The 2025 CSCO Guidelines Conference, co-hosted by the Chinese Society of Clinical Oncology (CSCO) and the Beijing Xisike Clinical Oncology Research Foundation, was successfully held in Jinan, April 18–19, 2025. Leading experts from across the country gathered once again to exchange cutting-edge research, discuss clinical hot topics, and witness the release of updated CSCO guidelines. Oncology Frontier had the honor of interviewing the conference chair, CSCO Council President, and Academician Jinming Yu of Shandong Cancer Hospital, who shared insights into proton therapy, combined radiotherapy and immunotherapy, and CSCO’s path toward deeper international collaboration.
132 Days: Turning Vision into Reality
The “Jinan Miracle” in Cancer Radiotherapy
Oncology Frontier: You’ve noted that radiation oncology has entered the era of “intelligent radiotherapy” in the 2020s. How should we understand this concept? What advancements has China made in this area? Given that radiotherapy is closely linked to technological and equipment capabilities, and under your leadership Shandong Cancer Hospital became the first in China to house both proton and heavy ion systems, what does this milestone mean for China and the global field? Can you also share your institution’s key strengths in radiotherapy?
Academician Jinming Yu: Radiotherapy is a discipline heavily reliant on advanced equipment and technology. We often say, “Equipment + Talent = Technology.” Both are essential. From the discovery of X-rays in 1895 to today’s integration of radiotherapy with immunotherapy, progress in this field has always been driven by technological innovation. Radiotherapy calls for interdisciplinary collaboration including physics, engineering, and information science. Artificial intelligence (AI), in particular, has become an integral part of every stage of development, from 3D conformal radiotherapy and intensity-modulated radiation therapy (IMRT) to image-guided therapy, proton therapy, and heavy ion therapy.
China has made remarkable achievements in radiotherapy, leading the world in two key areas. First, we have the largest number of patients undergoing conventional photon therapy in China. Second, the number of patients receiving proton therapy daily is now also the highest globally.
Our hospital, Shandong Cancer Hospital, is recognized internationally for its cutting-edge radiotherapy. The Proton Center located in Jinan’s International Medical Center is known among American colleagues as a “miracle,” a testament to “China speed,” “Shandong speed,” and “Jinan speed.” From submitting our proposal to the government to breaking ground, the entire process took just 132 days covering approvals, funding, environmental assessments, and more. In Western countries, such efficiency would be unimaginable.
Despite the COVID-19 pandemic, construction was completed, and 100,000 square meters became operational within two and a half years. Since receiving the National Medical Device Registration Certificate on November 1, 2023, we have treated over 1,300 patients with proton therapy. Our peak daily treatment volume exceeds 120 patients—placing us first in both total and average daily cases worldwide.
Heavy ion therapy is also on track, with clinical application expected by the end of next year. This means Chinese patients will soon have access to world-class treatment close to home.
With the support of new technologies, China’s standardized oncology care is also advancing to international levels. Take the example of our multi-disciplinary team (MDT) approach. Since March 4, 2020, we’ve implemented a fixed-time, fixed-location, fixed-expert system offering free and comprehensive MDT consultations, significantly improving care quality. For example, we published a series of studies in top-tier international journals. For some cancers, like stage III-IV colorectal cancer, our treatment outcomes now match or even exceed those in the United States.
China’s healthcare has achieved rapid progress thanks to strong support from local and national leadership. We take pride in how our voice is increasingly heard at major global conferences like the American Society of Clinical Oncology (ASCO) and World Conference on Lung Cancer WCLC, and in how CSCO’s clinical guidelines are gaining global recognition. As a Chinese scientist, I feel deeply proud of our accomplishments.
Radiotherapy + Immunotherapy
Toward a Future Beyond Surgery and Chemotherapy
Oncology Frontier: You’ve described immunotherapy as perhaps the most promising avenue for cancer treatment. What is your assessment of China’s current progress in this area? Are there any notable breakthroughs in “immunotherapy combinations”? You’ve led pioneering work in combining radiotherapy with immunotherapy, how do we identify the patient groups most likely to benefit from this, and how can we further enhance synergy between the two modalities?
Academician Jinming Yu: Immunotherapy is now widely recognized as one of the most promising approaches for cancer treatment—and even potential cure. From early attempts with Coley’s toxins and Bacillus Calmette-Guérin (BCG), to modern immune checkpoint inhibitors (ICIs) targeting one or two pathways, and now to cell and gene therapies, immunotherapy continues to evolve.
However, single-agent immunotherapy is not always effective. That’s why combining it with other treatments like surgery, chemotherapy, and radiotherapy is gaining traction globally.
