2024 CSCO Guidelines Conference | Prof. Jun Ma: The Chinese Society of Clinical Oncology (CSCO) Guidelines for Malignant Hematologic Diseases Promote Standardized Diagnosis and Treatment in China and Improve Clinical Outcomes

Editor’s Note: The “2024 Chinese Society of Clinical Oncology (CSCO) Guidelines for Malignant Hematologic Diseases” are set to be released, updating the latest treatment strategies and methods for malignant hematologic diseases. This is a significant event for the hematology field in China. “Oncology Frontier” conducted an exclusive interview with Professor Jun Ma from the Harbin Institute of Hematology and Oncology to discuss the CSCO guidelines and the treatment of hematologic diseases. The interview is summarized below.

Oncology Frontier: In recent years, the research and treatment of malignant hematologic diseases have been rapidly evolving. What requirements do you think this places on our guidelines and clinical practice?

Prof. Jun Ma: The CSCO guidelines have been in place for over a decade, with over 5 million copies distributed, making them the authoritative guide for treating malignant tumors in China. The guidelines are updated annually, and there are currently nine guidelines focused on the diagnosis and treatment of malignant hematologic and lymphatic tumors. This year, the guidelines have notably updated the progress in chimeric antigen receptor T-cell (CAR-T) therapy. China has approved seven CAR-T products for treating relapsed/refractory diffuse large B-cell lymphoma (r/r-DLBCL), mantle cell lymphoma (r/r-MCL), relapsed/refractory multiple myeloma (RRMM), and relapsed/refractory acute B-lymphoblastic leukemia (r/r B-ALL), with some now recommended for second-line treatment. Undoubtedly, CAR-T therapy has become the most prominent content in recent CSCO guidelines.

Over the past two decades, there have been significant advances in the treatment of hematologic and lymphatic tumors, including small molecule inhibitors, monoclonal antibodies, bispecific antibodies, antibody-drug conjugates (ADC), immune checkpoint inhibitors, and cell therapies. The CSCO guidelines comprehensively cover these advances to enhance the standardization of hematologic tumor treatment in China, aligning with international standards. This is particularly significant for promoting standardized treatment in grassroots hospitals. We understand that standardized treatment is crucial for improving patient survival rates. For example, the five-year disease-free survival (DFS) rate for lymphoma patients in central hospitals of major cities like Beijing, Shanghai, Guangzhou, and Shenzhen exceeds 60%, similar to Western countries. However, data from over 16,000 lymphoma patients in economically underdeveloped areas of China show a five-year DFS rate of only 37.9%, significantly lower than in major cities and Western countries. Therefore, advocating and implementing standardized treatment is essential to achieve the “Healthy China 2030” goal of increasing the five-year DFS rate of tumor patients by 15%, which is also the objective and essence of the CSCO guidelines.

Oncology Frontier: Internationally, authoritative organizations like NCCN, ESMO, EHA, ASCO, and ASH have their leukemia treatment guidelines. As the introducer and pioneer of the Chinese guidelines, can you describe the unique features and clinical impact of the CSCO guidelines for malignant hematologic diseases?

Prof. Jun Ma: Internationally, authoritative guidelines for malignant hematologic diseases include the NCCN guidelines, ESMO guidelines, and treatment guidelines from EHA, ASCO, and ASH, which are updated annually. The NCCN guidelines, for instance, are updated four times a year. The CSCO guidelines, as the authoritative guide for the treatment of malignant hematologic tumors in China, cover various diseases, including leukemia, lymphoma, myeloma, and myelodysplastic syndromes (MDS), with annual updates. These guidelines aim to incorporate the evidence-based medical experience from China and Western countries, providing clinical treatment guidelines for Chinese hematologic oncologists, leveraging new drugs and therapies to improve clinical outcomes and cure rates, and prolong survival. In the past five years, over 60,000 copies of the CSCO guidelines for malignant hematologic diseases have been distributed, and regional and grassroots hospital lectures have promoted their implementation, enhancing standardized treatment and ensuring that doctors have guidelines to follow and patients have access to effective treatments.

Oncology Frontier: What are the key updates in the new CSCO guidelines for malignant hematologic diseases, and how should we apply these guidelines?

Prof. Jun Ma: Firstly, the new CSCO guidelines for malignant hematologic diseases integrate guidelines from NCCN, EHA, and ASH for leukemia treatment, incorporating newly approved targeted drugs, including small molecule inhibitors, ADCs, and cell therapies. The guidelines are comprehensive, covering all drugs approved in China. Secondly, the CSCO guidelines classify the recommendation levels (I/II/III, A/B) for various treatment regimens based on international evidence-based medicine standards, guiding clinicians in correctly choosing the order of treatment regimens, making the treatment of malignant hematologic diseases more standardized and individualized.

Oncology Frontier: How should Chinese researchers leverage the CSCO platform and our rich case resources to conduct high-quality clinical research and enhance our international influence?

Prof. Jun Ma: The progress in hematologic tumors has been rapid, with 10-20 new drugs and methods emerging annually for the treatment of leukemia, lymphoma, myeloma, and MDS. The CSCO guidelines promptly update and publish these advancements for clinicians’ reference and study. Therefore, clinicians should utilize the standardized treatment experience provided by the CSCO platform to improve clinical outcomes. Additionally, we should align with international standards, promoting China’s excellent evidence-based medical experience in hematologic disease treatment to the international community. For example, China’s treatment of acute promyelocytic leukemia (APL) with arsenic trioxide and retinoic acid, as well as the “Beijing protocol” for haploidentical hematopoietic stem cell transplantation, have been introduced to the NCCN and ESMO guidelines and have gained global recognition. In summary, we should align with international standards, absorb the strengths of others, and share our experiences to ultimately prolong the survival of patients with malignant hematologic diseases and improve cure rates.