To further advance scientific research and clinical practice in hematologic malignancies in China and establish an authoritative academic exchange platform for the field, the 2026 Boren Hematologic Malignancies Precision Diagnosis and Treatment Conference, jointly organized by the Beijing Association for the Promotion of Integrated Chinese and Western Medicine in Chronic Disease Prevention and the Beijing Society of Bioengineering, was officially held in Beijing on May 16 in a hybrid online-offline format. The conference brought together leading experts and scholars in hematologic malignancies from across the country, focusing on cutting-edge technologies, clinical experience, and future directions in the discipline, creating a professional event with high academic value, strong clinical relevance, and broad industry influence.

During the conference, Professor Qinlong Zheng from Beijing Gaobo Boren Hospital gave an in-depth interview discussing the biological significance, molecular testing strategies, and clinical importance of clonal evolution from a practical clinical perspective, providing valuable insights for addressing tumor heterogeneity and drug resistance in hematologic malignancies.

Q1: Clonal evolution is considered a key mechanism underlying disease progression and drug resistance in hematologic malignancies. Professor Zheng, how do you understand the core concept of “clonal evolution” in hematologic cancers? From a clinical perspective, what is the significance of tracking clonal evolution for both patients and physicians?

Professor Qinlong Zheng:
Tumors are highly heterogeneous diseases, and their fundamental nature lies in the extensive diversity of genetic abnormalities and mutations among different tumor cells. During tumor development and progression, cancer cells continuously accumulate genetic mutations to adapt to their microenvironment and sustain abnormal proliferation.

In clinical treatment, tumors can also exploit their genetic variability and plasticity to evolve in different directions and adapt to therapeutic pressures, including targeted therapy, immunotherapy, and chemotherapy. This process often leads to the emergence of drug-resistance mechanisms, resulting in resistant clones that ultimately develop into treatment-resistant tumors. This represents one of the core challenges in tumor progression and clinical management.

Q2: Comprehensive molecular testing to analyze clonal evolution has become an important trend. In terms of technology selection and data interpretation, what are the current mainstream strategies? What practical experience has your team accumulated in this area?

Professor Qinlong Zheng:
From a clinical perspective, the process of tumor clonal evolution reflects the complex mechanisms tumors use to evade therapy and continue progressing. In the past, limitations in detection technologies, particularly in deep molecular analysis, made it difficult to accurately characterize and monitor the dynamic evolution of tumor clones.

With advances in molecular biology technologies, especially next-generation sequencing (NGS) and single-cell DNA sequencing, it has become possible to systematically analyze mutation composition, newly acquired mutations during clonal evolution, and clonal architecture at the single-cell level. These technologies allow us to reveal tumor evolutionary trajectories in a far more comprehensive and refined manner.

Of course, single-cell sequencing still faces challenges, including high cost and stringent technical platform requirements. As an alternative, NGS-based approaches can also be used by collecting serial patient samples at different time points and analyzing them longitudinally to reconstruct patterns of clonal evolution and identify newly acquired mutations or resistance-associated genes during disease progression.

These approaches provide powerful tools for understanding the biological规律 of tumor clonal evolution and the characteristics of emerging resistant clones, offering important guidance for clinical treatment decisions.

Q3: What are the major current challenges facing comprehensive molecular testing for clonal evolution? How can we further promote standardized clinical implementation, and what future developments do you find most promising?

Professor Qinlong Zheng:
In clinical practice, many physicians now recognize that tumors can escape treatment through clonal evolution, resulting in therapeutic resistance, disease relapse, and highly complex treatment courses. If we aim to better understand clonal evolution and its associated features through molecular testing, several strategies can be adopted in clinical pathways.

Whenever conditions permit, relatively comprehensive molecular testing should be performed at the time of initial diagnosis, and patient samples should be properly preserved. During follow-up and treatment, sequential sample collection and testing can then be conducted at different time points. Through integrated laboratory analysis, the entire process of tumor clonal evolution can be systematically reconstructed and characterized.

Such analyses can reveal which clones have developed resistance to specific drugs or acquired new mutations, some of which may themselves become potential therapeutic targets. This information can provide highly valuable guidance for designing subsequent treatment strategies and optimizing drug selection in clinical practice.

Expert Profile

Professor Qinlong Zheng
Gaobo Medical (Hematology) Beijing Research Center
Beijing Gaobo Boren Hospital
Director, Molecular Diagnostics Laboratory, Gaobo Diagnostic Center
Expert Member, Integrated Diagnostics Expert Group
Committee Member, 13th Clinical Laboratory Medicine Branch of the Beijing Medical Association
Member, American Association for Cancer Research (AACR)
Bachelor of Medicine, Shanghai Medical University
Postdoctoral Fellow, The University of Oklahoma Health Sciences Center, USA

Professor Zheng has more than 30 years of experience in laboratory testing and research related to cancer and other diseases, including risk assessment, early diagnosis, prognosis evaluation, drug screening, and therapeutic monitoring.

He has previously worked at The University of Oklahoma Health Sciences Center, the Department of Pathology and Laboratory Medicine at the University of California, Los Angeles (UCLA), the U.S. National Cancer Institute (NCI), Nordic Bioscience (Beijing) Co., Ltd., and the Nordic International Biochemical Pathology Research Center (Beijing).