Some studies in the U.S. and Japan show that in patients with unresectable stage III NSCLC and high PD-L1 expression, the outcomes of radiotherapy + immunotherapy are comparable to radiotherapy + chemotherapy. This opens the door to “chemo-free,” “radiation-free,” or even “surgery-free” strategies in select cases.
For instance, recent high-impact publications have reported a 100% clinical complete response (cCR) in patients with dMMR/MSI-H stage II/III colorectal cancer using immunotherapy alone or combined—as neoadjuvant treatment. This raises the hypothesis: for elderly or frail patients, could we opt for observation rather than surgery or radiotherapy? Ongoing studies are actively exploring this.
Moreover, immunotherapy is moving from late-stage to early-stage cancer settings. For NSCLC patients who are inoperable or decline surgery, stereotactic body radiotherapy (SBRT) is standard. Small-scale studies now suggest SBRT + ICI may improve event-free survival (EFS).
There are a few metaphors used to describe immunotherapy outcomes:
- “Home Run” – when immunotherapy is effective across early, locally advanced, and late stages.
- “High Leg Lift” – immunotherapy must work early, though its onset is slower than chemotherapy, and some patients experience “hyper progression.” Fortunately, we now have better strategies to address this.
- “Big Smile” – meaning sustained response throughout treatment.
- “Long Tail” – once effective, immunotherapy offers long-term benefit. This goal is now largely achievable.
Whether in neoadjuvant, adjuvant, or perioperative settings, immunotherapy (alone or combined) is making strides. Immunotherapy has already reshaped the systemic treatment landscape for lung cancer both NSCLC and SCLC. For instance, Professor Ying Cheng’s team published impressive results in The New England Journal of Medicine on using PD-1 inhibitors in limited-stage SCLC. At last year’s ASCO, Professor Linlin Wang presented successful findings on adebrelimab + chemotherapy followed by thoracic radiotherapy in extensive-stage SCLC—garnering widespread attention.
Still, we must remain cautious and apply these innovations responsibly. While pursuing therapeutic efficacy, we must also be mindful of potential toxicity. Key questions remain: How do we use biomarkers to identify responsive patients? How do we predict who will benefit, and who may be harmed? Immunotherapy is not a one-size-fits-all solution. For patients unlikely to respond, we should avoid its use. For those with limited benefit, we must proceed with caution. For those who benefit significantly, we need to determine whether monotherapy or combination therapy is best. These questions warrant further research.
A Rallying Call from the East
CSCO Amplifies China’s Voice on the Global Stage
Oncology Frontier: As CSCO President, you’ve placed great emphasis on international exchange and collaboration and global roadshows of CSCO guidelines. What plans do you have for expanding CSCO’s global collaborations? With growing participation of Chinese scholars in international research, which areas do you believe hold the most promise for future collaboration?
Academician Jinming Yu: CSCO has always upheld the principles of standardization, innovation, harmony, and inclusiveness. We’ve maintained strong ties with ASCO, European Society of Medical Oncology (ESMO), and other leading global organizations, as well as Japanese and Korean academic societies. Last year, our delegation met with the ASCO President at the ASCO Annual Conference. This May, we plan to visit Chicago for further exchanges and invite them to attend this year’s CSCO Annual Conference in Jinan this September.
We recognize the importance of international multicenter trials—they offer higher evidence levels due to the inclusion of diverse patient populations from both China and abroad. This model balances universality with specificity. Promoting collaboration with the U.S., Europe, and other advanced countries in Asia remains a core mission for CSCO.
China’s presence at global conferences is growing. For instance, at last year’s WCLC, the Chinese voice was stronger than ever garnering significant global attention. With the increasing volume and quality of Chinese-led clinical research, we expect even more impactful contributions.
China has unique advantages: a vast patient population, rich clinical data, and a large cohort of smart, experienced physicians. Backed by strong governmental support, we believe that in a few years, China’s clinical research will reach new heights. That is the future we’re working toward and one we fully believe in.
Jinming Yu President, Shandong Cancer Hospital Academician, Chinese Academy of Engineering MD, PhD, Doctoral Supervisor
- Delegate to the 17th National Congress of the Communist Party of China
- National Model Worker of China
- Deputy to the 10th, 12th, 13th, and 14th National People’s Congress
- Honorary President, Shandong First Medical University (Shandong Academy of Medical Sciences)
- President, Chinese Society of Clinical Oncology (CSCO)
- Honorary Chair, Radiotherapy Oncology Branch, Chinese Medical Association
- President, Shandong Anti-Cancer Association
- President, Shandong Society of Clinical Oncology
- Honorary President, Shandong Hospital Association
- President, Shandong Academician and Expert Association
- President, Shandong High-Level Talent Promotion Association
- Editor-in-Chief or Chinese Journal of Cancer Prevention and Treatment, Precision Radiation Oncology
