Advanced stage follicular lymphoma is incurable by conventional treatment. Important progress has been observed with the development of new therapies based on monoclonal antibodies and on the use of radioimmunotherapy (RIT) in the treatment of non-Hodgkin lymphomas (NHL). Rituximab in combination with chemotherapy in the upfront setting significantly improved treatment outcome as compared with chemotherapy alone. Different studies also indicate that RIT has an important role in the management of NHL and could be beneficial in combination with chemotherapy. These two new treatment options have clearly distinctive mechanisms of action, rituximab being an exclusively biological treatment and RIT adding targeted systemic radiation therapy. Both RIT and the unlabeled antibody treatments might be further improved by different strategies including repetition of RIT or combination of different antibodies. We present here our experience with RIT using 131I-tositumomab (Bexxar) and discuss different topics regarding RIT, like the use of different antibodies, the best choice of the radioisotope or the place of radio-imaging. From the therapeutic point of view, we argue that the debate should not be as to which one among antibody immunotherapy or RIT should be best added to chemotherapy, but that all three treatments might be optimally combined with the aim to get the highest chance of cure for advanced stage follicular lymphoma.
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Strahlenther Onkol
January 2025
Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
Purpose: Recent advancements in imaging, particularly 18F-fluorodeoxyglucose positron-emission tomography-computed tomography (FDG-PET/CT), have improved the detection of involved lymph nodes, thus influencing staging accuracy and potentially treatment outcomes. This study is a post hoc analysis of the GAZAI trial data to evaluate the impact of FDG-PET/CT versus computed tomography (CT) alone on radiation target volumes for involved-site radiotherapy (IS-RT) in early-stage follicular lymphoma (FL).
Methods: All patients in the GAZAI trial underwent pretherapeutic FDG-PET/CT examinations, which were subject to central quality control.
Am J Cancer Res
December 2024
Department of Hematology, Yantai Yuhuangding Hospital Yantai 264001, Shandong, China.
This review discusses multiple aspects of follicular lymphoma (FL), including etiology, treatment challenges, and future perspectives. First, we delve into the etiology of FL, which involves a variety of pathogenic mechanisms such as gene mutations, chromosomal abnormalities, immune escape, immune system dysregulation, familial inheritance, and environmental factors. These mechanisms provide the context for understanding the diversity and complexity of FL.
View Article and Find Full Text PDFJ Adv Pract Oncol
November 2024
H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida.
Follicular lymphoma (FL) is a disease often characterized by chronic and successive relapses after first-line chemoimmunotherapy. Although chemoimmunotherapy and combination therapy, such as lenalidomide with rituximab, are well established in the treatment sequence of FL, there is a need to streamline treatment options and determine placement of novel agents, such as chimeric antigen receptor T-cell therapy, an enhancer of zeste homolog 2 inhibitor, or a phosphoinositide 3 kinase inhibitor, into the treatment landscape. As such, the purpose of this review is to compare the safety profiles of approved agents in subsequent lines of therapy for relapsed or refractory FL and to assess how the management of adverse events may impact treatment choice.
View Article and Find Full Text PDFCancers (Basel)
December 2024
Hematology Division, A.O.U. Città della Salute e della Scienza di Torino, C.so Bramante 88, 10126 Turin, Italy.
Backgroud: The introduction of highly active immunotherapies has changed the outcome of B-cell non-Hodgkin lymphomas (B-NHLs) in the last two decades. Since then, important progress has been shown using newer and more active immunotherapies, including chimeric antigen receptor T-cell therapy (CAR-T), conjugated monoclonal antibodies, and bispecific antobodies, which currently plays a significant role in the treatment of diffuse large B-cell (DLBCL), follicular (FL), and mantle cell (MCL) lymphoma.
Purpose: In this review, we provide an updated overview of recently completed and ongoing BsAb trials in patients with relapsed/refractory(R/R) B-NHL and Hodgkin's lymphoma, including single-agent results, emerging combinations, safety data, and novel constructs.
Cancers (Basel)
December 2024
Department of Hematology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary.
: Follicular lymphoma (FL) is a heterogeneous disease, and identifying high-risk patients early is crucial for optimal management. This study aimed to evaluate the prognostic significance of interim positron emission tomography/computed tomography (PET/CT) in newly diagnosed FL patients undergoing first-line treatment. : This single-center, retrospective study included 103 patients with newly diagnosed FL who underwent interim PET/CT.
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