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In recent years, the field of lymphoma therapy has developed vigorously, and many achievements have been made in the pathogenesis of the disease to targeted and immunotherapy.
In order to promote domestic and international peer exchanges, the First National Lymphocytic Disease Academic Conference of the Chinese Medical Association and the 2021 International Lymphoma Update Symposium will be held on April 16-18, 2021.
The conference specially invited well-known experts at home and abroad to give wonderful speeches, covering many aspects of lymphocytic diseases.
During the conference, Yimaitong was honored to invite Professor Zou Dehui from the Hospital of Hematology of the Chinese Academy of Medical Sciences to introduce us the current status of treatment and research progress of classic Hodgkin's lymphoma (cHL).
Current status of cHL treatment and practical challenges Professor Zou pointed out that cHL does not account for a high proportion of lymphoma, but it is a type of lymphoma that can be cured.
Through standard first-line treatment, most patients can achieve long-term survival.
However, after first-line treatment, 20%-30% of patients eventually develop primary refractory or relapsed refractory cHL patients, and fail to achieve long-term survival.
At present, there are still unmet clinical needs for the treatment of patients with cHL, especially for patients with relapsed/refractory cHL (R/R cHL).
For young patients with R/R cHL who are suitable for transplantation, after salvage treatment is used to obtain disease remission, sequential autologous hematopoietic stem cell transplantation consolidation therapy, about 50% of patients can again achieve long-term survival.
But for patients who are not suitable for transplantation, traditional treatment is more difficult to obtain long-term survival opportunities.
The traditional salvage treatment is often a combination chemotherapy regimen with greater intensity, which has greater toxic and side effects and is poorly tolerated.
At the same time, the previous salvage chemotherapy has achieved complete remission (CR), especially the proportion of PET/CT negative complete metabolic remission.
Unsatisfactory, such as the commonly used combination chemotherapy containing platinum and/or gemcitabine, the CR rate does not exceed 50%.Professor Zou introduced that obtaining CR is the key to long-term survival of patients.
Therefore, whether it is patients receiving first-line treatment or R/R cHL patients, the treatment outcome needs to be further improved.
Under the wave of precision, new therapies have emerged, with more choices, and more hopes.
In the past ten years, innovative drugs in the field of lymphoma treatment have continued to emerge.
Among them, two types of cHL new drugs have attracted much attention.
The first category is antibody-conjugated drugs (ADC) against CD30.
As we all know, CD30 is widely and highly expressed on the surface of cHL tumor cells.
Therefore, an innovative ADC targeting CD30, Vebutuximab (BV), has been developed for the CD30 antigen.
The drug will be launched in China in 2020 for the treatment of relapsed/refractory CD30-positive HL or systemic anaplastic large cell lymphoma (sALCL).
It mainly exerts a direct anti-tumor effect through binding to cell surface antigens, endocytosis and toxin release; at the same time, it can also kill tumor cells through other means such as "bystander effect".
In addition to targeted therapy, immunotherapy has also been widely used in the field of cHL recently, such as immune checkpoint inhibitor PD-1/PD-L1 monoclonal antibody.
Due to the high expression of PD-L1 and PD-L2 in most cHL patients, immune checkpoint inhibitors have also achieved good results in the treatment of cHL.
Professor Zou introduced that the emergence of new drugs has brought hope to the treatment of more cHL patients.
Even for R/R cHL patients, through the treatment of the above new drugs, the single-drug effective rate can reach 60%-80%, and the overall toxicity is low and most patients can tolerate it.
CHL treatment continues to be sought, and the first-line treatment of combination therapy or new direction cHL has achieved great success in the past few decades.
However, the traditional combination chemotherapy regimen still has many limitations.
For example, the classic ABVD program, due to the lack of drugs such as bleomycin and vinblastine in my country, usually requires other methods to replace it; even if bleomycin can achieve drug accessibility, its toxicity risk to the elderly, especially patients with lung function impairment Also relatively large.
The BEACOPP regimen is more toxic, difficult to tolerate by most patients, and has a greater impact on fertility.
At the same time, the treatment of R/R cHL patients has made a lot of progress, but there is still a lot of room for improvement.
For example, patients receiving single-drug treatment with a new drug can obtain a higher effective rate, but the CR rate is still relatively low.
In order to further improve the efficacy of patients and increase the CR rate, it is necessary to actively explore the methods of combination therapy, including the combination of two new drugs, and the combination of cytotoxic drugs and other drugs.
Professor Zou introduced that the ideal combination therapy can not only increase the CR rate, but also have relatively low drug toxicity.
Both young patients who are suitable for transplantation and elderly patients who are not suitable for transplantation can benefit from it.
Professor Zou also pointed out that it is also important to screen out patients who are not ideal for traditional cytotoxic drugs.
For these patients, new therapies should be adopted as soon as possible, and the timing of treatment should be grasped to improve the efficacy and safety of the treatment.
Prof.
Dehui Zou, Chief Physician, Lymphoma Clinic, Hospital of Hematology, Chinese Academy of Medical Sciences (Institute of Hematology, Chinese Academy of Medical Sciences), Member of Lymphoma Professional Committee of Chinese Anti-Cancer Association, Deputy Leader, Lymphoma Group, Hematological Oncology Professional Committee of Chinese Anti-Cancer Association, Chinese Geriatrics Member of the Standing Committee of the Society of Hematology, Member of the Lymph and Hematology Committee of the Chinese Society of Geriatric Oncology, Vice Chairman of the Lymphoma Professional Committee of Tianjin Anti-Cancer Association, Deputy Director of the Oncology Critical Care Professional Committee of Tianjin Anti-Cancer Association, Member of China Multiple Myeloma Research Alliance "Learning Magazine" newsletter editor stamp "read the original", we make progress together
In order to promote domestic and international peer exchanges, the First National Lymphocytic Disease Academic Conference of the Chinese Medical Association and the 2021 International Lymphoma Update Symposium will be held on April 16-18, 2021.
