rewrite international guidelines, marking the official entry of liver cancer treatment into a new era of "chronic disease management" and "pursuit of cure", allowing more patients to achieve long-term survival and even clinical cure.

The publication of the CARES-009 research results in The Lancet marks that Chinese experts have provided the first high-quality, high-level phase III evidence-based medical evidence for the global perioperative treatment of liver cancer. This achievement not only represents the international academic community's recognition of the quality of China's research design and execution, but also affirmation of China's original research plan. It also means that the perioperative "sandwich" treatment model for liver cancer based on the Chinese team has moved from "Chinese exploration" to "global solution." This achievement will stimulate the initiation and promotion of innovative research on perioperative treatment of liver cancer worldwide, establish the leading position of Chinese scholars in this field, promote innovation in treatment concepts and clinical practice, and create a new era of perioperative target-immune therapy for liver cancer. This research was funded by the second round of three-year action plan "Multi-center Clinical Research on Major Diseases" special funds from Shanghai Shenkang Hospital Development Center.

The team of Academician Fan Jia and Professor Zhou Jian has been committed to clinical and basic research on hepatobiliary tumors and liver transplantation for a long time. They have carried out a series of original work and achieved a series of blockbuster results. They have led the forefront of global hepatobiliary tumor research and effectively enhanced the academic voice and influence of Chinese scholars in the global field of hepatobiliary tumor research. In response to the severe situation of global liver cancer prevention and treatment, Academician Fan Jia and Professor Zhou Jian, as co-chairs, invited world-renowned experts and scholars to jointly formulate the "Lancet Committee on Liver Cancer Prevention and Treatment Major Report", which scientifically predicted that the number of liver cancer incidence and deaths worldwide will double in 2050, and formulated a comprehensive strategy from prevention to treatment and ten major action plans to reverse the global development trend of liver cancer. The report was officially published in The Lancet as a cover paper in July 2025, attracting widespread attention from scholars and the public around the world. This is the first major epoch-making report led by Chinese scholars to address major global disease challenges in the more than 200 years since The Lancet was first published.

The research results of the team of Academician Fan Jia and Professor Zhou Jian have topped the Lancet twice within 3 months, which fully demonstrates the strong clinical and scientific research strength of Zhongshan Hospital and Fudan University in the field of liver cancer research, and continues to promote Chinese wisdom to lead global health governance and benefit the human health community.

Original link

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01720-9

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01042-6