Can we avoid chemotherapy entirely in follicular lymphoma?

During the European School of Haematology (ESH)'s 2nd How to Diagnose & Treat Lymphoma conference, the Lymphoma Hub spoke to Nathan Fowler, MD Anderson Cancer Center, Houston, US, who discussed the non-chemotherapy approaches to treating follicular lymphoma.

Treatment for follicular lymphoma has been improving over recent years. The addition of rituximab, an anti-CD20 antibody, to the clinician's arsenal has been a real game changer in the field. Nathan Fowler describes its mode of action and the role it plays in modern treatment strategies.

Fowler discusses the different courses the disease can take and how therapy can be tailored to suit an individual's needs. The current treatment standards and the response rates achieved with these agents are examined.

Lenalidomide, an immunomodulatory drug, in combination with rituximab was investigated in comparison to three different chemotherapy regimes in the RELEVANCE trial, and Fowler details the outcomes of this study. The differing adverse events experienced by patients following these therapies are listed. He goes on to say how this result has influenced his clinical practice and how the presence of high-risk factors impacts treatment decision making.

Nathan Fowler rounds off his talk by introducing other non-chemotherapy options, such as obinutuzumab, Pi3 kinase inhibitors, tazemetostat, and chimeric antigen receptor (CAR) T cells.