Big coffee interview with Professor Cai Qingqing: The application value of new drugs in NK/T cell lymphoma

In order to further promote the communication and development in the field of leukemia and lymphoma diagnosis at home and abroad, "The 6th Anti-leukemia·Lymphoma International Summit Forum and CSCO Anti-Leukemia Alliance & Anti-Lymphoma Alliance Tour Lecture-Harbin Station" in July 2021 Held in Harbin on 8-10
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This forum brought together many outstanding leukemia and lymphoma experts at home and abroad, and will conduct in-depth discussions and exchanges on new drug development and clinical applications
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During this period, Yimaitong was fortunate to invite Professor Cai Qingqing from Sun Yat-sen University Cancer Center for an interview to share the application value of the new drug in the treatment of NK/T cell lymphoma (NKTCL)
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Yimaitong: Recently, many new anticancer drugs have been published, some of which are also used in the field of NK/T cell lymphoma
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Could you please talk about the new drugs applied in the field of NK/T cell lymphoma? What are the advantages and disadvantages? Professor Qingqing Cai’s new drugs in the field of NKTCL include immunotherapy drugs, signal transduction pathway targeted drugs, epigenetics drugs, and some antibody-conjugated drugs (ADC)
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Immunotherapeutic drugs include monoclonal antibodies and immune checkpoint inhibitors.
Prospective clinical studies have confirmed that CD30 monoclonal antibody Vibutuximab (BV), CD38 monoclonal antibody Daratumab (Daratumab), etc.
are in NKTCL The efficacy of PD-1 monoclonal antibody in NKTCL is also more significant.
There have been many research reports, including the high-efficiency and low-toxicity PD-1 combined with P-GemOx program (peaspartase , Gemcitabine, oxaliplatin); other immune checkpoint inhibitors may also have a certain effect and need to be actively explored in the future
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The abnormally activated signaling pathways in NKTCL include JAK/STAT and other pathways.
Small molecule inhibitors for signaling pathways have been proven to inhibit the growth of NKTCL cells in vitro
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Epigenetic drugs such as histone deacetylase inhibitor chidamide, have been shown to benefit NKTCL patients, and the combination of immune checkpoint drug PD-1 monoclonal antibody can further improve the efficacy of patients
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The existing single-agent treatment of NKTCL with new drugs has limited efficacy.
The combination of new drugs and asparaginase-based chemotherapy or new drug combinations can further improve the effective rate on the basis of existing therapies.
For example, the combination of immunotherapy drugs and chemotherapeutic drugs can promote each other The curative effect improves its killing efficiency on tumor cells.
Because the new drug has a different mechanism of action from traditional cytotoxic drugs, its side effects are less additive.
More and more new drug combination therapies have gradually shown their advantages
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Although new drugs have made some progress, not all patients can benefit from it.
Finding efficient biomarkers can help screen patients suitable for specific targeted/immunotherapy, so that new drugs can play a more powerful role in specific populations
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Yimaitong: Could you please talk more about the application value of these new drugs in the field of NK/T cell lymphoma? And what benefits will it bring to NK/T cell lymphoma patients in my country? Professor Cai Qingqing’s current NKTCL treatment model is not uniform.
The prognosis of NKTCL patients in the asparaginase era is quite different, and there is a huge unmet need for treatment.
On the basis of existing therapies, further improving survival is the focus of new drug research and development.
One
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The emergence of various new drugs provides new options for the treatment of NKTCL patients.
Combined asparaginase-based chemotherapy or combined new drug regimens are expected to improve the prognosis of NKTCL patients and increase the survival rate of the entire population
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Compared with traditional chemotherapy drugs, new drugs have the characteristics of precise targeting and specific killing of tumor cells, bringing more extensive benefits to patients, and bringing hope to the NKTCL treatment that has not made a breakthrough in more than a decade
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Yimaitong: You have rich clinical experience in the treatment of NK/T cell lymphoma.
Could you please combine with the research results published by your team to talk about which new drugs or new therapies in the field of NK/T cell lymphoma may have better results? Good development potential? Professor Qingqing Cai’s PD-1 monoclonal antibody is very effective in NKTCL.
In the early stage, we added PD-1 monoclonal antibody to the traditional asparaginase-based chemotherapy regimen P-Gemox, and the results showed the total effective rate (ORR) It reached 88.
9%, and the complete remission (CR) rate was 77.
8%
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The PD-1 monoclonal antibody + P-Gemox regimen has been recommended by the Chinese Society of Clinical Oncology (CSCO) lymphoma diagnosis and treatment guidelines as one of the first-line treatment options for advanced NKTCL
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In addition, immune checkpoint inhibitors, ADC drugs, small molecule inhibitors, epigenetic drugs, etc.
other than PD-1 monoclonal antibody also have considerable prospects, and perhaps they can highlight the new drugs under the combined treatment mode.
Great potential
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Yimaitong: As researchers are getting more and more in-depth research on NK/T cell lymphoma, the pursuit of precise treatment and the search for more efficient new solutions are the concepts that medical researchers have always upheld
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In your opinion, what new directions do you think are worth exploring in the development of drugs for the treatment of NK/T cell lymphoma? Professor Qingqing Cai’s current prospects for immunotherapy in this field are huge, and NKTCL treatment is about to transition from the age of asparaginase to the age of immunochemotherapy or immunotherapy, leading the new direction of the lymphoma field in the future
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However, not all patients are sensitive to immunotherapy.
How to improve the efficacy of these patients is a huge challenge in the future
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In terms of new drug development, if NKTCL's special genes and immune mechanism are used to target a key target, thereby reversing the patient’s immunotherapy resistance, or having a synergistic effect with immunotherapy, it will greatly improve the prognosis of NKTCL patients.
This is also a new direction that needs to be explored in the future
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Professor Cai Qingqing, Chief Physician, PhD Supervisor, Deputy Director of the Department of Internal Medicine, Sun Yat-sen University Tumor Hospital, Head of the Lymphoma Group of the Oncology Branch of the Guangdong Medical Association, Deputy Chairman of the Youth Committee of the Oncology Branch of the Chinese Medical Association, Lymphoma Major, China Medical Education Association Deputy Chairman of the Committee, Deputy Chairman of the Lymphoma Professional Committee of the Guangdong Provincial Association of Women Physicians, Deputy Chairman of the Guangdong Anti-Cancer Association, Hematological Oncology Committee, Deputy Chairman of the Youth Committee, Beijing Cancer Society ) The corresponding author has published 16 SCI articles on Blood, Leukemia, CCR, etc.
, presided over 3 National Natural Funds and a number of provincial funds stamped "Read the original text", we make progress together