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The 24th National Conference on Clinical Oncology and the 2021 CSCO Annual Conference will be held on September 25-29, 2021.
The theme of this conference is "Focus on Innovative Research, Leading the Original Future"
.
The conference continues to adhere to the fundamental purpose of CSCO, adopts new forms to actively carry out academic exchange activities in special periods, promotes academic exchanges and scientific and technological cooperation in the field of clinical oncology in China, encourages support for clinical research and innovation, and advocates multidisciplinary standardized comprehensive treatment based on Precision oncology actively promotes the development of the discipline
.
At the CSCO conference, Professor Junning Cao from the Cancer Hospital of Fudan University gave a theme report on "Treatment Progress in Hodgkin's Lymphoma (HL)".
Yimaitong organized the main contents as follows
.
Professor Junning Cao first introduced the current status of HL treatment
.
For newly treated low-risk HL, the ABVD regimen combined with radiotherapy at the affected site can bring cure for most patients
.
For newly treated high-risk HL, there is still room for improvement in the safety of the commonly used BEACOPP regimen
.
At present, the research direction of newly-treated HL is to reduce the intensity of treatment and reduce the long-term adverse reactions of HL patients
.
At present, the preferred treatment for relapsed and refractory (R/R) HL is conventional salvage chemotherapy combined with autologous hematopoietic stem cell transplantation (ASCT).
In recent years, verbutuximab (BV), PD-1 monoclonal antibody, chimeric antigen receptor The emergence of new drugs and new therapies such as T cell (CAR-T) immunotherapy has brought new treatment options for patients with R/R HL
.
Treatment of newly-treated stage I/II low-risk HL Professor Junning Cao then introduced the treatment progress of newly-treated stage I/II low-risk HL
.
The HD10 study conducted by the German Hodgkin Lymphoma Research Group (GHSG) explored the effects of the number of cycles of the ABVD regimen and the dose of radiotherapy on the prognosis of HL patients
.
The results of the study show that the 2-cycle ABVD regimen combined with 20Gy radiotherapy has similar efficacy to other treatment regimens, and at the same time has better safety.
It is a better treatment option for newly treated low-risk HL patients
.
Mid-term PET-CT evaluation has important guiding significance for the treatment strategy of HL
.
The RAPID study compared the efficacy of 30Gy involved field radiotherapy and no radiotherapy in patients with HL who had a negative mid-term PET-CT test
.
The results of the study showed that patients receiving radiotherapy had a higher 3-year PFS rate, but there was no significant difference in the 3-year OS rate between the two groups
.
The results of the EORTC/LYSA/FIL H10 study also showed that omission of radiotherapy in HL patients with a negative mid-term PET-CT test can lead to an increase in the probability of early recurrence (<2 years)
.
For newly treated low-risk cHL patients, radiotherapy is still necessary
.
The HD14 study for the treatment of newly-treated stage I/II high-risk HL compared the efficacy of a 4-cycle ABVD regimen and a 2-cycle enhanced BEACOPP regimen combined with a 2-cycle ABVD regimen in newly-treated high-risk HL patients
.
The results of the study showed that the two-cycle enhanced BEACOPP regimen combined with the two-cycle ABVD regimen had a better effect, but the regimen also brought more adverse reactions to HL patients
.
At present, some studies are exploring the efficacy of new drugs in the initial treatment of high-risk HL
.
The Phase II NIVAHL study explored two first-line treatment strategies for HL based on the PD-1 monoclonal antibody nivolumab.
The study included patients with early high-risk HL aged 18-60 years who were randomly assigned to receive 4 cycles of nivolumab Uumab combined with AVD regimen, or receive 4 doses of nivolumab pre-treatment, followed by 2 cycles of nivolumab combined with AVD regimen and 2 cycles of standard-dose AVD regimen, followed by two cycles All patients in the group received 30Gy of radiotherapy to the affected area
.
The results of the study showed that the nivolumab combined with AVD program achieved a higher early CR rate in the newly treated high-risk HL, and the safety was acceptable
.
The therapeutic prospects of immunotherapeutic drugs in the initial treatment of stage I/II high-risk HL are worth looking forward to
.
The results of the HD9 study on the treatment of stage III/IV HL for newly-treated patients showed that compared with ABVD regimen, BEACOPP regimen can bring better curative effect for patients with stage III/IV HL
.
The SWOG S0816 study also showed that for HL patients with a positive PET-CT test after 2 cycles of ABVD treatment, enhanced BEACOPP can improve the prognosis
.
However, it should be noted that the incidence of second primary tumors in HL patients after treatment with BEACOPP regimen reaches 14%.
When using this regimen to treat HL patients, attention should be paid to the management of long-term adverse reactions
.
For patients with stage III/IV HL, BV is also a better treatment
.
The ECHELON-1 study compared the efficacy and safety of the BV-AVD regimen and the ABVD regimen in stage III/IV HL patients
.
The results of the study show that the BV-AVD regimen can reduce the risk of disease progression and death in patients with stage III/IV HL compared with the ABVD regimen, and is a better treatment option for patients with stage III/IV HL
.
