Update on follicular lymphoma: Time beyond chemotherapy?
EHA Library. Hübel K. 06/14/17; 185011
Topic: 3Af Follicular lymphoma
Kai Hübel
Contributions
Contributions
Learning Objectives
Pauline Brice - Chair Introduction
Indolent B – cell lymphomas have a good prognosis with a low rate of mortality, but relapses are frequent even late and for the advanced stages they are usually not curable diseases. Molecular techniques have shed new light on the pathobiology of indolent lymphoma and helped to identify lesions with prognostic implications and therapeutic targets. Some specific biological abnormalities may help for targeted therapies; like In HCL the high frequency of BRAF mutations may suggest a key role in the pathogenesis of the disease or MYD88 in LPL lymphomas. The survival of FL has dramatically increased since 1997 with the use of Rituximab° initially in relapse setting than in first line. Patients with a high-tumor burden need chemotherapy (CT) combined with rituximab and this CT may expose them to long term complication (secondary malignancies, cardiac toxicity…) mostly for patients experiencing multiple relapses. New agents are studied in this setting e.g. Antibodies drug conjugates, intracellular targets or drugs targeting the microenvironment. The high efficacy of these drugs used alone or with antiCD20 antibodies let us hope that they will soon be used in first line delaying the time to CT.
Management of MALT lymphomas has evolved among time but for gastric lymphoma it must begin with antibiotics for Helicobacter Pylori eradication, stage I disease can receive radiation therapy at 30 gys and for advanced stages if a treatment is required the best published combination is represented by Rituximab /chlorambucil, but new agents have shown efficacy like LENALIDOMIDE and IBRUTINIB.
Learning Objectives of the manuscript
After viewing this presentation the participant will be able to:
- There is still a place for watchful waiting in asymptomatic patients.
- Major changes in identification of new therapeutic targets in indolent lymphomas.
- New agents studied in this setting (antibodies, intracellular targets or drugs targeting the microenvironment).
- Development of targeted treatments delaying the time to first chemotherapy in advanced patients requiring therapy.
Learning Objectives of the presentation:
After viewing this presentation the participant will be able to:
- Understand requirements for a chemotherapy-free approach in Follicular Lymphoma.
- Recognize the potential of existing and emerging therapeutics in the management of Follicular Lymphoma.
- Assess critically the benefits and risks of common cytotoxic regimens versus targeted therapies in different lines of treatment.
Indolent B – cell lymphomas have a good prognosis with a low rate of mortality, but relapses are frequent even late and for the advanced stages they are usually not curable diseases. Molecular techniques have shed new light on the pathobiology of indolent lymphoma and helped to identify lesions with prognostic implications and therapeutic targets. Some specific biological abnormalities may help for targeted therapies; like In HCL the high frequency of BRAF mutations may suggest a key role in the pathogenesis of the disease or MYD88 in LPL lymphomas. The survival of FL has dramatically increased since 1997 with the use of Rituximab° initially in relapse setting than in first line. Patients with a high-tumor burden need chemotherapy (CT) combined with rituximab and this CT may expose them to long term complication (secondary malignancies, cardiac toxicity…) mostly for patients experiencing multiple relapses. New agents are studied in this setting e.g. Antibodies drug conjugates, intracellular targets or drugs targeting the microenvironment. The high efficacy of these drugs used alone or with antiCD20 antibodies let us hope that they will soon be used in first line delaying the time to CT.
Management of MALT lymphomas has evolved among time but for gastric lymphoma it must begin with antibiotics for Helicobacter Pylori eradication, stage I disease can receive radiation therapy at 30 gys and for advanced stages if a treatment is required the best published combination is represented by Rituximab /chlorambucil, but new agents have shown efficacy like LENALIDOMIDE and IBRUTINIB.
Learning Objectives of the manuscript
After viewing this presentation the participant will be able to:
- There is still a place for watchful waiting in asymptomatic patients.
- Major changes in identification of new therapeutic targets in indolent lymphomas.
- New agents studied in this setting (antibodies, intracellular targets or drugs targeting the microenvironment).
- Development of targeted treatments delaying the time to first chemotherapy in advanced patients requiring therapy.
Learning Objectives of the presentation:
After viewing this presentation the participant will be able to:
- Understand requirements for a chemotherapy-free approach in Follicular Lymphoma.
- Recognize the potential of existing and emerging therapeutics in the management of Follicular Lymphoma.
- Assess critically the benefits and risks of common cytotoxic regimens versus targeted therapies in different lines of treatment.
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