Professor Jun Ma: Fruitful Updates to the 2024 CSCO Lymphoma Treatment Guidelines | 2024 CSCO Guidelines Conference

Editor's Note : Lymphoma has become the most prevalent malignant hematological tumor in China. Enhancing the standardized diagnosis and treatment of lymphoma is crucial for improving cure rates. The "Chinese Society of Clinical Oncology (CSCO) Lymphoma Treatment Guidelines" are updated annually and play a significant role in promoting standardized care for lymphoma. At the recent 2024 CSCO Guidelines Conference, the 2024 edition of the CSCO Lymphoma Treatment Guidelines was released as scheduled. To better understand the key updates in the 2024 edition, "Oncology Frontier - Hematology Frontier" invited Professor Jun Ma, Director of the Harbin Institute of Hematology Oncology, to discuss the current status of lymphoma diagnosis and treatment in China, and to share the significance and highlights of the new guidelines.

Oncology Frontier – Hematology Frontier : Lymphoma is one of the most common malignant tumors of the hematolymphoid system in China. Could you first talk about the current incidence, treatment status, and challenges of lymphoma in China?

Professor Jun Ma : The incidence of lymphoma exceeds 10 per 100,000, ranking it first among hematological malignancies, followed by leukemia, myeloma, myelodysplastic syndromes (MDS), and myeloproliferative neoplasms (MPN). These four types of malignant hematolymphoid tumors account for over 95% of such cancers. With the aging population, it is expected that by 2030, the incidence of lymphoma in China will rise from the eighth to the sixth most common malignant tumor, aligning with rates in Western countries. Unlike other malignancies, lymphoma is curable. The cure rates for large B-cell lymphoma and diffuse large B-cell lymphoma (DLBCL) are over 60%. While indolent lymphomas are not curable, they do not affect lifespan, allowing patients to live long lives. As one of the most common hematological malignancies, it is essential to promote disease treatment and patient education, increasing awareness that lymphoma is curable and improving survival and cure rates for patients.

Oncology Frontier- Hematology Frontier : The CSCO Lymphoma Treatment Guidelines have been published annually since 2016, playing a significant role in promoting standardized treatment of lymphoma in China. Could you discuss the main updates in the 2024 edition?

Professor Jun Ma : The CSCO Lymphoma Guidelines have a history of over a decade, initially drafted when the R-CHOP immunotherapy regimen was introduced in China. After several iterations and annual updates, particularly numerous updates in the 2024 edition. On one hand, between 2023 and 2024, several new lymphoma treatments were approved in China, including anti-CD79b antibody-drug conjugates (ADCs), bispecific antibodies targeting CD20/CD3, trispecific antibodies targeting CD3/CD19/CD20, cellular therapies, and many small molecule drugs. Notably, an ADC for treating DLBCL was first approved in China. On the other hand, the new guidelines incorporate domestic clinical trials and real-world studies of approved drugs, as well as the latest international clinical research and evidence-based medicine findings. Thus, the CSCO Lymphoma Guidelines are among the most frequently updated and rapidly progressing guidelines.

Lymphoma has become a curable disease, and some of its incurable subtypes, such as Chronic Lymphocytic Leukemia (CLL)/Small Lymphocytic Lymphoma (SLL), have turned into chronic conditions manageable throughout a patient’s life, similar to diabetes and hypertension. In China, the current priority is to adopt standardized treatment. Compared to precision and personalized treatments, standardized treatment is crucial. Although in major cities and university-affiliated hospitals in China, the cure rate for lymphoma can exceed 50%, across nearly 300 centers and over 16,000 patients nationally, the five-year disease-free survival rate is only 37.7%, which is significantly lower than the 60% to 70% rates seen in advanced countries. The “Healthy China 2030” planning outline aims to increase the five-year disease-free survival rate for lymphoma by 15% by 2030. Thus, we have a long journey ahead, requiring collaboration among doctors, patients, pharmaceutical companies, and health policymakers to advance standardized treatment for lymphoma, allowing patients to live longer and achieve higher clinical cure rates.

Oncology Frontier – Hematology Frontier : DLBCL is the most common type of adult lymphoma. Could you explain the key updates in the new guidelines for the diagnosis and treatment of DLBCL, particularly regarding the latest treatment recommendations for relapsed/refractory patients?

Professor Jun Ma : As previously mentioned, the most significant advancements have been in B-cell lymphomas, whether small B-cell or large B-cell lymphomas, which have rapidly progressed. The R-CHOP immunotherapy regimen, proposed 20 years ago, has become the classic treatment for DLBCL, achieving optimal outcomes of 60% to 70%. Recently, however, with the increase in drugs for relapsed/refractory DLBCL, such as anti-CD79b ADCs, 30% to 40% of relapsed patients have again achieved remission. Two approved CAR-T therapies have provided very effective results for relapsed/refractory advanced large B-cell lymphomas, with a five-year disease-free survival rate reaching 50%. Additionally, we now have the bispecific antibody tafasitamab, which is simpler and more convenient compared to CAR-T therapies. Thus, the new guidelines for DLBCL treatment are indeed bountiful. Currently, the cure rate for DLBCL can reach over 70%, and with everyone’s efforts, we hope to further improve the survival quality and cure rate for DLBCL patients in China.