New drugs such as R/R HL for the treatment of BV and PD-1 monoclonal antibody also show considerable curative effects in R/R HL
.
The KEYNOTE-204 study compared the efficacy of PD-1 monoclonal antibody pembrolizumab and BV in patients with R/R HL
.
The results of the study showed that compared with BV, the PFS of pembrolizumab for R/R HL was significantly longer (median PFS: 13.
2 months vs 8.
3 months; P=0.
0027)
.
The efficacy of BV combined chemotherapy regimens (such as the BV-ICE regimen or the BV combined bendamustine regimen) in R/R HL patients is also worthy of attention.
In related studies, the ORR of the BV combined chemotherapy regimen in the treatment of R/R HL is higher than 90%, PFS rate is higher than 65%
.
In addition, the "no chemotherapy regimen" of BV combined with PD-1 monoclonal antibody can reduce the adverse reactions of patients with R/R HL and is also a viable option for the treatment of patients with R/R HL
.
Although compared with B-cell lymphoma, the progress of CAR-T therapy in R/R HL is relatively lagging, but in related studies, CD30 CAR-T therapy has shown considerable initial efficacy in R/R HL
.
We look forward to the development of follow-up studies to further verify the efficacy of CD30 CAR-T therapy in R/R HL, and provide new treatments for R/R HL patients who have failed BV, PD-1 monoclonal antibody treatment, and relapsed after ASCT or allogeneic hematopoietic stem cell transplantation.
Treatment options
.
Summary Professor Junning Cao finally concluded: The current research direction for initial treatment of HL is to reduce the long-term adverse effects caused by treatment
.
Mid-term PET-CT evaluation has important guiding significance for the treatment strategy of HL
.
New drugs such as BV and PD-1 monoclonal antibody have shown considerable efficacy in the treatment of HL, which has further enriched the treatment options for HL
.
The efficacy of CD30 CAR-T therapy in R/R HL needs to be further verified by follow-up studies
.
Professor Junning Cao, Deputy Director of the Lymphoma Specialist, Department of Oncology, Cancer Hospital of Fudan University, Deputy Chief Expert of Lymphoma, and Deputy Chief Expert of Lymphoma Member of the Standing Committee of the Tumor Alliance Member of the Chinese Society of Clinical Oncology Member of the Chinese Anti-Cancer Association Clinical Chemotherapy Committee of the Chinese Medical Association Member of the Lymph and Blood Group of the Chinese Medical Association Member, Vice Chairman of the Lymphoma Professional Committee of China Association for Geriatric Health Care
The theme of this conference is "Focus on Innovative Research, Leading the Original Future"
.
The conference continues to adhere to the fundamental purpose of CSCO, adopts new forms to actively carry out academic exchange activities in special periods, promotes academic exchanges and scientific and technological cooperation in the field of clinical oncology in China, encourages support for clinical research and innovation, and advocates multidisciplinary standardized comprehensive treatment based on Precision oncology actively promotes the development of the discipline
.
At the CSCO conference, Professor Junning Cao from the Cancer Hospital of Fudan University gave a theme report on "Treatment Progress in Hodgkin's Lymphoma (HL)".
Yimaitong organized the main contents as follows
.
Professor Junning Cao first introduced the current status of HL treatment
.
For newly treated low-risk HL, the ABVD regimen combined with radiotherapy at the affected site can bring cure for most patients
.
For newly treated high-risk HL, there is still room for improvement in the safety of the commonly used BEACOPP regimen
.
At present, the research direction of newly-treated HL is to reduce the intensity of treatment and reduce the long-term adverse reactions of HL patients
.
At present, the preferred treatment for relapsed and refractory (R/R) HL is conventional salvage chemotherapy combined with autologous hematopoietic stem cell transplantation (ASCT).
In recent years, verbutuximab (BV), PD-1 monoclonal antibody, chimeric antigen receptor The emergence of new drugs and new therapies such as T cell (CAR-T) immunotherapy has brought new treatment options for patients with R/R HL
.
Treatment of newly-treated stage I/II low-risk HL Professor Junning Cao then introduced the treatment progress of newly-treated stage I/II low-risk HL
.
The HD10 study conducted by the German Hodgkin Lymphoma Research Group (GHSG) explored the effects of the number of cycles of the ABVD regimen and the dose of radiotherapy on the prognosis of HL patients
.
The results of the study show that the 2-cycle ABVD regimen combined with 20Gy radiotherapy has similar efficacy to other treatment regimens, and at the same time has better safety.
It is a better treatment option for newly treated low-risk HL patients
.
Mid-term PET-CT evaluation has important guiding significance for the treatment strategy of HL
.
The RAPID study compared the efficacy of 30Gy involved field radiotherapy and no radiotherapy in patients with HL who had a negative mid-term PET-CT test
.
The results of the study showed that patients receiving radiotherapy had a higher 3-year PFS rate, but there was no significant difference in the 3-year OS rate between the two groups
.
