Dr. Owen O’Connor: The Vessel of Hope for Peripheral T-Cell Lymphoma Braves the Storm and Forges Ahead Fearlessly

MediaMedic made the following blog on LinkedIn:

“In order to further improve the diagnostic and treatment level of leukemia and lymphoma in China, ‘The 8th Hematologic Oncology Academic Conference of CSCO,’ co-hosted by the Chinese Society of Clinical Oncology (CSCO), the Leukemia Expert Committee of CSCO, and the Lymphoma Expert Committee, and co-organized by the Harbin Hematological Tumor Research Institute and Peking University Cancer Hospital, was grandly held in Harbin from July 26 to 28. The conference aims to build an important platform for in-depth learning and extensive exchange for many experts and scholars in the field of hematologic oncology. On the occasion of the conference, ‘Hematology Frontier’ specially invited Dr. Owen O’Connor, Director of Translational Orphan Blood Cancer Center, to conduct in-depth academic discussions and share exciting insights around the cutting-edge progress of Peripheral T-Cell Lymphoma (PTCL).

Hematology Frontier: What do you consider to be the greatest challenges in the treatment of Peripheral T-cell Lymphomas (PTCL) at present? In your presentation today, you mentioned the latest advancements in PTCL. Could you elaborate on what key breakthroughs have been achieved in this field this year?

Dr. Owen O’Connor: There are so many challenges. It’s gonna be hard to summarize them all in a short period of time. The two biggest and obvious challenges are that these are incredibly rare diseases in the United States, only about 10,000 to 15,000 cases per year. These are incredibly heterogeneous diseases, very diverse. We now recognize nearly 36 kinds of T cell lymphoma. Those two challenges make it very hard to develop a consensus around how best to manage these diseases.
In fact, the lack of a consensus on care be it in frontline or relapse setting is probably the third big Challenge. We have regimens that are predicated on combination chemotherapy developed in the past. They have been, by default, become the new standards of care. But those three aspects conspire to create enormous Challenge.

The next big category of challenges revolves around biology. Many cancers have clear biological underpinnings, and we can point to targets. The networks in T cell lymphoma that has been slow to evolve. Pathologists have done a great job over the last 20 years, really defining the different sub types, defining their unique molecular profiles. And that coupled with some new drugs. And the Information from those new drugs has informed us that maybe there is a biological basis for these diseases. And that biological basis, maybe its underlying dis-regulated, epigenetic biology.

One of the great challenges then cut that comes from that is what are the drugs we have available to target that biology? Are those drugs optimized? And in my opinion, from the former colleges perspective, they’re not optimized. From the point of view of how do we understand the scientific basis for how to move those drugs forward? Scientists need good laboratory models. They need cell lines, they need mouse models, and they need know how. And that represents a really huge Challenge, because most of the advances we try to make in the disease are based upon random selection of drugs, not science, the science is retrofitted.

So I think if we can find a way to think about how to survey these drugs that try to target the critical underlying biology that’s common across the 36 sub types will be able to make progress. And in my opinion, that progress will be made by developing new chemotherapy, Free platforms predicated on those targeted therapy combinations.

Hematology Frontier: In your research and practice, what do you believe to be the most effective strategies for treating PTCL currently? How do you assess the potential of new therapeutic approaches, such as immunotherapy or targeted therapy, in the treatment of PTCL?

Dr. Owen O’Connor: Unfortunately, we haven’t made many advances over the last 30 or 40 years, chop based chemotherapy or widely regarded as standard, and in many parts of the world for the appropriate patient. Those patients go on to receive an autologous stem cell transplant in first remission. That’s probably the universal standard in some form. I believe that in my practice, we use clinical trials, not everybody has access to clinical trials. So that becomes harder, but where we can collaborate in a country or in a region or a city with colleagues that do have clinical trials for these diseases. I believe a clinical trial in the front line and the relapse setting should be the standard of care until we define better standards of care. In fact, if you look at the NCCN criteria, or the criteria from North America, Europe, even Asia, recommend clinical trials very early in the care of patients.

Regarding immunotherapy, I think it’s a fascinating area. It’s taken us a long time. Immune checkpoint inhibitors are not terribly active by themselves. CAR-T is taking a long time to develop in these diseases. But I think there are lots of interesting advances and developments by various groups around the world. That suggests that those kinds of treatments will soon become available with meaningful clinical benefit for all patients.

Hematology Frontier: You mentioned ‘new hope’ in your speech. How can patients in the field of PTCL treatment embrace this new hope? How can scholars and clinicians more effectively bring new hope to more patients? Looking forward to the future, what do you think is the development direction of PTCL treatment with ‘new hope’?

Dr. Owen O’Connor: New hope is tied to the last , and the new hope has to be based on research. The key, whether you’re a patient, a government, physicians, foundations, is to make sure that we allocate dollars for that research. There are very few doctors around the world that do research in these diseases. Lots of doctors treat a lot of doctors will put together clinical trials, but fundamental research on how to exploit the biology, to find new therapies that’s rare.

And I think the new hope has to be that form of the private sector, the government and physicians with interests, including those institutions where the physicians work is going to become very important to coalesce a singular community. Working individually is not going to do it. We’re gonna have to work as a team. But I think for me, trying to figure out what’s the biology worth targeting is important, and then comparing those new therapies against our standard of care. In randomized studies, in the clinic, which isn’t hard and can be done, is gonna be the only way we make those advances.”

Source: MediaMedic/LinkedIn