Understanding Follicular Lymphoma with Sarah Rutherford, MD
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Published 2020-04-23
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).
LEARN MORE!
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The Lymphoma Research Foundation is the nation's largest non-profit organization devoted to funding innovative research and providing people with lymphoma and healthcare professionals with up-to-date information about this type of cancer.
All Comments (21)
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Close to midnight, just want to thank you for sharing this video.
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Recently diagnosed with Follicular NHL..Completed 20 Radiation treatments now will see. Having scan on 2/22/2023. I'm very hopeful. I will face the news and cont. to fight if necessary.
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I’m happy to have found this channel. Dr explained everything so well. I’ve had a lump by my left collarbone. A needle biopsy showed no cancer, but the core biopsy showed Follicular Lymphoma. I am to meet with the Hematologist/Oncologist next week. At 74 years old, I don’t know what will be my options. I also have rampant papilloma in my mouth, which now seems like surgery will be put on the wayside for now.
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Thank you Dr. Rutherford. i envy your patients!
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I have it too, as well a Parkinson Disease. Tough going currently.
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Excellent video. Very nicely explained by Dr. Rutherford.
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I thought this was a well presented, useful overview of follicular lymphoma - thanks!
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Thank you for such an informative video - really appreciate the professional approach .. .. 13:42
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Excellent video. I just got diagnosed with low grade lymphoma. Best video I have watched this far
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I'm grade I stage II but the last two years I experience extreme fatigue and shortness of breath, so we decided to start chemo R-CHOP. My lymph nodes are located in groin and abdominal area.
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I have low grade follicular cancer and thyroid cancer too, I was just diagnosed and feel as though I have been forgotten, with the covid virus and christmas i am waiting to hear from the consultants
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I have this also
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Thank you for this information. I am doing WW with stage 3 FL age 58 and I heard when it comes to Rituximab one must be able to tolerate steroids. I have allergy to steroids which causes swelling and itching, hives... Is there any way around that allergy to use this therapy? It is too late for radiation and chemo isn't an effective option.
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I am 83 this month Feb 2021
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mine dad was diagnosed with low grade lymphoma and tata doctors said to wait till it becomes high grade lymphoma..When it came to do treatment he expired today
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can you PLEASE speak specifically to Non-Hodgkins Follicular Lymphoma? I can NOT find any videos that deal with this type of Lymphoma. I am 11 years living with it and need more information. I think I am out of remission and need more information. Thank you
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I have a lump or mass on my rt collarbone its been sore and bothers me when I side sleep n at times throughout the day. I don't think its anything to worry about, but it hasn't gone away, I've noticed this past 2 months.
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What the one that juts cause itching itching itching this is so horrible this makes me feel like crying when I’m like this
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I listened to the video but must have missed it.. What is it that you treat the patient with when you don't administer chemotherapy?
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Up to 60% of patients can change to Diffuse Large B Cell Lymphoma which is more Agressive. Also many secondary diseases can be triggered by Follicular Lymphoma, so taking such a Blasé attitude to it is concerning. Misdiagnosis or not being diagnosed is common because many doctors do not have any level of suspicion. Many will wait until it is blatantly obvious and has spread throughout the body such as bone marrow and spleen. There are still many people whom have disabling symptoms which are often ignored by doctors and unfortunately this type of dismissive video promotes leaving it and letting it spread. Some will spread faster, not all are the same.
