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    Home > Active Ingredient News > Blood System > Professor Zhu Jun: Progress in the Treatment of Peripheral T-Cell Lymphoma The 2nd China Hematology Development Conference

    Professor Zhu Jun: Progress in the Treatment of Peripheral T-Cell Lymphoma The 2nd China Hematology Development Conference

    • Last Update: 2022-02-23
    • Source: Internet
    • Author: User
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    From January 14th to 16th, 2022, the 2nd China Hematology Development Conference will be held online
    .

    With the theme of "Strengthening the Foundation, Emphasizing Clinical Practice, and Promoting Transformation—Building a New Ecology of Hematology Innovation and Development", many experts and colleagues in the field of hematology gathered together to exchange the cutting-edge progress of hematology and discuss the future development direction
    .

    At the meeting, Professor Zhu Jun from Peking University Cancer Hospital gave a report on "Current Status of Diagnosis and Treatment of Peripheral T-cell Lymphoma"
    .

    Peripheral T-cell lymphoma (PTCL) is a group of malignant tumors originating from mature T cells.
    Compared with B-cell lymphoma, the progress of PTCL treatment is relatively lagging behind
    .

    According to Prof.
    Zhu Jun, data from Peking University Cancer Hospital showed that between 1996 and 2015, the 5-year overall survival (OS) rate of classic Hodgkin lymphoma (cHL) increased by 23.
    6%, and the 5-year OS rate of B-cell lymphoma increased by 16.
    4%.
    %, the 5-year OS rate of PTCL is only increased by 9.
    8% (the current 5-year OS rate is only about 50%)
    .

    In addition, the number of PTCL patients in China is significantly higher than that in foreign countries, so to attract domestic attention, more new drugs are needed
    .

    Next, Professor Zhu Jun introduced the latest treatment of PTCL based on the clinical experience and clinical trials of Peking University Cancer Hospital
    .

    1 Anti-CD30 mAb At the 2021 EHA meeting, the Public Health Agency of England (PHE) announced the survival data of BV monotherapy in patients with relapsed and refractory anaplastic large cell lymphoma (R/R ALCL), and the results showed that the patients survived The benefit was significant, with a 2-year OS rate of 46.
    6%, a 2-year OS rate of 50.
    3% for second-line therapy, and a 2-year OS rate of 29.
    7% for third-line therapy
    .

    So what is the efficacy of BV first-line treatment for PTCL patients? The ECHELON-2 study is a multicenter, randomized, placebo-controlled, double-blind, open-label, global phase III trial that enrolled patients with >10% CD30 expression (n=452), and patients were randomized (1:1) Assigned to receive BV combined with CHP regimen or CHOP regimen, short-term efficacy analysis showed that the overall response rate (ORR) was 83% and 72% (p=0.
    0032), and the complete response (CR) rate was 68% and 56%, respectively ( p=0.
    0066); the long-term efficacy analysis showed that the BV+CHP group had a significant benefit in progression-free survival (PFS) (48.
    2 months vs 20.
    8 months), and the risk of death was reduced by 34%
    .

    Prof.
    Zhu Jun said that if the price of BV drugs decreases and the accessibility to Chinese patients is getting higher and higher, it is believed that more and more BV applications will enter the first-line treatment of PTCL, benefiting more patients
    .

    Chidamide, a 2HDAC inhibitor, is a new generation of histone deacetylase (HDAC) inhibitor independently developed and produced in China, and has strong accessibility in China
    .

    The key clinical study conducted in China is the CHIPEL registration study, which enrolled 83 patients with R/R PTCL, and the median follow-up was 29 months.
    The ORR of Chidamide alone was 28%
    .

    Chidamide is thus approved in China for PTCL patients who have failed first-line therapy
    .

    Subsequently, a number of first-line and second-line clinical trials (combined chemotherapy and non-chemotherapy) were also carried out in China for related exploration, and some studies were selected for the 2021 ASH annual meeting (as shown below)
    .

    3PD1 monoclonal antibody Professor Zhu Jun introduced that at present, PD1 monoclonal antibody treatment of PTCL is basically in the trial stage of small-sample, single-drug, single-arm research, and some studies have been terminated early due to the risk of toxic side effects or poor efficacy
    .

    However, the availability of PD1 monoclonal antibody in China is relatively good.
    At present, a number of studies using PD1 monoclonal antibody to treat unapproved lymphoma or solid tumors are undergoing related attempts and explorations
    .

    4JAK inhibitor Professor Zhu Jun said that JAK inhibitors are also expected to play a role in T-cell lymphomas.
    AZD4205 is an oral, highly selective JAK inhibitor with a half-life of 50 hours.
    In March 2020, Peking University Cancer Hospital launched The excellent clinical results of the phase I/II multicenter open-label single-arm dose escalation study of R/R PTCL are expected
    .

    5PI3K inhibitor PI3K (phosphatidylinositol-3-kinase) is an endophosphatidylinositol kinase
    .

    Existing studies have demonstrated that PI3K-dependent signaling pathway plays a key role in the occurrence and development of various cancers, and thus is an important cancer therapeutic target
    .

    At present, there are also related studies exploring its application in the treatment of PTCL, including Tenalisib, Copanlisib, Duvelisib, YY-20394,
    etc.

    In a phase I study evaluating copanlisib in patients with R/R PTCL, ORR was 21.
    4% in 14 evaluable patients; in a study evaluating copanlisib plus gemcitabine in 28 patients with R/R PTCL, ORR was 71.
    4% , the CR rate was 32.
    1%, and the median effective time was 8.
    2 months
    .

    YY-20394 also showed good efficacy in the phase Ib study of R/R PTCL, with an ORR of 57.
    1%
    .

    Professor Zhu Jun said that he also looked forward to the excellent progress of such drugs in PTCL
    .

    The 6XPO1 inhibitor nuclear export protein 1 (XPO1) inhibitor selenisole has been approved in China for relapsed and refractory multiple myeloma (RRMM), which is related to B-NHL and T and NK cell lymphomas.
    Also underway, a multicenter, single-arm, phase Ib TOUCH study evaluating selinexor in combination with investigator's choice of chemotherapy (GemOX or ICE) in patients with R/R PTCL who have received multiple lines of therapy , the results of which were published at the 2021 ASH annual meeting, showing positive efficacy and safety, and more results need further observation
    .

    In the end, Professor Zhu Jun said that the current lymphoma diagnosis and treatment has entered a new era, and it is necessary to actively explore a new model of standardized diagnosis and treatment, promote the development of multi-disciplinary specialties, and advocate new drug clinical trials.
    In addition, the quality of life of patients and the cost-effectiveness of treatment issues Also worth watching
    .

    Professor Zhu Jun, Secretary of the Party Committee of Peking University Cancer Hospital, Director of Internal Medicine, Director of Lymphoma Department, doctoral tutor, mainly focusing on diagnosis and treatment of malignant lymphoma Chairman of the Lymphoma Alliance Member of the Standing Committee of the Geriatric Oncology Professional Committee of the Chinese Geriatrics Association Vice Chairman of the Cancer Targeted Therapy Professional Committee of the China Anti-Cancer Association (CACA) Vice-chairman of the Beijing Anti-Cancer Association President of the China Association for the Promotion of Human Health Science and Technology Click "read the original text", we progress together
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