[perspective] from 1949 to 2017, "malignant lymphoma" has 41 therapeutic drugs in the world

Malignant lymphoma is one of the ten most common cancers in China According to the data published in the annual report of China Cancer Registry, the incidence rate of malignant lymphoma is about 5/10 million from 2003 to 2013 Malignant lymphoma is considered incurable in the past However, the molecular target therapy has increased the survival rate of patients over 50% in recent years, including early Hodgkin's lymphatic lymphoma The cure rate of tumor can reach more than 80%; through further inquiry, from the listing of nitrogen mustard in 1949 to the listing of furadilicin in 2017 for the treatment of peripheral T-cell lymphoma, 41 drugs (chemical drugs + biological drugs) have been listed; this article will briefly describe the disease and listed drugs, and take you to know malignant lymphoma! 1 What is malignant lymphoma? According to the pathological classification, it can be divided into two categories: Hodgkin's lymphoma and non Hodgkin's lymphoma, which is a common type of adult malignant spleen tumor Strictly speaking, malignant lymphoma is not just a disease, but a group of diseases, which can be divided into Hodgkin's lymphoma and non Hodgkin's lymphoma according to pathological classification Among them, there are 4 pathological subtypes of Hodgkin's lymphoma and 80 pathological subtypes of non Hodgkin's lymphoma, and diffuse large B cell is the most common subtype 2 In 1832, Dr Thomas Hodgkin of guy hospital in London dissected seven corpses that died of abdominal lymphadenopathy and splenomegaly In the pathological examination of the corpse, he found a large and unique giant tumor cell, reed Sternberg cell (RS cell for short) Later, he named the disease Hodgkin's disease after him Until 2001, the WHO classification changed "Hodgkin's disease (hd)" to "Hodgkin's lymphoma (HL)", and named "non Hodgkin's lymphoma (NHL)" as lymphoma without RS cells 3 The diagnosis of lymphoma The clinical manifestations of lymphoma include systemic symptoms and local symptoms Systemic symptoms include fever, night sweat, weight loss, pruritus and asthenia of skin with unknown causes; local symptoms depend on different primary and invaded parts, and the most common manifestation is painless progressive lymphadenopathy Physical examination should pay special attention to the enlargement of lymph nodes in different areas, the size of liver and spleen, accompanying signs and general state The laboratory tests to be completed include blood routine, liver and kidney function, lactate dehydrogenase, β 2 microglobulin, ESR, hepatitis B and hepatitis C virus detection, bone marrow aspiration cytology and / or biopsy, etc For patients with the risk of central nervous system invasion, lumbar puncture should be carried out and CSF biochemical, routine and cytological examination should be carried out For NK / T cell lymphoma patients, the DNA titer of EBV in peripheral blood should be detected The commonly used imaging methods are CT, MRI, positron emission, ultrasound and endoscope 4 The clinical characteristics of common lymphoma pathological types: treatment of ☆ - Hodgkin's lymphoma, men are more than women, the ratio of men to women is 1.3-1.4:1; the age of onset is a typical bimodal distribution in developed countries in Europe and America, respectively, 15-39 years old and after 50 years old; while in East Asia, including China, the age of onset is mostly between 30-40 years old, with a single peak distribution Non Hodgkin's lymphoma is a group of heterogeneous lymphoproliferative diseases, which originated from B lymphocyte, T lymphocyte or NK cell Among them, diffuse large B-cell lymphoma is the most common type of NHL, accounting for 30% - 40% of adult NHL in the West and about 35% - 50% in China The median age of DLBCL was 50-70 years old, which was slightly higher in males than in females 5 Introduction of representative drugs: Rituximab is the first monoclonal antibody to CD20 antigen on cell surface Rituximab specifically binds to CD20 antigen on the surface of B-cell lymphoma cell membrane, and plays an anti-tumor effect through complement dependent cytotoxic effect (CDC) and antibody dependent cytotoxic effect (ADCC) At present, rituximab is widely used in the treatment of CLL / SLL, FL, DLBCL, MCL and some highly invasive B-cell lymphoma In the critical phase II clinical trial of chidamide, 83 patients with recurrent or refractory PTCL were enrolled into the group, all of whom received 30 mg / time and 2 times / week of sidamide tablets until the disease progressed or intolerable adverse reactions occurred The main outcome measure was objective remission rate The results showed that the orr was 28%, the median progression free survival and total survival were 2.1 months and 21.4 months, respectively, and the sustained remission rate of 3 months was 24% The most common grade 3-4 adverse reactions were thrombocytopenia (22%), leucopenia (13%) and neutropenia (10%) 6 41 lymphoma drugs on the market According to the data query, there are 41 kinds of drugs on the market in the world about the development of malignant lymphoma drugs, among which the number of chemical drugs is far more than that of biological drugs, and the proportion of biological similar drugs in biological drugs is very large; the drugs independently developed in China are xidaban of microchip biology and recombinant human tumor necrosis factor of Shanghai Vico biology; the key information of the drugs on the market is shown in the table below Statement: this opinion only represents the author, not the position of yaozhi.com, welcome to exchange and supplement in the message area; if you need to reprint, please be sure to indicate the author and source of the article.