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Lymphoma is a type of highly heterogeneous hematological tumors.
At present, its treatment has made significant progress.
Multi-omics research has provided many new ideas for the diagnosis and treatment of lymphoma.
Through the study of DNA, RNA, protein, epigenetics and The composition of metabolites and the interaction and relationship between these components under specific conditions, fusion analysis to find accurate diagnosis and treatment targets and related treatment plans, and ultimately benefit patients
.
In order to further promote the communication and development in the field of leukemia and lymphoma diagnosis, the 3rd Hematological Tumor Accurate Detection Summit Forum was successfully held in Beijing from July 3 to 4, 2021
.
During this period, Yimaitong specially invited Professor Bai Ou from Bethune First Hospital of Jilin University to share the latest research, opportunities and challenges in the diagnosis and treatment of lymphoma in the multi-omics era
.
Yimaitong: In the era of big data, multi-omics research, which combines multiple omics data, is a major trend
.
Based on your current clinical practice, please talk about the opportunities and challenges that multidisciplinary studies have brought to the diagnosis and treatment of lymphoma? Professor Baiou's multi-omics (Omics) research refers to a research method that integrates genomics, transcriptomic, proteomic, metabolomics and other omics.
Each group has the suffix "omic", hence the name
.
For example, the initial morphological stratification of diffuse large B-cell lymphoma (DLBCL) mainly includes ABC subtypes, GCB subtypes, etc.
, and the "2016 WHO Classification of Hematopoietic and Lymphoid Tissue Tumors" newly added Double-Beat Lymphoma (Double- Hit lymphoma (DHL), Triple-Hit lymphoma (THL), etc.
are further stratified from the aspect of genetic changes, so that each type of DLBCL, each subtype in each subtype, and each subtype The molecular typing in China has entered a new era, that is, the era of multi-omics
.
On the one hand, multi-omics research is single-omics, including genomics, transcriptomics, proteomics and metabolomics, and covers the analysis of fusion information of these subgroups
.
On the other hand, further expand the breadth, including the combination of immune microenvironment, protein post-translational epigenetics, and expand the depth of single-cell sequencing
.
The comprehensive use of these tests makes the diagnosis of lymphoma extremely accurate, which is helpful to guide the research and selection of clinical treatment plans, improve the effect of targeted therapy, reduce the side effects of chemotherapy and other programs, and enable patients to obtain a higher quality of life.
Patients benefit
.
Yimaitong: In the current multi-omics era, what progress has been made in the precise diagnosis and treatment of lymphoma? What are the specific instructions for clinical practice? Professor Bai Ou took DLBCL as an example.
At first, based on the expression of protein molecules and different cell origins, DLBCL was divided into GCB subtypes, ABC subtypes, and non-differentiable types.
After treatment with the R-CHOP regimen, the prognosis of each subtype was different.
Not the same, the efficacy of GCB subtype is significantly better than other subtypes
.
Subsequently, according to the MYC, BCL-2, and BCL-6 gene rearrangements, two gene rearrangements were defined as double hit subtypes, and three gene rearrangements were defined as triple hit subtypes
.
Combined with the determination of double hit and triple hit subtypes, the classification of DLBCL is further refined into high-grade B-cell lymphomas with MYC and BCL-2 and/or BCL-3 gene rearrangements, and high-grade B-cell lymphomas that are not specific Finger type
.
However, the clinical effect of R-CHOP regimen in the treatment of high-grade B-cell lymphoma is not good.
Researchers are currently actively exploring enhancement programs, including R-CHOP regimen combined with specific target inhibitors, that is, CHOP regimen combined with new targets or sustain CHOP regimen with a new treatment with the targeted drug therapy X X after treatment
.
At present, the second-generation sequencing method is used in the world for genotyping, and DLBCL has been classified and refined by the quartet method and the heptagon method to guide the clinical selection of different targeted therapies for different molecular subtypes
.
Therefore, the combination of multi-omics testing can guide the choice of clinical treatment, and it can also bring better clinical benefits to patients
.
