Current and Emerging Treatment Strategies in Follicular Lymphoma

Learn how follicular lymphoma often appears later in life, shows subtle symptoms, and follows a relapsing course with remission cycles and transformation risk.

Understand diagnosis, watchful waiting, and long-term risks in slow-growing lymphoma—monitoring symptoms, relapse, and transformation.

Fevers, drenching night sweats, weight loss, significant or progressive lymphadenopathy, involvement of the bone marrow that is significant that leads to cytopenias, or if the disease is threatening the function of an important organ are among the reasons to start treatment, says Poh.

Efficacy is obviously important, Poh says, but so is finding the right balance of toxicity, convenience and value for patients.

In the relapse or refractory setting, there is growing interest in adding immune-based therapies such as tafasitamab and epcoritamab to the established combination of rituximab plus lenalidomide, says Poh.

The dosing schedules for both tafasitamab and epcoritamab in combination with rituximab and lenalidomide are quite intensive initially, Poh says, but become less intensive over time.

More treatment doesn't automatically mean better treatment, Poh stresses, and the combinations that can improve progression-free survival come with the risks of additional toxicity and treatment complexity.

Poh says there is no single algorithm that applies to the treatment for patients with relapse or refractory follicular lymphoma.

Tafasitamab targets CD19, and epcoritamab targets CD20 and CD3, bringing T cells into close contact with the lymphoma cells, Poh notes.

The treatment landscape continues to evolve, Poh says, and move away from a one-size-fits-all approach toward more individualized treatment strategies.

Poh says treatment of follicular lymphoma is entering an exciting era in follicular lymphoma with multiple treatment options and an opportunity to be selective according to what a patient wants from therapy.

Christine Poh, M.D., of the City of Hope Los Angeles, discusses follicular lymphoma treatment.