Learning from both China and the West, focusing on the gathering of big names in the "shi" world, focusing on the frontier progress of hematology and tumor, and promoting in-depth exchanges in the field

Introduction: The 63rd ASH Annual Meeting in 2021 was successfully concluded in Atlanta, USA in December.
The meeting focused on the frontier research of blood diseases and the improvement of the level of disease diagnosis and treatment
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In order to promptly and quickly convey the latest progress in the field of lymphoma in the field of lymphoma at the ASH annual meeting to domestic hematologic lymphoma experts, and promote in-depth exchanges and development in the field of hematologic lymphoma
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In 2022, the "Learn Chinese and Western, Look into the World" Blood Pioneer Forum and Post ASH series conferences were successfully held recently.
The conference was organized by Professor Huang Huiqiang of Sun Yat-sen University Cancer Center, Professor Zhao Weili of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, and Harbin Hematology Diseases.
Professor Ma Jun of Cancer Research Institute, Professor Zhu Jun of Peking University Cancer Hospital, Professor Xu Caigang of West China Hospital of Sichuan University and Professor He Pengcheng of the First Affiliated Hospital of Xi'an Jiaotong University jointly served as the chairman of the conference (the above rankings are in no particular order, according to the live broadcast time).
Gathered together and brought us a feast of academic exchanges
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Yimaitong organizes the main highlights of this forum as follows for readers
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>>>The icing on the cake to break through the bottleneck of first-line DLBCL treatment.
Professor Guo Ye from Tongji University Affiliated Oriental Hospital, Professor Song Yuqin from Peking University Cancer Hospital, and Professor Zou Liqun from Sichuan University West China Hospital Cancer Center shared in this meeting that in the 2021 ASH annual meeting, diffuse large Current first-line treatment progress and cutting-edge clinical research data for B-cell lymphoma (DLBCL)
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DLBCL is the most common type of non-Hodgkin lymphoma (NHL) and is highly aggressive and heterogeneous
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At present, the R-CHOP regimen is still the standard treatment regimen for first-line DLBCL in the past 20 years.
About 60% of DLBCL patients achieve remission through first-line treatment, but about 40% of patients still face disease progression or recurrence and have a poor prognosis.
For relapsed and refractory (R/R) patients with monthly PFS, the 5-year OS rate is only 19%, and new drugs are urgently needed to increase the remission rate, improve the curative effect, and reduce the risk of recurrence
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In the era of flourishing new drugs, most new drug studies are still exploring the first-line treatment of DLBCL, and most new drugs such as BCL-2 inhibitors, BTK inhibitors and some new antibodies are still exploring their efficacy in phase I/II studies
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In a phase Ib study of the safety of a novel T cell-binding bispecific antibody Glofitamab (hereinafter referred to as Glofit) combined with R-CHOP regimen for newly treated DLBCL, preliminary data showed that the overall response rate of 9 patients was as high as 100% , In terms of safety, the incidence of CRS in patients is extremely low, and there is no ICANS adverse event, and more samples are expected to be verified in the future
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The phase III POLARIX study won the 2021 ASH annual meeting LBA1, and is expected to become the new standard of first-line treatment of DLBCL.
Polatuzumab vedotin (hereinafter referred to as Pola) is an antibody-drug conjugate (ADC) targeting CD79b.
The approved ADC, with its unique mechanism of action and good clinical trial data, brings new hope of cure for newly diagnosed DLBCL patients
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In the global randomized, double-blind, multicenter phase III POLARIX study, the Pola-R-CHP regimen helped significantly prolong progression-free progression in patients with intermediate-to-high-risk DLBCL with an IPI score of 2-5 compared with the conventional regimen R-CHOP.
Survival (PFS) (HR 0.
73, p<0.
02), the 2-year PFS rate of the Pola-R-CHP group was 76.
7%, which was 6.
5% higher than that of the R-CHOP group
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The relative risk of disease progression/relapse/death is reduced by 27%, and the safety profile is similar to that of the R-CHOP regimen.
It is an important clinical research breakthrough for the first-line treatment of DLBCL in the past two decades
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 >>>Blossoms look like brocade to find the optimal R/R DLBCL program from Professor Cao Junning from Fudan University Cancer Hospital, Professor Zhang Qingyuan from Harbin Medical University Cancer Hospital, and Professor Gao Guangxun from Xijing Hospital of Air Force Military Medical University, respectively, to discuss the current optimal clinical practice of R/R DLBCL.
