Professor Gong Tiejun: Therapeutic progress of targeted therapy in young patients with acute myeloid leukemia The 7th International Summit Forum on Anti-Leukemia and Lymphoma

Medical Pulse: Although the median age of onset of AML is high, the proportion of young patients with AML is not low
.
At present, the survival of elderly patients with AML has improved
significantly.
So, what is the current state of treatment for young patients?

In recent years, AML treatment has made significant progress mainly in elderly and relapsed refractory patients, while the research progress in young patients with AML is not satisfactory
.
Due to the increase in the dose of anthracyclines and cytarabine in chemotherapy regimens and the popularity of allogeneic hematopoietic stem cell transplantation, the 5-year overall survival rate of young patients with AML has increased to about 70%, but for young patients with AML who are refractory to recurrence or with high-risk factors, treatment is not particularly numerous
.
Therefore, the overall treatment status of young patients with AML needs to be further improved
.

As you said, the treatment of young patients with AML needs further improvement
.
Recently, a number of new drug marketing applications on the official website of the Center for Drug Evaluation (CDE) of the National Medical Products Administration have attracted much attention, so what are the exploration of targeted therapy in young AML patients?

Research progress on targeted drugs, including chimeric antigen receptor T cell (CAR-T) therapy, bispecific antibody drugs and antibody drug conjugates, focuses on lymphoma, myeloma and acute lymphoblastic leukemia
.
Due to the complex cellular and molecular genetic characteristics of AML, it is difficult for researchers to accurately fix a specific effective target
.
Nevertheless, AML-targeted therapy is also being explored and developed, such as CAR-T therapy targeting CD33, CD123, CLL-1, in addition, bispecific/trispecific antibodies targeting CD16 to induce cytotoxic effects of NK cells are newly developed drugs, and their efficacy and safety are still being explored, hoping that the development of new drugs can provide better and more accurate treatment options
for patients with relapsed and refractory AML.

With the development of targeted drugs such as BCL2 inhibitors and FLT3 inhibitors, AML therapy has slowly moved from the stage of chemotherapy transplantation to the stage of precision medicine
.
What is your view on individualized precision treatment for AML?

Thanks to advances in basic research, the cellular and molecular genetic profile of AML is clearer, which makes it possible
to distinguish between intermediate-risk and high-risk AML patients early in the disease.
Therefore, some patients with AML can receive corresponding targeted therapy in the induction therapy stage to achieve deep remission early and thus achieve long-term survival improvement
.

Despite advances in targeted AML therapy, treatment of high-risk and young AML patients relies on high-dose chemotherapy and allogeneic hematopoietic stem cell transplantation, and targeted therapy is only an adjuvant treatment
.
It is hoped that there will be new technological breakthroughs in targeted therapy in the future, so that AML will enter the era of targeted therapy like lymphoma and myeloma, and even the era
of chemo-free.

Professor Gong Tiejun

• Deputy Director of Harbin Institute of Hematology and Oncology

• Member of the 9th and 10th Youth Committee of the Hematology Branch of the Chinese Medical Association

• Member of Hematologist Branch of Chinese Medical Doctor Association

• Member of the Standing Committee of the Hematology and Cancer Committee of the Chinese Anti-Cancer Association

• Member of the Standing Committee of the Hematology Transformation Committee of the Chinese Anti-Cancer Association

• Vice Chairman of the Youth Committee of the Anti-leukemia Lymphoma Alliance of the Chinese Society of Clinical Oncology (CSCO).
  

• Secretary of the Leukemia Expert Committee of the Chinese Society of Clinical Oncology (CSCO) and member of the Lymphoma Expert Committee

• Member of the Standing Committee of the Hematology Branch of the Chinese Hospital Association

• Member of the National Health Commission's Capacity Building and Continuing Education Oncology Expert Committee

• Corresponding editorial board member of Chinese Journal of Hematology, editorial board member of "Leukemia Lymphoma"

• Vice Chairman of the Lymphoma Myeloma Special Committee of Heilongjiang Medical Doctor Association

• Vice Chairman of Heilongjiang Anti-leukemia Lymphoma Alliance of Chinese Society of Clinical Oncology (CSCO).
  

• Vice Chairman of Hematology Branch of Heilongjiang Association of Integrative Medicine