Advancements in FL Treatment (Especially PI3K Inhibitors)

A little follow-up from my last post, which was about PI3K Inhibitors discussed at ASCO:

The American Journal of Managed Care did a special issue on PI3K Inhibitors in Follicular Lymphoma. Very timely.

There are four articles in the special issue. the first is called "Follicular Lymphoma: A Review of Mechanisms, Risk Factors, and Unmet Needs." It's a decent introduction to FL, though its purpose is to go through a lot of information. I think it needs to be read with a very careful eye. (It would be easy to misread this, for example, and think FL has two options -- either watching and waiting, or immunochemotherapy. there are, of course, lots of other options. It's a good intro for the doctors it was written for, but it doesn't present everything it could or should.

Skip it and go to the next article, "The PI3K Pathway: The Benefits of Dual Inhibition in Follicular Lymphoma." This one does a better job of laying out treatment options for FL, and where PI3K Inhibitors (Copanlisib and Duvelisib) fit into the picture. It's as good a summary of the research as you'll find.

The other two articles are interviews with FL experts. The first is "Advancements in Follicular Lymphoma Treatment: Where We Are and Where We Are Going. A Q&A With Andrew M. Evens, DO, MSc." Dr. Evans discusses current treatments for FL, especially PI3K Inhibitors. In some ways, it repeats what the previous article said, but in easier-to-understand language. It also gets into how one doctor would use them on actual patients. Dr. Evans also gives some thoughts on where FL research should go in the next few years. One area is paying more attention to Quality of Life -- and I am in total agreement.

Finally, there is "Evolving Population Health Strategies for an Expanding Treatment Spectrum A Q&A With Sheila M. Arquette, RPh." This article focuses on managed care, which is, of course, the whole focus on the journal it appears in. Managed care is a system of healthcare where a manager has some influence over treatment, making sure it is likely to work (statistically) and that the cost is worth the benefit. So while this article doesn't get into the treatment of FL the way Dr. Evans' interview did, it does provide a pretty fascinating look into how decisions are made by the people who have to pay for them. At its best, managed care reduces the cost of treatment while increasing its effectiveness. Patients don't always see the decisions in the same way. I'll leave it at that.

The special issue is definitely written for a particular group of readers, but it does give some additional insight into how FL gets looked at by people other than patients. That's pretty valuable.