[Current standard treatments and future outlook for follicular lymphoma].

Rinsho Ketsueki

Department of Hematology Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research.

Published: October 2024

AI Article Synopsis

  • * For patients with limited-stage FL, radiation therapy is preferred and can result in nearly 20 years of median survival, whereas advanced-stage patients with low tumor burden may benefit from a strategy of careful monitoring (watchful waiting).
  • * Advanced-stage patients with high tumor burden typically receive chemoimmunotherapy, while various treatments are being explored for relapsed cases, including new therapies like CAR T-cell and bispecific antibodies.

Article Abstract

Follicular lymphoma (FL) is the most common subtype of indolent lymphoma. Survival outcomes for FL have improved since the introduction of anti-CD20 monoclonal antibodies, such as rituximab, and median overall survival has reached 15-20 years. However, FL is an incurable disease that subsequently progresses or relapses, and progression-free and overall survival tend to shorten with repeated relapses. For patients with limited-stage disease, radiation therapy is generally the treatment of choice and results in a median survival of approximately nearly 20 years. For advanced-stage patients with low tumor burden, watchful waiting continues to be the appropriate strategy at present. It remains unclear whether rituximab monotherapy might change this watchful waiting approach and result in a benefit from early intervention in patients with low tumor burden. For advanced-stage patients with high tumor burden, chemoimmunotherapy including rituximab or obinutuzumab followed by maintenance therapy is the standard treatment. For relapsed or refractory patients, treatment options such as chemoimmunotherapy, lenalidomide-rituximab, tazemetostat, chimeric antigen receptor T-cell therapies, and CD3/CD20 bispecific antibodies are available or in development. This review presents current standard treatments, recent advances, and future perspectives on the management of FL.

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Source
http://dx.doi.org/10.11406/rinketsu.65.1004DOI Listing

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