The results of the EORTC/LYSA/FIL H10 study also showed that omission of radiotherapy in HL patients with a negative mid-term PET-CT test can lead to an increase in the probability of early recurrence (<2 years)
.
For newly treated low-risk cHL patients, radiotherapy is still necessary
.
The HD14 study for the treatment of newly-treated stage I/II high-risk HL compared the efficacy of a 4-cycle ABVD regimen and a 2-cycle enhanced BEACOPP regimen combined with a 2-cycle ABVD regimen in newly-treated high-risk HL patients
.
The results of the study showed that the two-cycle enhanced BEACOPP regimen combined with the two-cycle ABVD regimen had a better effect, but the regimen also brought more adverse reactions to HL patients
.
At present, some studies are exploring the efficacy of new drugs in the initial treatment of high-risk HL
.
The Phase II NIVAHL study explored two first-line treatment strategies for HL based on the PD-1 monoclonal antibody nivolumab.
The study included patients with early high-risk HL aged 18-60 years who were randomly assigned to receive 4 cycles of nivolumab Uumab combined with AVD regimen, or receive 4 doses of nivolumab pre-treatment, followed by 2 cycles of nivolumab combined with AVD regimen and 2 cycles of standard-dose AVD regimen, followed by two cycles All patients in the group received 30Gy of radiotherapy to the affected area
.
The results of the study showed that the nivolumab combined with AVD program achieved a higher early CR rate in the newly treated high-risk HL, and the safety was acceptable
.
The therapeutic prospects of immunotherapeutic drugs in the initial treatment of stage I/II high-risk HL are worth looking forward to
.
The results of the HD9 study on the treatment of stage III/IV HL for newly-treated patients showed that compared with ABVD regimen, BEACOPP regimen can bring better curative effect for patients with stage III/IV HL
.
The SWOG S0816 study also showed that for HL patients with a positive PET-CT test after 2 cycles of ABVD treatment, enhanced BEACOPP can improve the prognosis
.
However, it should be noted that the incidence of second primary tumors in HL patients after treatment with BEACOPP regimen reaches 14%.
When using this regimen to treat HL patients, attention should be paid to the management of long-term adverse reactions
.
For patients with stage III/IV HL, BV is also a better treatment
.
The ECHELON-1 study compared the efficacy and safety of the BV-AVD regimen and the ABVD regimen in stage III/IV HL patients
.
The results of the study show that the BV-AVD regimen can reduce the risk of disease progression and death in patients with stage III/IV HL compared with the ABVD regimen, and is a better treatment option for patients with stage III/IV HL
.
New drugs such as R/R HL for the treatment of BV and PD-1 monoclonal antibody also show considerable curative effects in R/R HL
.
The KEYNOTE-204 study compared the efficacy of PD-1 monoclonal antibody pembrolizumab and BV in patients with R/R HL
.
The results of the study showed that compared with BV, the PFS of pembrolizumab for R/R HL was significantly longer (median PFS: 13.
2 months vs 8.
3 months; P=0.
0027)
.
The efficacy of BV combined chemotherapy regimens (such as the BV-ICE regimen or the BV combined bendamustine regimen) in R/R HL patients is also worthy of attention.
In related studies, the ORR of the BV combined chemotherapy regimen in the treatment of R/R HL is higher than 90%, PFS rate is higher than 65%
.
In addition, the "no chemotherapy regimen" of BV combined with PD-1 monoclonal antibody can reduce the adverse reactions of patients with R/R HL and is also a viable option for the treatment of patients with R/R HL
.
Although compared with B-cell lymphoma, the progress of CAR-T therapy in R/R HL is relatively lagging, but in related studies, CD30 CAR-T therapy has shown considerable initial efficacy in R/R HL
.
We look forward to the development of follow-up studies to further verify the efficacy of CD30 CAR-T therapy in R/R HL, and provide new treatments for R/R HL patients who have failed BV, PD-1 monoclonal antibody treatment, and relapsed after ASCT or allogeneic hematopoietic stem cell transplantation.
Treatment options
.
Summary Professor Junning Cao finally concluded: The current research direction for initial treatment of HL is to reduce the long-term adverse effects caused by treatment
.
Mid-term PET-CT evaluation has important guiding significance for the treatment strategy of HL
.
New drugs such as BV and PD-1 monoclonal antibody have shown considerable efficacy in the treatment of HL, which has further enriched the treatment options for HL
.
The efficacy of CD30 CAR-T therapy in R/R HL needs to be further verified by follow-up studies
.
Professor Junning Cao, Deputy Director of the Lymphoma Specialist, Department of Oncology, Cancer Hospital of Fudan University, Deputy Chief Expert of Lymphoma, and Deputy Chief Expert of Lymphoma Member of the Standing Committee of the Tumor Alliance Member of the Chinese Society of Clinical Oncology Member of the Chinese Anti-Cancer Association Clinical Chemotherapy Committee of the Chinese Medical Association Member of the Lymph and Blood Group of the Chinese Medical Association Member, Vice Chairman of the Lymphoma Professional Committee of China Association for Geriatric Health Care
