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Treatment selection for patients with early progression (POD24) in follicular lymphoma
Enrico Derenzini, MD, PhD, European Institute of Oncology, Milan, Italy, comments on the treatment selection for patients with early progression (POD24) in follicular lymphoma. Dr Derenzini highlights that he treats both early and late progressors with the same regimen in the second line, and considers CAR T-cell therapy and bispecific antibodies as options for third-line treatment. This interview took place during the 18th International Conference on Malignant Lymphoma (18-ICML) in Lugano, Switzerland.
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Transcript
Follicular lymphoma with the POD24, so early progressors, historically actually representing a very difficult to treat patient population, but these data are based on a different era of therapy so now that we are approaching the era of immunotherapy with the advent of bispecific antibodies and the CAR T-cell therapy so the distinction between POD24 and late progressors is less relevant...
Follicular lymphoma with the POD24, so early progressors, historically actually representing a very difficult to treat patient population, but these data are based on a different era of therapy so now that we are approaching the era of immunotherapy with the advent of bispecific antibodies and the CAR T-cell therapy so the distinction between POD24 and late progressors is less relevant. So therefore in my clinical practice I treat basically early progressors and late progressors with the same regimen in the second line which is combination of lenalidomide and rituximab of course outside clinical trials. And in third line they can receive either bispecific antibodies or even CAR T-cell therapy you know depending on the patient fitness and comorbidities. Regarding the identification of early progressors there are several studies focusing on microenvironment so we know and also our group recently published on the role of T regulatory cells in the tumor microenvironment in affecting the outcome of follicular lymphoma treated either with single agent rituximab or chemoimmunotherapy in first line. Of course, in this disease, the microenvironment plays a great role and therefore this is why immunotherapy could become really the new standard and we are going towards a chemo-free treatment approach even in first line.
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