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    Home > Active Ingredient News > Antitumor Therapy > Summit Dialogues to Participate in the Grand Event | Focus on the first cwCLL and iwCLL joint conference

    Summit Dialogues to Participate in the Grand Event | Focus on the first cwCLL and iwCLL joint conference

    • Last Update: 2021-04-27
    • Source: Internet
    • Author: User
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    On March 20, 2021, the 4th China Chronic Lymphocytic Leukemia Conference and the 1st China Chronic Lymphocytic Leukemia Working Group (cwCLL) and International Chronic Lymphocytic Leukemia Working Group (iwCLL) joint conference were successfully held in Tianjin.

    The conference was jointly organized by Professor Qiu Lugui from the Hospital of Hematology of the Chinese Academy of Medical Sciences (Institute of Hematology, Chinese Academy of Medical Sciences), Professor Li Jianyong from the First Affiliated Hospital of Nanjing Medical University, Professor Michaef Hallek from the University of Cologne Hospital in Germany, and Professor Peter Hillmen from the University of Leeds School of Medicine in the United Kingdom.
    Chairman, Professor Ma Jun from Harbin Institute of Hematology and Tumor, Professor Zhou Jianfeng from Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Professor Feng Ru from Southern Hospital of Southern Medical University, Professor Yang Shenmiao from Peking University People's Hospital, and Professor Bai Ou from Bethune First Hospital of Jilin University As the chairperson of the meeting, Professor Xu Wei from the First Affiliated Hospital of Nanjing Medical University, Professor Davide Rossi from the Southern Swiss Tumor Research Institute, Professor Paolo Ghia from the Vita-Salute San Rafael University in Milan, Italy, and Hematology Hospital of the Chinese Academy of Medical Sciences (Chinese Academy of Medical Sciences Institute) Professor Yi Shuhua attended the conference as a speaker to discuss the biological characteristics, diagnosis, prognosis, and treatment strategies of chronic lymphocytic leukemia (CLL).

    Opening remarks The opening of the meeting was presided over by Professor Ma Jun.
    Professor Li Jianyong, Professor Qiu Lugui, Professor Michaef Hallek and Professor Peter Hillmen respectively delivered opening speeches for the conference.
    Professor Qiu first addressed the 4th China Chronic Lymphocytic Leukemia Conference and the 1st cwCLL and All colleagues and online audiences of the iwCLL joint conference expressed a warm welcome.
    Professor Qiu said that cwCLL has made breakthroughs in its work in the past two years, and the exchanges and cooperation with iwCLL have gradually become closer, and I look forward to this exchange with iwCLL.Professor Li said that cwCLL has just started, and there is still a big gap compared with the international advanced level.
    Today, I am very honored to be able to communicate with the most famous CLL professor in the world.
    As the host, I would like to express my gratitude to colleagues at home and abroad, and wish this meeting in advance.
    A complete success.

     iwCLL's work review and plan Professor Michaef Hallek, chairman of iwCLL, first introduced the history of iwCLL.
    iwCLL was born in 1979 and has achieved great success in the field of CLL.

    Today, iwCLL is an international non-profit organization registered in Cologne, Germany, dedicated to improving the prognosis management of CLL patients worldwide.

    The vision of iwCLL is to create a world where all CLL patients can be cured.

    In the past few years, iwCLL has been committed to supporting the basic research and clinical transformation of CLL, strengthening mutual exchanges, and coordinating clinical research to establish international standards for diagnosis and treatment of CLL patients.

    In the future, iwCLL hopes to hold an annual meeting with the China Chronic Lymphocyte Working Group, establish new treatment sub-committees, revise guidelines, hold educational meetings and other measures to ensure that regardless of the income, education, gender, and medical system of CLL patients around the world All are able to receive the same quality of treatment; through the establishment of an international affairs committee, more standardized exchanges with peers, and jointly promote the development of global CLL.