The conference specially invited well-known experts at home and abroad to give wonderful speeches, covering many aspects of lymphocytic diseases.
During the conference, Yimaitong was honored to invite Professor Zou Dehui from the Hospital of Hematology of the Chinese Academy of Medical Sciences to introduce us the current status of treatment and research progress of classic Hodgkin's lymphoma (cHL).
Current status of cHL treatment and practical challenges Professor Zou pointed out that cHL does not account for a high proportion of lymphoma, but it is a type of lymphoma that can be cured.
Through standard first-line treatment, most patients can achieve long-term survival.
However, after first-line treatment, 20%-30% of patients eventually develop primary refractory or relapsed refractory cHL patients, and fail to achieve long-term survival.
At present, there are still unmet clinical needs for the treatment of patients with cHL, especially for patients with relapsed/refractory cHL (R/R cHL).
For young patients with R/R cHL who are suitable for transplantation, after salvage treatment is used to obtain disease remission, sequential autologous hematopoietic stem cell transplantation consolidation therapy, about 50% of patients can again achieve long-term survival.
But for patients who are not suitable for transplantation, traditional treatment is more difficult to obtain long-term survival opportunities.
The traditional salvage treatment is often a combination chemotherapy regimen with greater intensity, which has greater toxic and side effects and is poorly tolerated.
At the same time, the previous salvage chemotherapy has achieved complete remission (CR), especially the proportion of PET/CT negative complete metabolic remission.
Unsatisfactory, such as the commonly used combination chemotherapy containing platinum and/or gemcitabine, the CR rate does not exceed 50%.Professor Zou introduced that obtaining CR is the key to long-term survival of patients.
Therefore, whether it is patients receiving first-line treatment or R/R cHL patients, the treatment outcome needs to be further improved.
Under the wave of precision, new therapies have emerged, with more choices, and more hopes.
In the past ten years, innovative drugs in the field of lymphoma treatment have continued to emerge.
Among them, two types of cHL new drugs have attracted much attention.
The first category is antibody-conjugated drugs (ADC) against CD30.
As we all know, CD30 is widely and highly expressed on the surface of cHL tumor cells.
Therefore, an innovative ADC targeting CD30, Vebutuximab (BV), has been developed for the CD30 antigen.
The drug will be launched in China in 2020 for the treatment of relapsed/refractory CD30-positive HL or systemic anaplastic large cell lymphoma (sALCL).
It mainly exerts a direct anti-tumor effect through binding to cell surface antigens, endocytosis and toxin release; at the same time, it can also kill tumor cells through other means such as "bystander effect".
In addition to targeted therapy, immunotherapy has also been widely used in the field of cHL recently, such as immune checkpoint inhibitor PD-1/PD-L1 monoclonal antibody.
Due to the high expression of PD-L1 and PD-L2 in most cHL patients, immune checkpoint inhibitors have also achieved good results in the treatment of cHL.
Professor Zou introduced that the emergence of new drugs has brought hope to the treatment of more cHL patients.
Even for R/R cHL patients, through the treatment of the above new drugs, the single-drug effective rate can reach 60%-80%, and the overall toxicity is low and most patients can tolerate it.
CHL treatment continues to be sought, and the first-line treatment of combination therapy or new direction cHL has achieved great success in the past few decades.
However, the traditional combination chemotherapy regimen still has many limitations.
For example, the classic ABVD program, due to the lack of drugs such as bleomycin and vinblastine in my country, usually requires other methods to replace it; even if bleomycin can achieve drug accessibility, its toxicity risk to the elderly, especially patients with lung function impairment Also relatively large.
The BEACOPP regimen is more toxic, difficult to tolerate by most patients, and has a greater impact on fertility.
At the same time, the treatment of R/R cHL patients has made a lot of progress, but there is still a lot of room for improvement.
For example, patients receiving single-drug treatment with a new drug can obtain a higher effective rate, but the CR rate is still relatively low.
In order to further improve the efficacy of patients and increase the CR rate, it is necessary to actively explore the methods of combination therapy, including the combination of two new drugs, and the combination of cytotoxic drugs and other drugs.
Professor Zou introduced that the ideal combination therapy can not only increase the CR rate, but also have relatively low drug toxicity.
Both young patients who are suitable for transplantation and elderly patients who are not suitable for transplantation can benefit from it.
Professor Zou also pointed out that it is also important to screen out patients who are not ideal for traditional cytotoxic drugs.
For these patients, new therapies should be adopted as soon as possible, and the timing of treatment should be grasped to improve the efficacy and safety of the treatment.
Prof.
Dehui Zou, Chief Physician, Lymphoma Clinic, Hospital of Hematology, Chinese Academy of Medical Sciences (Institute of Hematology, Chinese Academy of Medical Sciences), Member of Lymphoma Professional Committee of Chinese Anti-Cancer Association, Deputy Leader, Lymphoma Group, Hematological Oncology Professional Committee of Chinese Anti-Cancer Association, Chinese Geriatrics Member of the Standing Committee of the Society of Hematology, Member of the Lymph and Hematology Committee of the Chinese Society of Geriatric Oncology, Vice Chairman of the Lymphoma Professional Committee of Tianjin Anti-Cancer Association, Deputy Director of the Oncology Critical Care Professional Committee of Tianjin Anti-Cancer Association, Member of China Multiple Myeloma Research Alliance "Learning Magazine" newsletter editor stamp "read the original", we make progress together