Treatment protocols and data updates in this area at the ASH Annual Meeting
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About 30%-40% of DLBCL patients relapse after first-line treatment, and 10% have refractory disease
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Intensive chemotherapy and autologous hematopoietic stem cell transplantation (HD-ASCT) are often selected for post-line treatment of DLBCL, but most patients are not suitable for the existing HD-ASCT program
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For this group of patients, there are still many unmet clinical needs
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In the era of new drugs, the development of new drugs has brought new treatment hope and options for R/R DLBCL patients
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"Chemo-free" double antibody single drug is expected to improve the treatment dilemma of R/R DLBCL With the progress of antibody engineering technology, a variety of CD20×CD3 bispecific antibodies are undergoing clinical research in NHL.
The specific antibody Glofit has attracted much attention
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At the 2021 ASH annual meeting, the results of the phase I/II study of Glofit single-agent fixed-course treatment for R/R NHL were updated.
Among 175 patients with aNHL, the ORR was 53.
7%, and the complete remission (CR) rate was 39.
4%.
In the recommended phase II dose enrollment cohort, the CR rate of 14 patients reached 71.
4%, achieving good efficacy and controllable safety
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The powerful combination of "Chemo-light" ADC drugs helps to upgrade the efficacy In the 2021 ASH annual meeting, the ADC-based Chemo-light regimen for the treatment of R/R DLBCL has a number of data updates.
showed surprising efficacy and tolerable safety
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An open-label, multicenter, dose-escalating and expansion phase Ib/II study of Pola in combination with Glofit in R/R NHL is ongoing.
Preliminary safety and efficacy data from dose-escalation and RP2D expansion phase show that The ORR of 49 patients with evaluable efficacy was 79.
6%, and the CR rate was 51%; the overall safety was good, most adverse events (AEs) were low-grade, and the most common grade 3-4 AEs were neutropenia ( 27%) and anemia (10%), no grade 3-4 CRS was reported
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Another combination regimen was a phase Ib/II study of Pola combined with Mosunetuzumab (Mosun) in the treatment of R/R aNHL.
The results showed that in the dose escalation phase of 60 patients, the ORR was 65%, and the CR rate was 48.
3%, with manageable Overall security features
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 >>>New expectations for the diagnosis and treatment of FL from the First Affiliated Hospital of Xiamen University, Professor Xu Bing of the First Affiliated Hospital of Xiamen University, Professor Zhang Huilai of Tianjin Medical University Cancer Hospital and Professor Liu Yao of Chongqing University Affiliated Cancer Hospital respectively on the treatment of patients with follicular lymphoma (FL) Share the progress
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FL originates from germinal center B lymphocytes and is one of the most common indolent lymphomas
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Optimizing the first-line treatment of FL and exploring the treatment progress of newly-treated patients In this ASH annual meeting, the clinical data comparison of the first-line treatment regimens for FL was updated.
The 5-year OS rates of patients treated with R-CVP/CHOP and R-CVP/CHOP were 80% and 75%, respectively.
Compared with R-CVP/CHOP, the BR regimen helped to improve the overall survival of patients
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In recent years, the emergence of many new drugs has revolutionized the treatment landscape of FL.
The exploration direction of the first-line treatment of FL is gradually changing from optimizing chemotherapy regimens to optimizing anti-CD20 monoclonal antibodies.
Among them, octuzumab has been shown in many clinical studies of FL.
The good curative effect was further confirmed in this ASH annual meeting
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The results of a phase II study of octuzumab combined with veneclax and bendamustine as first-line treatment of FL patients with high tumor burden (HTB) showed that after induction therapy, 56 patients achieved ORR of 92.
9%, CR The rate was 73.
2%, and the efficacy was significant; however, the overall safety data was slightly lacking, with a serious adverse event rate of 55.
4%
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Practice "practice" and look forward to the progress of R/R FL treatment.
With the continuous improvement of medical level, the survival and prognosis of FL have been significantly improved, but FL is still an incurable disease, and most patients face relapse and refractory disease.
In the dilemma, the remission rate and duration of remission decrease with the increase of the number of subsequent treatment lines (conventional drugs), and new mechanism drugs are urgently needed to induce deep and sustained remission in patients and break the predicament
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Novel CD20xCD3 Bispecific Antibody Mosun Demonstrates High Sustained Response and Controllable Safety Profile in Patients: Results from a Single-Arm, Pivotal Phase II Extension Study in R/R FL Patients With ≥2 Previous Treatments , with a median follow-up of 18.
3 months, the CR rate was 60%, which was significantly higher than the previous control CR rate (14%) referenced in the study design
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 >>>Exploring another way to treat CLL within a limited time period Prof.
Xu Wei from the First Affiliated Hospital of Nanjing Medical University, Prof.