Yimaitong: In your opinion, what areas may be the focus of research on precise diagnosis of lymphoma in the future? What are your prospects? Professor Bai Ou, this is a highly general question.
Although it is difficult to refine, it is hoped that "one key opens a lock"
.
Each individual's disease can find its exact molecular target, so that the corresponding target inhibitor can be used to achieve precise molecular targeted therapy
.
As former US President Barack Obama mentioned in the "Moon Landing Project" that year: "Can lymphoma be treated like a blood type? After the blood type is determined, the patient can be completely cured by rationing the same blood type
.
" But lymphoma There is a high degree of heterogeneity in the molecular stratification of tumors, and more importantly, this heterogeneity merges and intersects with each other, which is the reason for the multi-omics fusion analysis based on different omics tests
.
I personally think that it is not easy to achieve, and single-target blocking therapy may not completely cure the disease
.
You can try to explore the most prominent targets and the most critical targets
.
Therefore, multi-omics fusion and cross-analysis based on different omics tests may be a more important development direction.
It is expected that multi-omics research can change the treatment model of lymphoma in the future and better guide the choice of clinical treatment
.
Professor Bai Ou, Deputy Director, Department of Hematology, Bethune First Hospital, Jilin University, Head of the Lymphoma Specialist Alliance, Bethune First Hospital, Jilin University, Member of the Lymphocytic Disease Group of the 11th Committee of the Chinese Medical Association Hematology Branch, Chinese Society of Clinical Oncology (CSCO) Member of the Standing Committee of the Lymphoma Professional Committee of the Chinese Anti-Cancer Association CSCO Member of the Standing Committee of the Chinese Anti-Lymphoma Alliance (UCLI) Member of the Standing Committee of the 5th Clinical Chemotherapy Committee of the Chinese Anti-Cancer Association Member of the Standing Committee of the First Committee of the Hematology Branch of the Chinese Society of Geriatrics China Healthcare Member of the Standing Committee of the Oncology Branch of the International Exchange Promotion Association CSCO Member of the Chinese Anti-Leukemia Alliance (UCLI) stamp "Read the original text", we make progress together
At present, its treatment has made significant progress.
Multi-omics research has provided many new ideas for the diagnosis and treatment of lymphoma.
Through the study of DNA, RNA, protein, epigenetics and The composition of metabolites and the interaction and relationship between these components under specific conditions, fusion analysis to find accurate diagnosis and treatment targets and related treatment plans, and ultimately benefit patients
.
In order to further promote the communication and development in the field of leukemia and lymphoma diagnosis, the 3rd Hematological Tumor Accurate Detection Summit Forum was successfully held in Beijing from July 3 to 4, 2021
.
During this period, Yimaitong specially invited Professor Bai Ou from Bethune First Hospital of Jilin University to share the latest research, opportunities and challenges in the diagnosis and treatment of lymphoma in the multi-omics era
.
Yimaitong: In the era of big data, multi-omics research, which combines multiple omics data, is a major trend
.
Based on your current clinical practice, please talk about the opportunities and challenges that multidisciplinary studies have brought to the diagnosis and treatment of lymphoma? Professor Baiou's multi-omics (Omics) research refers to a research method that integrates genomics, transcriptomic, proteomic, metabolomics and other omics.
Each group has the suffix "omic", hence the name
.
For example, the initial morphological stratification of diffuse large B-cell lymphoma (DLBCL) mainly includes ABC subtypes, GCB subtypes, etc.
, and the "2016 WHO Classification of Hematopoietic and Lymphoid Tissue Tumors" newly added Double-Beat Lymphoma (Double- Hit lymphoma (DHL), Triple-Hit lymphoma (THL), etc.
are further stratified from the aspect of genetic changes, so that each type of DLBCL, each subtype in each subtype, and each subtype The molecular typing in China has entered a new era, that is, the era of multi-omics
.
On the one hand, multi-omics research is single-omics, including genomics, transcriptomics, proteomics and metabolomics, and covers the analysis of fusion information of these subgroups
.
On the other hand, further expand the breadth, including the combination of immune microenvironment, protein post-translational epigenetics, and expand the depth of single-cell sequencing
.
