Professor Jun Ma : Continuous Innovation in Drugs Powers the Transition of Cancer into Chronic Disease Management

Editor’s Note: For cancer patients, prolonged drug therapy, particularly intravenous treatments, can lead to various inconveniences like infusion reactions and phlebitis. The emergence of new formulations of anticancer drugs not only reduces treatment costs and saves time but also brings convenience to both patients and clinicians. In an era where chronic disease management is becoming more prevalent, how will these new formulations be implemented to help cancer patients move towards recovery? “Oncology Frontier” has invited Professor Jun Ma from the Harbin Institute of Hematology and Oncology to discuss these issues.

Oncology Frontier: Meeting the needs of all cancer patients for innovative treatment plans and helping them “spend less time as patients and more time as themselves” should be a common aspiration for all experts in the oncology field. Now that cancer treatment has entered the era of chronic disease management and cancer is no longer considered a “death sentence,” how should our patients continue to live alongside cancer? Early detection means more treatment opportunities and a higher possibility of cure. Do you have any recommendations for cancer prevention?

Professor Jun Ma : In recent years, the field of cancer treatment has rapidly evolved, and cancer has become a common “chronic disease.” Particularly, early-stage hematologic lymphoid tumors have a high cure rate. In terms of treatment methods, beyond chemotherapy, radiotherapy, and intervention, the emergence of immunotherapy, monoclonal antibodies, bispecific antibodies, and ADCs has provided more options for cancer patients, making treatments more precise and personalized as we move towards “chronic disease management” of cancer.

The reason we say cancer is moving towards “chronic disease management” is that most cancers, like lymphoid system tumors, require comprehensive management similar to diabetes or hypertension. Patients can be completely cured through long-term medication. However, for some advanced cancers, such as those in the digestive system, the mortality rate is still high, and we currently lack effective treatment drugs. Therefore, there are still many challenges in the field of cancer treatment.

For chronic diseases, we should provide patients with active treatment strategies to extend their lives while also improving their quality of life. Therefore, for the treatment of cancer patients, I believe that proper stratification and classification, and providing standardized, precise individualized treatment are key. Compared to developed countries like those in Europe and America, the cure rate for cancer patients in China is relatively lower, especially in impoverished areas. Hence, the “Healthy China 2030” planning outline clearly states that by 2030, we aim to achieve comprehensive health management of chronic diseases across all populations and throughout the entire lifespan, while also increasing the overall cancer survival rate by 15%. Therefore, we continuously advocate learning from advanced diagnostic and treatment technologies of developed countries, increasing the proportion of major illness assistance, and the rate of free medical care. Only then can our country truly enter the era of chronic disease management for cancer.

Oncology Frontier: Looking at the number of innovative drugs approved from 2018 to 2023, there has been a rapid increase in the number of new drugs on the market. Since 2018, the field of oncology has been a focal point for new drug development. Treatment formulations and models are constantly evolving. Several anticancer drugs, such as subcutaneous formulations for breast cancer trastuzumab injection and blood cancer’s rituximab injection (subcutaneous), have been approved. What are your thoughts on the future layout of subcutaneous formulations for anticancer drugs?

Professor Jun Ma : Cancer treatment includes a variety of methods. In addition to the basic treatments like chemotherapy, radiotherapy, and surgery, the field continues to innovate with immunotherapy drugs, large molecule targeted drugs, small molecule monoclonal antibodies, and ADCs. However, I believe that based on the rate of increase in innovative drug types each year, countries can be divided into three categories: The first world, represented by the United States, where 10-13 new innovative drugs appear each year; the second world, represented by Japan and the UK, with 1-3 new innovative drugs annually; and the third world, represented by China, where domestically originated innovative drugs are very scarce, often being Fast Follow or Me too, Me Better types of drugs.

The reasons for the scarcity of innovative drugs in China include: first, the low investment in R&D by pharmaceutical companies; second, the rarity of original innovative drugs, as most drugs produced are structurally altered versions of original research drugs, lacking original innovation; and third, compared to first world countries, China has fewer leading PIs who can dominate clinical research.

For the treatment of cancer patients, I advocate for innovating the mode of drug administration without changing the clinical structure of the drug. Subcutaneous formulations, compared to intravenous administration, are more convenient, easier to operate, and have shorter treatment times with fewer side effects like fever and shock. Therefore, “using subcut

aneous formulations wherever possible instead of intravenous administration” is my treatment principle.

Oncology Frontier: Could you share how the advances in subcutaneous formulations will bring significant changes to cancer patient treatment?

Professor Jun Ma : New drug development should include not only new target drugs but also innovative or improved formulations. The simpler the drug, the higher the acceptance by cancer patients. Therefore, many different types of drugs are being explored for subcutaneous formulation; the modes of transdermal/subcutaneous administration are also becoming more diversified, such as pen-style injectors for one-time subcutaneous injection devices, patch-style subcutaneous administration, and wearable devices for subcutaneous administration. The richness of subcutaneous administration options will further promote changes in diagnostic and treatment models. In the future, patients might flexibly and conveniently use drugs at home, in community hospitals, or any other suitable environment, and we will witness and welcome increasingly new anticancer treatment models.

As more products with better efficacy emerge, malignant tumors are gradually transitioning to chronic diseases, and outpatient cancer immunotherapy will become routine. The transition and optimization of antibody drugs from intravenous injections to subcutaneous formulations also cater to this need, helping cancer patients manage their diseases more conveniently.