2022 SHS Professor Ma Jun: Take the helm of innovation, raise the sail of precision, the current situation and development of precision oncology in China

In autumn and October, the fragrance of cinnamon fills the city
.
The "2022 Suzhou Hematology Summit and National Continuing Medical Education Class" was grandly opened
in Suzhou on October 7-9, 2022.
This conference invited well-known hematology experts at home and abroad to conduct in-depth discussions
on the research and development of new drugs in hematology, precision medicine and leukemia, the construction of big data platform, and the blood innovation forum.
On this occasion, Yimaitong specially invited Professor Ma Jun of Harbin Institute of Hematology and Oncology to talk about the current situation and future development direction
of precision medicine in China.

Yimaitong: The treatment of tumors has undergone a transformation from empirical medicine to evidence-based medicine, and then to translational medicine and precision medicine.
What tangible changes has cutting-edge technology brought to the precision diagnosis and treatment of tumors?

Since European and American countries proposed "precision medicine", it has quickly become the focus of heated discussion and attention in the global medical community, and at that time, it mainly focused on precision surgery, precision radiotherapy and precision chemotherapy
.
With the development of targeted therapy, immunotherapy, and individualized and standardized diagnosis and treatment, precision medicine has set off a new round of medical revolution
.

In 1960, two scientists in Philadelphia, USA, first discovered the Philadelphia chromosome (Ph chromosome), which is the culprit of chronic myeloid leukemia (CML), and the Philadelphia chromosome also became the first-ever drug target for
tumor-targeted therapy.
In 2001, imatinib, the first tyrosine kinase inhibitor (TKI) for the treatment of Philadelphia chromosome-positive CML, was approved by the FDA for marketing, which successfully opened up the application of small molecule inhibitors in precision therapy and individualized treatment of tumors, making the efficacy of CML a leap forward and becoming a cancer
that can survive for a long time.
Subsequently, a variety of second- and third-generation TKIs came out successively, and the 20-year disease-free survival rate of CML patients reached 88%, and CML went from an "incurable disease" to a chronic manageable disease
like hypertension and diabetes.

In 1997, rituximab was approved by the FDA for marketing, becoming the world's first macromolecular monoclonal antibody to enter the precision treatment of tumors, opening a new era of
immunochemotherapy.
Rituximab combined with chemotherapy has enabled about 70% of patients with diffuse large B-cell lymphoma (DLBCL) to achieve clinical cure, creating a precedent
for curable tumors.

CAR-T cell therapy is a successful example of precision medicine, and in 2012, the world's first patient with relapsed/refractory acute lymphoblastic leukemia treated with CAR-T therapy from the University of Pennsylvania was successful, and CAR-T cell therapy also ushered in a new era of
tumor treatment.

With the gradual popularization and deepening of the concept of precision medicine, more and more small molecule TKIs, macromolecular monoclonal antibodies, PD-1/PD-L1 monoclonal antibodies, etc.
have entered the clinic, and the research and development and application of precision drugs have benefited
more and more patients.
The era of precision medicine requires us to be absolutely precise in treatment, and formulate individualized and precise treatment plans for patients to achieve the best treatment results, which is truly patient-centered
.

With the development of modern biological science and technology, precision oncology has ushered in new opportunities
.
At this meeting, Academician Zhan Qimin shared the supporting role of cutting-edge science and technology on the development of tumor precision medicine, Academician Zhan said that big data and artificial intelligence have brought revolutionary changes to the medical model, and we need to carry out big data research and master the epidemiological data of malignant tumors; Secondly, with the support of big data, the law of tumorigenesis and development and treatment strategies are studied; In addition, precision medicine requires multidisciplinary collaboration, and the development of many cutting-edge disciplines today has also laid a solid foundation for precision medicine, such as biomics, stem cells and regenerative medicine
.

All in all, the development of precision medicine requires innovation, and technological innovation and clinical transformation are the core driving forces
for the rapid development of the field of cancer in the past 60 years.
Only innovation can have a future, and malignant tumors can be cured
.
Although in the past 20 years, China's oncology field has developed rapidly, but China is still a large country of oncology, ranking first
in the world in new cancer cases and deaths.
The overall five-year survival rate for cancer patients in the United States has reached nearly 70 percent, compared to about 40 percent
in our country.
Therefore, we should learn from advanced foreign experience and strive to let Chinese cancer patients live longer and achieve a higher clinical cure rate
.

Yimaitong: China has made gratifying achievements in the field of precision cancer treatment, how can the results of precision medicine be extended to a wide range of clinical applications in the future?

Although China has become the world's second largest economy, we still belong to the third world countries
from the perspective of scientific and technological innovation.
The United States is the country with the most innovative drugs in the world, with more than a dozen first-in-class new drugs approved every year, and developed countries such as Europe and Japan also have 2-3 innovative drugs approved every year, while there are only a few
first-in-class new drugs in China in the past 20 years.
The reason is mainly due to the insufficient medical innovation capacity in China, secondly, the insufficient R&D investment of China's pharmaceutical enterprises, and the lag in the construction of high-quality clinical research teams, which limits the development of
innovative drugs in China.

At present, China has entered the spring of innovative drug research and development, and it may take a long time
before the autumn harvest.
However, we are confident that adhering to the principle of "life first, everything patient-centered", through multidisciplinary and multi-field extensive collaboration, including radiation medicine, nuclear medicine, imaging medicine, basic medicine, clinical medicine, translational medicine, biostatistics, big data, etc.
, give full play to the advantages of multidisciplinary cross-integration, accelerate source innovation, continuously improve the research and development level of new anti-tumor drugs in China, and promote the research and clinical application of new drugs, so as to bring longer-term survival benefits
to tumor patients.

Professor Ma Jun

• Chief physician, professor, doctoral supervisor

• Director of Harbin Institute of Hematology and Oncology

• Chairman of the Supervisory Board of the Chinese Society of Clinical Oncology (CSCO).
  

• Vice Chairman of the Asian Society of Clinical Oncology

• Chairman of the Leukemia Expert Committee of the Chinese Society of Clinical Oncology

• Leader of the expert group of the lymphoma specialty construction project of the National Health Commission Capacity Building and Continuing Education Center

• Honorary Consultant of Nursing Group, Lymphoma Expert Committee, Chinese Society of Clinical Oncology

• In 1979, he went to Japan to study at the University of Tokyo School of Medicine, and has been committed to the diagnosis and treatment of benign and malignant diseases of the blood system, especially for the treatment of leukemia and lymphoma

• In 1982, the in vitro pluripotent hematopoietic progenitor cell culture system was first established in China to fill the domestic gap

• Since 1983, more than 1200 cases of acute promyelocytic leukemia have been treated with sequential therapy of retinoic acid and arsenic trioxide, and the disease-free survival rate in 10 years is 85%, reaching the international advanced level

• He has published more than 200 papers and more than 40 monographs in domestic and foreign journals, and won 20 national, provincial and municipal science and technology awards
  .
  It has undertaken 8 national 863 major scientific research projects and 25 provincial and municipal scientific research projects