The comprehensive use of these tests makes the diagnosis of lymphoma extremely accurate, which is helpful to guide the research and selection of clinical treatment plans, improve the effect of targeted therapy, reduce the side effects of chemotherapy and other programs, and enable patients to obtain a higher quality of life.
Patients benefit
.
Yimaitong: In the current multi-omics era, what progress has been made in the precise diagnosis and treatment of lymphoma? What are the specific instructions for clinical practice? Professor Bai Ou took DLBCL as an example.
At first, based on the expression of protein molecules and different cell origins, DLBCL was divided into GCB subtypes, ABC subtypes, and non-differentiable types.
After treatment with the R-CHOP regimen, the prognosis of each subtype was different.
Not the same, the efficacy of GCB subtype is significantly better than other subtypes
.
Subsequently, according to the MYC, BCL-2, and BCL-6 gene rearrangements, two gene rearrangements were defined as double hit subtypes, and three gene rearrangements were defined as triple hit subtypes
.
Combined with the determination of double hit and triple hit subtypes, the classification of DLBCL is further refined into high-grade B-cell lymphomas with MYC and BCL-2 and/or BCL-3 gene rearrangements, and high-grade B-cell lymphomas that are not specific Finger type
.
However, the clinical effect of R-CHOP regimen in the treatment of high-grade B-cell lymphoma is not good.
Researchers are currently actively exploring enhancement programs, including R-CHOP regimen combined with specific target inhibitors, that is, CHOP regimen combined with new targets or sustain CHOP regimen with a new treatment with the targeted drug therapy X X after treatment
.
At present, the second-generation sequencing method is used in the world for genotyping, and DLBCL has been classified and refined by the quartet method and the heptagon method to guide the clinical selection of different targeted therapies for different molecular subtypes
.
Therefore, the combination of multi-omics testing can guide the choice of clinical treatment, and it can also bring better clinical benefits to patients
.
Yimaitong: In your opinion, what areas may be the focus of research on precise diagnosis of lymphoma in the future? What are your prospects? Professor Bai Ou, this is a highly general question.
Although it is difficult to refine, it is hoped that "one key opens a lock"
.
Each individual's disease can find its exact molecular target, so that the corresponding target inhibitor can be used to achieve precise molecular targeted therapy
.
As former US President Barack Obama mentioned in the "Moon Landing Project" that year: "Can lymphoma be treated like a blood type? After the blood type is determined, the patient can be completely cured by rationing the same blood type
.
" But lymphoma There is a high degree of heterogeneity in the molecular stratification of tumors, and more importantly, this heterogeneity merges and intersects with each other, which is the reason for the multi-omics fusion analysis based on different omics tests
.
I personally think that it is not easy to achieve, and single-target blocking therapy may not completely cure the disease
.
You can try to explore the most prominent targets and the most critical targets
.
Therefore, multi-omics fusion and cross-analysis based on different omics tests may be a more important development direction.
It is expected that multi-omics research can change the treatment model of lymphoma in the future and better guide the choice of clinical treatment
.
Professor Bai Ou, Deputy Director, Department of Hematology, Bethune First Hospital, Jilin University, Head of the Lymphoma Specialist Alliance, Bethune First Hospital, Jilin University, Member of the Lymphocytic Disease Group of the 11th Committee of the Chinese Medical Association Hematology Branch, Chinese Society of Clinical Oncology (CSCO) Member of the Standing Committee of the Lymphoma Professional Committee of the Chinese Anti-Cancer Association CSCO Member of the Standing Committee of the Chinese Anti-Lymphoma Alliance (UCLI) Member of the Standing Committee of the 5th Clinical Chemotherapy Committee of the Chinese Anti-Cancer Association Member of the Standing Committee of the First Committee of the Hematology Branch of the Chinese Society of Geriatrics China Healthcare Member of the Standing Committee of the Oncology Branch of the International Exchange Promotion Association CSCO Member of the Chinese Anti-Leukemia Alliance (UCLI) stamp "Read the original text", we make progress together
