2022CSH Race against the tide, precision treatment is just in time! ——Professor Ji Chunyan talked about the precise treatment of leukemia

Hematological tumors have been leading the progress and direction
of the entire field of tumors.
In the past decade, the field of lymphoma and myeloma has developed rapidly, and in recent years, the field of leukemia has entered the fast lane, and many targeted and immune drugs have emerged, which has promoted the accurate diagnosis and treatment process
of leukemia.
At the "Precision Diagnosis and Treatment Frontier Forum" of the "17th National Hematology Academic Conference of the Chinese Medical Association" held recently, a number of well-known experts at home and abroad conducted in-depth academic exchanges on
the "Precision Diagnosis and Treatment of Blood System Diseases".
On this occasion, Professor Ji Chunyan of Qilu Hospital of Shandong University, who served as the chairman of the "Precision Diagnosis and Treatment Frontier Forum", was invited to interpret
the current situation and future development direction of precision treatment of leukemia.

Medical Pulse Pass: What progress has been made in the field of precision treatment in the field of leukemia?

Hematological tumors are the touchstone of oncology drugs, and many new anti-cancer drugs were first approved
in the field of hematological tumors.
From tyrosine kinase inhibitors (TKIs) to monoclonal antibodies against CD20 to immune checkpoint inhibitors (such as PD-1, PD-L1) and CAR-T, almost all new drugs or therapies begin
with the treatment of blood tumors.
In recent years, FLT3 inhibitors, BCL-2 inhibitors, IDH1/IDH2 inhibitors, etc.
have successively entered the clinic, which has made the treatment of acute myeloid leukemia enter the era
of individualized targeted therapy.
There are also many new drugs in the field of acute lymphoblastic leukemia, including bispecific antibodies targeting CD3/CD19 and antibody drug conjugates targeting CD22, which have laid the foundation
for the precise treatment of acute lymphoblastic leukemia.
In addition, with the update and iteration of TKI inhibitors, the survival of patients with chronic myeloid leukemia is also close to normal, and patients in the chronic stage can be managed
throughout the process like chronic diseases.
In chronic lymphocytic leukemia, BTK inhibitors also bring patients a considerable prognosis as well as long-term survival
.

Medical Pulse Communication: Just past September 22 is the International Slow Grain Day, please talk about the current situation of precision treatment of chronic myeloid leukemia in China and the future development direction
.

Chronic myeloid leukemia (CML) is a paragon
of precision treatment of tumors.
At present, China has listed first, second and third generation of TKI drugs, such as imatinib, nilotinib, dasatinib, and orebatinib
.
With the support of existing TKI drugs and medical resources, the survival of CML patients has approached normal people, and the treatment goals of patients have evolved to pursue treatment-free remission (TFR) and higher quality of
life.
One of the directions of exploration for CML precision therapy in the future is to solve the problem
of TKI acquired drug resistance.
Although the prognosis of CML patients has improved greatly after the advent of TKI, with a 10-year survival rate of nearly 90%, 10% of patients will develop drug resistance or disease progression
.
How to break the drug resistance dilemma, solve the survival problem of a small number of patients, and make CML truly transform into a controllable and curable chronic disease has become a goal
for researchers to explore.
Secondly, meeting the personalized diagnosis and treatment needs of patients, such as discontinuing drugs to avoid adverse reactions caused by long-term treatment, improving the quality of life, reducing economic burden, and meeting the fertility needs of young patients are also the direction
of future exploration.

Medical Pulse Pass: How do you think about the treatment status of domestic generic drugs and the current domestic application?

The efficacy of the original drug is proven by rigorously designed long-term clinical studies and is reliable
.
Domestic generic TKI drugs such as imatinib mesylate, dasatinib, etc.
, have completed consistency evaluation and have been approved by
the State Drug Administration.
At present, a number of domestic imitation TKI have been on the market for more than five years, which has brought good efficacy
to many patients.
There are also domestic research data to confirm that the efficacy and side effects of domestic imitation TKI are not significantly different from
the corresponding original research drugs.
All in all, the overall efficacy of the current domestic imitation TKI is good, the price is relatively low, and it provides high-quality and low-cost drug options
for patients with low income and no ability to bear the expensive imported original research drugs.
However, no matter which drug is chosen, the most important thing is to carry out standardized management after treatment, ensure adequate dosage medication, standardize the treatment of adverse drug reactions, regularly monitor the efficacy, and timely switch to therapeutic drugs
for patients who are intolerant or resistant.

Medical Pulse Tong: How do you think about the strong combination of the Hematology Branch of the Chinese Medical Association and the Hematology Committee of the Chinese Anti-Cancer Association?

All along, the two associations have carried out strong alliances at all levels and in all latitudes, promoting academic exchanges in the field of hematology, promoting the development of diagnosis and treatment in the field of hematology, and bringing more benefits
to patients with hematological tumors.
It is expected that in the future, the accurate diagnosis and treatment of hematological tumors can achieve more results, so that patients can receive better and more standardized treatment and achieve long-term survival
.

Professor Ji Chunyan

• Famous teacher of Shandong University, distinguished professor of outstanding talent system

• Vice Dean of Qilu Medical College, Shandong University

• Vice President of Qilu Hospital of Shandong University and Director of Cancer Center

• Director of the Joint Laboratory of Intelligent Diagnosis and Treatment of Hematological Diseases of Shandong University

• Expert in the Tarzan Scholar Climbing Program

• Young and middle-aged experts who have made outstanding contributions to national health and family planning

• Enjoy the special government allowance of the State Council

• Outstanding discipline leader of Shandong Provincial Health System

• He is the chairman of the Hematology and Oncology Professional Committee of the Chinese Anti-Cancer Association

• He is the chairman of the Hematology and Tumor Branch of Shandong Anti-Cancer Association

• He is a member of the Hematology Branch of the Chinese Medical Association

• He is the chairman of the Hematology Branch of Shandong Medical Association

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