Relapsed and Refractory Follicular Lymphoma (Video)

The Lymphoma Research Foundation sponsored an online webinar last month on Relapsed and Refractory Follicular Lymphoma, featuring Dr. Bruce Cheson. If you've been reading the blog for a while, you might recognize the name. I believe he is retired now, but still very active in the Lymphoma community. I've always found him to be very informative and very entertaining.

This webinar (which you can watch by clicking the link above) is aimed at R/R FL patients, and Dr. Cheson addresses them directly. It's a very good overview of the landscape of what is happening for R/R patients -- those whose first treatment stopped working, or didn't work at all. (I think the webinar took place last November, but was posted online last month.)

Some highlights:

He begins by giving some statistics about R/R FL: the overall survival rate at 10 years is about 80%, and patients who are not POD24 have a lifespan that is very similar to the overall population.

He also shows some statistics that discuss older treatments (that is, it doesn't include things like CAR-T and bispecifics). At one time -- and I remember this very well -- it was thought that the typical path for most FL patients was that we would need many different treatments over time, and that each treatment would give us a shorter Progression Free Survival. In other words, we might have chemo, which would put us in remission for maybe 5 years. Then another treatment would work for 3 years. Then another for 1 year. That was definitely what I expected to happen 15 years ago. But that's not the case anymore. We get much longer times between treatments these days.

Dr. Cheson also spends some time discussing current treatment options, with their strengths and weaknesses: Rituxan/Obinutuzumab, RIT, Bendamustine, R-squared, Tazemetostat, PI3K inhibitors (no longer available), CAR-T, and Bone Marrow Transplants (which Dr. Cheson hasn't used in a very long time). He discusses many of these in detail, including PI3K Inhibitors. He is enthusiastic about Zandelisib, though this isn't being studied much anymore.

He moves on to some of the "more exciting stuff," including bispecifics. He's careful to spend some time on side effects of these treatments, as well as their effectiveness. It's nice to hear the excitement in his voice. He gives a similar discussion of CAR-T, explaining what it is, and reviewing some studies and discussing their effectiveness and side effects. He also gives a nice comparison between CAR-T and bispecifics.

Finally, he looks at some of the treatments that are currently in development. His conclusion about Relapsed and Refractory FL: chemo should not be considered an option, because there are so many non-chemo options. And with more options coming available, "newer approaches will clearly improve outcomes." Patients should consider clinical trials as a way of getting access to these treatments and helping them along the process. 

It's a nice overview of where we are with R/R FL, and as I said, I have always found Dr. Cheson to be entertaining. [Watch for his joke about "transformation" at about the 10 minute mark.] Most importantly, he is hopeful, and that's what I like most about him (and his presentations) -- he sees a very big picture, knows where the world of Lymphoma has been, and can see where it is going, and he is very happy about the direction it is moving in. 

This is a useful video for anyone with FL, but especially those who have had a first treatment. It should give you lots to be positive about.