    Review and prospect of cwCLL's work After Professor Michaef Hallek introduced the overall work of iwCLL, Professor Xu Wei reviewed and prospected the work of cwCLL.

    Professor Xu said that cwCLL was established in 2017 to train professional CLL clinicians through scientific activities and conferences in China, promote CLL-related research in China, and strengthen the voice of Chinese hematology in the world.

    Currently cwCLL has 7 core members and 83 committee members.

    In the first half of 2020, due to the outbreak of the new crown epidemic, cwCLL quickly launched an online public course on standardized diagnosis and treatment at the China Institute of Chronic Lymphology.
    A total of 9 sessions were held.
    The number of effective viewers reached 5154, and the average viewing time was 54 minutes.
    Finally, it was awarded 202.
    In the second half of 2020, as the epidemic eases, cwCLL will actively support the establishment of local chronic lymphocyte working groups in combination with the development of chronic lymphocytes in various provinces.
    A total of 16 local working groups have been established, covering 243 hospitals.

    In 2021, the work of cwCLL will focus on "standardization", mainly in three aspects: 1.
    Standardization of CLL diagnosis and differential diagnosis; 2.
    Standardization of CLL treatment indications; 3.
    Standardization of CLL treatment options, which will be standardized with CLL The format of the case competition will be held in the local working group for the preliminary round and the final at the 5th China Chronic Lymphocytic Leukemia Conference.

    At the same time, cwCLL also hopes that through close communication with iwCLL, it can promote national multi-center clinical trial cooperation, explore the biological characteristics of China's CLL, and finally form China's own CLL diagnosis and treatment model.

    The biological progress of CLL Professor Davide Rossi said that we have a more in-depth understanding of the biological characteristics of BCR pathway activation, BCL-2 signaling pathway opportunities, genetic instability, and immune escape in newly treated and relapsed patients.
    There are still some controversies about the biological characteristics of residual disease (MRD).

    It is well known that most patients treated with ibrutinib have moderate or high levels of MRD in the blood and bone marrow, and the resistance of ibrutinib is due to mutations in the BTK gene that drive the interaction between ibrutinib and BTK targets.
    Blocking or restarting the BCR signaling pathway through PLCG mutations activates the downstream signals of the BCR pathway, destroys the effect of BTK inhibitors, and causes disease progression.
    However, the biological characteristics of MRD before progression are still unclear.

    In order to solve this problem, Professor Davide Rossi Center conducted a systematic study that included 33 patients who received ibrutinib monotherapy, aiming to understand the adaptation process that allows CLL cells to persist even if they are attacked by BTK inhibitors.
    The multi-level features.

    Research evidence shows that BTK target mutation or downstream PLCG mutation activation has nothing to do with MRD after ibrutinib treatment.

    MRD is dormant at the cellular level and is characterized by activation of the PAS-BRAF-MAPK-ERK bypass signaling pathway.

    Inhibiting these cascade pathways through combination medications and achieving MRD negative is the future direction of exploration.

    Accurate diagnosis of CLL Professor Paolo Ghia pointed out that the diagnosis of CLL no longer requires bone marrow biopsy/aspiration, nor imaging examination.
    Complete blood count and immunophenotype are mandatory items for the diagnosis of CLL, among which immunophenotype is very important.
    .

    The European Chronic Lymphocytic Leukemia Research Project (ERIC) and the European Association for Clinical Cell Analysis (ESCCA) recently jointly released the ranking of CLL recommended test markers, among which CD5, CD19, CD20, etc.
    are necessary test items.
    These items help CLL and Differential diagnosis for other lymphomas.

    At the same time, this set of markers can lay the foundation for MRD analysis.
    The combined use of these markers can achieve the sensitivity level required by MRD, and can even reliably identify cells at the level of one in ten thousand cells.

    Cytogenetic testing and molecular testing play an important role in judging the prognosis of CLL disease.

    TP53 and IGHV mutations have become predictors of treatment response.

