On July 20, 2024, the 5th Lymphoma & Myeloma Immunotherapy and Targeted Therapy Conference, along with the Gaobo Medical Academic Conference, was successfully held in Beijing. With the core concepts of "Precision, Integration, Innovation," the conference closely followed the latest developments and frontier topics from the 29th European Hematology Association (EHA 2024) and the 2024 American Society of Clinical Oncology (ASCO) annual meetings. To capture the conference's dynamics and facilitate in-depth exchange, Oncology Frontier - Hematology Frontier invited Dr. Kai Hu from Beijing GoBroad Hospital for an exclusive interview. He provided insightful explanations on the topic of "The Application of Immunotherapy in Lymphoma/Myeloma."Oncology Frontier – Hematology Frontier: As the conference chair, could you first introduce the highlights of this conference?
Dr. Kai Hu: The incidence of hematologic malignancies is gradually increasing in China. Despite the emergence of many effective treatments, no single method can achieve a complete cure, leading to frequent cases of relapsed or refractory hematologic malignancies in clinical practice. For these patients, immunotherapy and targeted therapy are crucial treatment methods. In recent years, there have been many research advancements and breakthroughs in this field, with several new technologies and therapies being applied clinically. Therefore, this conference focused on the immunotherapy and targeted therapy for relapsed/refractory hematologic malignancies, covering commonly seen lymphoma types (B-cell and T-cell lymphomas), which are among the highlights. Additionally, the conference also emphasized precise diagnosis of lymphomas, involving molecular biology, pathological diagnosis, and flow cytometry. National experts in precise diagnosis and treatment of lymphomas were invited to discuss the immunotherapy and targeted therapy for relapsed/refractory hematologic malignancies, providing rich and cutting-edge content.
Oncology Frontier – Hematology Frontier: At this conference, you shared insights on the immunotherapy for patients with different types of large B-cell lymphomas. Could you discuss the progress in this area?
Dr. Kai Hu: Large B-cell lymphoma (LBCL) is the most common type of adult lymphoma and also the most prevalent among relapsed/refractory (R/R) lymphoma patients. In the treatment of R/R-LBCL, CAR-T cell therapy has seen significant advancements, moving from clinical research to real-world applications. The progress can be summarized in two aspects: 1) The exploration of different CAR-T designs, including autologous and universal CAR-T cells in clinical applications; 2) The management of short-term and long-term toxicities of CAR-T treatment, such as the management of hemophagocytic lymphohistiocytosis post-CAR-T therapy. Moreover, for certain special types of LBCL, such as primary central nervous system diffuse large B-cell lymphoma and Richter’s syndrome (transformed chronic lymphocytic leukemia to diffuse large B-cell lymphoma), where there have been relatively few cases and limited treatment experience, accumulated data from immunotherapy show promising efficacy in improving patient outcomes, though these cases require different management strategies.
In the realm of targeted drugs, there have also been numerous advancements for LBCL, especially with the recent approval of bispecific antibodies and ADC drugs in China. Clinical trial data for these drugs in LBCL treatment are increasing, particularly in shifting from late-line to frontline therapy and comparing the efficacy of different treatment regimens. This conference aimed to convey these dynamics and advancements to guide clinical application, thereby improving LBCL treatment outcomes.
Oncology Frontier – Hematology Frontier: How should immunotherapy be strategically integrated into the overall treatment of lymphoma/myeloma?
Dr. Kai Hu: Immunotherapy, as a relatively novel treatment approach, is influenced by many factors beyond the tumor itself and the immunotherapy regimen, including the patient’s immune status, which significantly affects the treatment outcome. If a patient is immunocompromised, the efficacy of immunotherapy is often suboptimal. Additionally, immunotherapy has evolved from a standalone therapy to being combined with other treatments, enhancing its effectiveness and overall strategic integration.
In terms of strategy, first, we need to identify patients at high risk of relapse/refractory disease early, as they are typically suitable candidates for immunotherapy. Second, we should choose the appropriate timing to prepare the patient’s immune function, such as collecting lymphocytes in advance for those planning to undergo CAR-T therapy. Third, we must carefully assess whether the patient’s tumor status is suitable for immunotherapy; for example, patients with very high tumor burden or tumors in high-risk locations may not be ideal candidates. Finally, if immunotherapy achieves good results, we should evaluate the need for subsequent consolidation and maintenance therapies. Overall, aiming for the cure of lymphoma/myeloma and improved event-free survival (EFS), immunotherapy should be an integral part of the overall treatment plan, heavily relying on the patient’s immune function. We should approach patient management with a strategic mindset to ensure immunotherapy delivers the best possible outcomes and greater benefits.
Oncology Frontier – Hematology Frontier: What are the key exploration directions and future research plans for immunotherapy in lymphoma/myeloma?
Dr. Kai Hu: Although immunotherapy is highly effective for relapsed/refractory lymphoma or myeloma patients, it does not achieve remission and long-term survival for all patients, highlighting its limitations and areas needing improvement. First, the available targets for immunotherapy are still relatively few, and the applicable disease spectrum is not broad enough. Currently, it is mainly used for B-cell lymphomas and multiple myeloma, while immunotherapy for T-cell lymphomas remains immature with unclear efficacy benefits, requiring further exploration. We believe the future should see an expansion of the disease spectrum for immunotherapy, including more types of hematologic malignancies and even solid tumors. Second, some patients have very poor lymphocyte function, making them unsuitable for immunotherapy. For such patients, exploring universal immunotherapies, such as universal CAR-T therapies and in vivo mRNA CAR-T generation, is an important future direction. These approaches create conditions for immunotherapy, marking a development direction and part of our team’s research plans.
Dr. Kai Hu
- Chief Physician, Doctor of Medicine, Director of the Lymphoma and Myeloma Department at Beijing GoBroad Hospital
- Nearly 20 years of experience in hematology, specializing in the standardized diagnosis and treatment of hematologic malignancies such as leukemia, lymphoma, and multiple myeloma, as well as immunotherapy (CAR-T cell therapy, CIK/NK cell immunotherapy)
- Expertise in comprehensive standardized treatment primarily based on internal medicine chemotherapy, molecular targeted therapy, autologous/allogeneic hematopoietic stem cell transplantation, and biotherapy
- Innovator in the domestic field with exploratory research on CAR-T therapy for central nervous system lymphoma, myeloma, and post-CD19 CAR-T failure, as well as the combination of allogeneic CAR-T with allogeneic hematopoietic stem cell transplantation for lymphoma and myeloma
- Conducted nearly 1000 CAR-T treatments and participated in nearly 40 clinical trials as the principal investigator, involved in over 100 studies
- Published over 40 Chinese and English papers as first author and corresponding author, co-authored and translated 5 books, and presented research findings at domestic and international academic conferences (American Society of Hematology Annual Meeting, European Hematology Association Annual Meeting)
- Academic Positions: Chairman of the Precision Diagnosis and Treatment Committee for Hematologic Oncology, Beijing Health Promotion Association Standing Committee Member of the Lymphoma Immunotherapy Professional Committee, Beijing Cancer Prevention and Treatment Society Member of the Geriatric Oncology Professional Committee, Chinese Gerontology Society Member of the Health Science Popularization Professional Committee, China Health Management Association Member of the Oncology Professional Committee, Beijing Society of Integrated Chinese and Western Medicine Member of the Hematopoietic Stem Cell Transplantation and Cell Therapy Professional Committee, China Medical Education Association Member of the T-cell Lymphoma Working Group, Hematologic Oncology Professional Committee, China Anti-Cancer Association