Zhang Wei from Peking Union Medical College Hospital, and Prof.
Wen Shujuan from the Cancer Hospital Affiliated to Xinjiang Medical University discussed the progress in the treatment of chronic lymphocytic leukemia (CLL)
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CLL is a chronic lymphoproliferative disorder
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The advent of BTK inhibitors has brought the treatment of CLL to a new level
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However, the current treatment mode of BTK inhibitors is still insufficient, and some patients face difficulties such as primary refractory treatment and drug resistance
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Many ongoing trials have demonstrated the clinical need for time-limited treatment regimens, and the powerful combination of targeted drugs is also a hot spot of current research to bring longer and deeper disease remission to CLL patients
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Exploring a new mode of first-line treatment of CLL and helping patients to upgrade the first-line treatment of CLL requires the combination of drugs with different mechanisms of action to improve the efficacy and prolong the survival of patients
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The phase III GAIA (CLL13) study published at the 2021 ASH annual meeting compared the efficacy and safety of fixed-course combination therapy (Rve, Gve, GIVe) and standard immunochemotherapy (CIT) in patients with newly diagnosed fit CLL, The results showed that the Gve and GIVe regimens had a higher rate of MRD negativity in peripheral blood at 15 months (GVe vs CIT: 86.
5% vs 52.
0%, p < 0.
0001; GIVe vs CIT: 92.
2% vs 52.
0%, p < 0.
0001) , and GVe and GIVe were superior to RVe in reducing the risk of tumor lysis syndrome (TLS) (p<0.
001; p=0.
001), with good safety
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In an investigator-initiated phase II clinical trial, among 28 previously untreated CLL patients with a median follow-up of 14.
6 months, veneclax, octuzumab, and a PD-L1 checkpoint inhibitor Combination therapy with atezolizumab showed a high rate of early MRD negativity, with a bone marrow MRD negativity rate of 78% in cycle 6 (4 cycles of veneclax), and no patients had disease progression
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CLL patients with Richter's transformation usually have a poor prognosis, and the exploration of treatment options for these patients is also a research hotspot in the field of CLL
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The results of the study of veneclax combined with octuzumab and atezolizumab in the treatment of patients with Richter's transformation showed that the ORR of 7 patients was 100%, of which 6 patients achieved complete metabolic remission, bringing benefits to patients with Richter's transformation of CLL.
new hope
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 >>>Summary by the chairman of the conference (Note: The following rankings are in no particular order, according to the live broadcast time) In the new drug era, many blockbuster drugs have emerged, bringing the clinical results of key research
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In the 2021 ASH annual meeting, a large amount of updated research data is worth our interpretation, and through exchanges and learning, we can jointly promote the improvement of the treatment level in the field of lymphoma
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Professor Zhao Weilai, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, should use retrospective analysis and other methods to explore the clinical characteristics of patients with FL and CLL, actively seek new treatment plans, and work together to find a suitable treatment method for Chinese patients.
road
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Professor Ma Jun of Harbin Institute of Hematology and Oncology launched rituximab more than 20 years ago, which has revolutionized the treatment pattern of DLBCL.
Ortuzumab was officially included in medical insurance on January 1 this year, benefiting more patients.
Thank you healthcare workers for their continued efforts to enable patients to experience longer clinical benefits
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Professor Zhu Jun of Peking University Cancer Hospital has learned from both China and the West, and looks at the world.
Whether it is the icing on the cake or the blossoms, the application of new drugs still requires us to complete clinical trials with our hearts, accumulate more real-world data, and bring the most suitable for each patient.
treatment! Thank you to all the speakers and Prof.
Huang Wenrong from the Fifth Medical Center of PLA General Hospital, Prof.
Liu Haisheng from the Fourth Hospital of Hebei Medical University, Prof.
Yang Wei from Shengjing Hospital Affiliated to China Medical University, and Prof.
Zhu Zunmin from Henan Provincial People's Hospital for their wonderful discussions at the meeting
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Professor Xu Caigang from West China Hospital of Sichuan University Although new research and new drugs have brought us many surprises, how to choose a good treatment plan is a problem that we need to think about.
The diagnosis and treatment of DLBCL should be further refined and truly accurate Stratified diagnosis, stratified treatment
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Professor He Pengcheng of the First Affiliated Hospital of Xi'an Jiaotong University thanked the speakers and all the guests for their participation, and hoped that there will be more opportunities to participate in such academic exchange conferences in the future, so that more clinicians can understand the dynamics of lymphoma at home and abroad, and provide patients with better information.
More and better treatment options
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