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Practical Solutions and Value in Follicular Lymphoma Treatment
Introduction
- Follicular lymphoma (FL) is a common type of non-Hodgkin lymphoma in Western countries.
- While FL is generally not curable, there are effective initial therapies and new treatments for relapsed or refractory disease.
Treatment Options
- Initial treatment options for FL include active surveillance, radiotherapy, rituximab monotherapy, and chemoimmunotherapy.
- Staging with PET/CT and bone marrow biopsy is crucial for identifying early-stage patients.
- Most patients with FL will receive chemoimmunotherapy as initial treatment with options including rituximab or obinutuzumab plus CVP, CHOP, bendamustine, or lenalidomide.
Value of Maintenance Therapy
- Maintenance therapy with rituximab or obinutuzumab in responders to initial chemoimmunotherapy improves progression-free survival.
Relapsed/Refractory FL Treatment
- Treatment options for relapsed/refractory FL include chemoimmunotherapy, lenalidomide-based regimens, tazemetostat, CAR T cell therapy, and CD3/CD20 bispecific antibodies.
- Encouraging outcomes with CAR T cell therapy and bispecific antibodies are being tested in earlier lines of therapy and among high-risk patients with early relapse after frontline chemoimmunotherapy.
Conclusion
- Further studies and follow-up are needed to understand how these novel agents may further change treatment algorithms for FL.
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