Understanding Follicular Lymphoma with Sarah Rutherford, MD

Sarah Rutherford, MD gives a deep dive into follicular lymphoma.

About Dr. Rutherford: Sarah Rutherford, MD (Weill Cornell Medicine)

Treatment Options

In patients requiring chemotherapy, physicians may use one or more chemotherapy drugs often including the monoclonal antibodies obinutuzumab (Gazyva) or rituximab (Rituxan) Rituximab hyaluronidase human (Rituxan Hycela) can be given as a subcutaneous (under the skin) injection instead of IV (intravenously) rituximab after the first IV infusion of rituximab.


Monoclonal antibodies, which are a type of immunotherapy, like rituximab and obinutuzumab target particular markers found on tumor cells and recruit immune cells to promote tumor destruction, which can increase response to chemotherapy drugs. Common combination regimens include: Bendamustine (Treanda) and obinutuzumab (Gazyva), R-Bendamustine (rituximab [Rituxan] and bendamustine), R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone), R-CVP (rituximab, cyclophosphamide, vincristine, and prednisone) and R-Lenalidomide (rituximab and lenalidomide [Revlimid])

Some monoclonal antibodies, such as obinutuzumab, can also be used as maintenance therapy to prolong remission for patients with no signs of lymphoma.

After treatment, many patients can go into a remission that lasts for years; however, this disease should be considered a chronic, or lifelong, condition. Thus, relapse (returns after treatment) and in some cases refractory (no longer responds to treatment) disease can occur. For patients with relapsed FL, the same management choices as listed above may be utilized, or additional therapies may be successful in providing another remission, such as the PI3 kinase inhibitors idelalisib (Zydelig), copanlisib (Aliqopa), and duvelisib (Copiktra).

Treatments Under Investigation

Many treatments are currently being tested in clinical trials for patients who are newly diagnosed or have relapsed/refractory FL. These trials help determine what is the best treatment for patients with newly diagnosed FL and also help discover new treatments for FL that has recurred. Examples of therapies under investigation include tazemetostat; new monoclonal antibodies such as Ublituximab (TG-1101); PI3 kinase inhibitors; ibrutinib (Imbruvica), acalabrutinib (Calquence), and other BTK inhibitors; durvalumab (Imfinzi), nivolumab (Opdivo), pembrolizumab (Keytruda), and other checkpoint inhibitors; and new immunotherapies including chimeric antigen receptor (CAR) T-cell therapies. Other classes of therapy include dual inhibitors such as umbralisib which inhibits both PI3K delta and CK1 epsilon; B-cell lymphoma-2 (BCL-2) inhibitors, venetoclax (Venclexta).

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Видео Understanding Follicular Lymphoma with Sarah Rutherford, MD канала Lymphoma Research Foundation