Professor Zhu Jun: A new generation of anti-CD20 monoclonal antibody brings new choices and hopes to lymphoma patients!

Mace Medicine: Anti-CD20 monoclonal antibody has been in a cornerstone position in the field of lymphoma, and its application status and prospect in the field of B cells? With the addition of the new generation of anti-CD20 monoclonal antibody-obinutuzumab, from your perspective, how should the two monoclonal antibodies be decided?

Professor Zhu Jun:

CD20 monoclonal antibody is a milestone in the field of medical oncology, which represents the practical application of precision targeted immunotherapy in clinical practice
.
As the first monoclonal antibody applied to clinical tumor treatment, its emergence has increased the cure rate and 5-year survival rate of lymphoma patients, especially aggressive B-cell lymphoma patients, by at least 15%~20%, bringing good news
to millions of patients around the world.

CD20 monoclonal antibody combined with CHOP has become the classic treatment regimen
.
The new generation of CD20 monoclonal antibody - obinentuzumab is a new humanized anti-CD20 monoclonal antibody, which has a unique mechanism of action and structure, and has shown its advantages
through a series of clinical trial data.
Compared with the primary antibody CD20 monoclonal antibody, the two are neither identical nor substituted
for each other.
The indications of the two are different, and Garowara is suitable for follicular lymphoma, small B-cell lymphoma, etc.
, mainly for first-line or second-line use
.
There are differences in the application of lymphoma, such as Carowara cannot be used as a first-line replacement, while rituowar's biosimilars have appeared and been put into clinical use
in China.
The two drugs do not contradict or conflict, and each has its own characteristics
.
In recent years, the popularity of these drugs has also greatly improved, bringing better benefits
to our Chinese patients.

Currently, both CD20 monoclonal antibodies are manufactured by Roche
.
20 years ago, as the beautiful "flower" of Roche, it is still blooming
in China and the world.
Together with the new CD20 monoclonal antibody Jialuohua, the "flower" of Shuanghua provides patients with more new opportunities and choices
.
We look forward to the emergence of more similar drugs to bring better choices and hope
to lymphoma patients in China.
"

Metz Medicine:

Mace Medicine: Are PD1 inhibitors that are booming in the field of solid tumors a surprise for B-cell lymphoma?

Professor Zhu Jun:

PD1 is an immune checkpoint inhibitor, mainly targeting the body's own immune system, especially the T lymphoid immune system, and plays an important role
in enhancing the autoimmune system against tumors.
In recent years, there have been more and more original drugs in China, and through clinical trials, they have finally been approved for marketing
.

Throughout the history of China's drug development, from the first two imported drugs "one poor and two white" development to the current 7~8 domestic drugs successively listed, it can be said that it is a very big progress
.
This not only improves the accessibility of these medicines to Chinese patients, but also increases the likelihood of
application by Chinese patients.

The application of PD1 inhibitors in the field of B-cell and T-cell lymphoma is still in a stage
of clinical research and accumulation of experience.
At present, we have evidence that the application of PD1 inhibitors in the field of B-cell lymphoma can bring some changes, but whether this change is breakthrough, revolutionary, and landmark needs further observation
.

Metz Medicine:

Mace Medical: What is the difference between the upstart CAR-T and CAR-NK that were just approved in China last year?

Professor Zhu Jun:

In recent years, CAR-T has been gradually used in the treatment
of lymphoma.
It takes less than a year from foreign approval for patients to approval in China, so we have very little
experience.
The small number of patient cases and the unfamiliarity of various difficult situations are the main problems
at present.
The observation of the long-term efficacy and safety of CAR-T for lymphoma treatment also requires a long process
.

The situation is even worse with CAR-NK
.
So far, CAR-NK has not been fully approved as a drug or product for use in cancer patients, and is still in an experimental stage
.
Of course, at this stage, there seems to be some experimental data to prove that it is superior to CAR-T cells, but to really enter the clinical use to benefit more patients, it needs a rigorous, long-term, complex process
.
All we need to do is move forward in the process of adhering to the norms, respecting the classics, and constantly innovating
.

In short, on the one hand, we must abide by the norms and guidelines, on the other hand, we should not give up the goal of innovation, and seek solutions to problems in the spirit of science and taking patients as the starting point
.
Only then can we get better and better
.

Metz Medicine:

Mace Medicine: Looking back at 2021, in this year or so, in addition to immunotherapy, what breakthroughs have been made in the treatment of B-cell lymphoma?

Professor Zhu Jun:

In recent years, in addition to a new generation of CD20 monoclonal antibody, other antibody drugs such as anti-CD19, CD47, bispecific antibody, and ADC drugs have also appeared, such as the ADC drug of CD79B that is about to be approved for marketing
.
In the field of small molecules, we have also participated in many clinical trials, such as the regulation of various cell signaling pathways
.

Cell therapy such as CAR-T therapy and CAR-NK are also constantly improving, improving and standardizing
.
I firmly believe that the treatment of lymphoma, especially B-cell lymphoma, has entered a new era, and more new drugs will emerge
every year in the future.
The key question is: how to do a good clinical trial? How to use new drugs well? How to work better with patients? This is what
we should focus on.

Audit | Professor Zhu Jun

Edit the | Shang Xiaojuan