    The 2021 European Society of Oncology (ESMO) guidelines point out that although almost all types of patients can be treated with the same type of drugs due to the emergence of new therapies, all CLL patients in need of treatment should first be stratified from a genetic point of view.
    Guide individualized precision treatment of CLL.

    In this regard, ERIC created the TP53 and IGHV network, aiming to popularize the importance of TP53 gene and IGHV gene testing, assist laboratory analysis, and certify the quality of the laboratory.

    The best treatment option for CLL Professor Peter Hillmen said that to determine the treatment plan for CLL, the treatment goal of CLL must be determined.

    The age of the patient, the choice of the patient, the previous treatment plan, and the biological characteristics of the disease will all affect the choice of treatment.

    Untreated patients first need to choose a fixed course of treatment for deep relief or continuous treatment for disease control according to the characteristics of the disease and their own needs.

    Although continuous treatment to control the disease is equally effective in patients with poor prognosis such as TP53 and IGHV without mutations, the toxicity of long-term treatment and the possibility of drug resistance must be considered; fixed course of treatment can also make patients in the non-treatment period It is in remission and is not easy to resist, but most patients will relapse.

    Whether it is continuous treatment to control the disease or a fixed course of treatment, the long-term survival benefits of patients with MRD negative are significantly higher, and MRD may be the best method to evaluate the results.

    In the future, both targeted combination therapy and cell therapy targeting MRD are worth exploring.

    The biological characteristics of CLL in China Professor Yi Shuhua said that the incidence of CLL in China is much lower than that in Western countries, and there are more younger and more advanced patients.

    The main biological characteristics of CLL patients in China are also somewhat different from those in Western countries.

    The mutation pattern of the IgHV gene in China is different from that of Western countries.
    The frequency of V1-69, V1-2 and V3-21 is significantly lower.
    The frequency of use of V4-34 and V4-39 is higher than that of Western countries, which may be affected by potential environmental antigens.
    And/or specific genetic background.

    MYD88 and KMT2D are highly mutated genes unique to Chinese CLL, concentrated in China-specific IGHV subgroups such as V4-34 and V4-39.
    KMT2D mutations reduce the expression of H3K4me3, which may benefit from epigenetic therapy drugs. Panel discussion In the discussion session, Professor Michael Hallek, Professor Peter Hillmen, Professor Davide Rossi and Professor Li Jianyong, Professor Qiu Lugui, Professor Zhou Jianfeng, Professor Wang Xin, Professor Feng Ru, Professor Yang Shenmiao, Professor Xu Wei, Professor Yi Shuhua, Professor Xu Zhenshu, etc.
    The diagnostic value of CD5, CD43, and CD200 by many domestic experts in CLL; whether MRD can guide the selection of targeted drugs in the future; the safety and effectiveness of long-term treatment of ibrutinib; and the diagnosis of patients with IGHV mutations and IGHV non-mutated patients In-depth discussions on issues such as the choice of treatment options, exchange of experience and opinions, pointed out the direction for the future work development of cwCLL and the revision and revision of the CLL diagnosis and treatment guidelines, and also provided constructive suggestions.

    Summary This meeting is jointly participated by Chinese and foreign experts.
    It is the first joint meeting of cwCLL and iwCLL.
    It provides an in-depth review of the past work and future planning of cwCLL and iwCLL, the biological characteristics of Chinese and international CLL, and the progress of precise diagnosis and treatment of CLL.
    Sharing and communication, attracted more than 6000 people to watch online! In the future, cwCLL and iwCLL will continue to carry out in-depth cooperation in the education and scientific research of CLL specialists.
    China will also actively apply for iwCLL's biennial annual meeting in 2023, inviting iwCLL members to come to China to guide work and promote the development of CLL in China.

    Finally, the Chinese and foreign experts who participated in this meeting took a group photo together, and the first cwCLL and iwCLL joint conference ended successfully! Poke "read the original text" and we will make progress together
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