Living with Follicular Lymphoma: Counseling Patients, Evolving Treatments, and Remaining Unmet Needs

In 'Living with Follicular Lymphoma: Counseling Patients, Evolving Treatments, and Remaining Unmet Needs,' Christina Poh, MD delves into the following critical questions:

Follicular lymphoma (FL) is characterized by a pattern of remission and relapse. How do you frame this disease trajectory for your patients, and how has your approach to relapsed or refractory (RR) disease evolved over the last several years?

What do you consider the most significant unmet needs in the RRFL setting today?

How does the number of prior lines of therapy shape your thinking about treatment selection at relapse?

Christina Poh discussed how she counsels patients on follicular lymphoma as a chronic, relapsing-remitting disease that is highly treatable, with many patients living for years or even decades with good quality of life, while being transparent that current standard-of-care treatments are unlikely to be curative, framing this honest, forward-looking conversation as the foundation for a long-term therapeutic partnership built on realistic expectations and shared planning. She also described how her approach to relapsed or refractory disease has evolved significantly in recent years, driven by the emergence of bispecific antibodies, the addition of tafasitamab to lenalidomide and rituximab, and the growing use of CAR-T cell therapy, a shift away from sequential chemotherapy that has enabled a more personalized, patient- and disease-specific approach to treatment selection. Christina Poh also identified the most pressing unmet needs remaining in the RRFL setting, including the lack of clear guidance on optimal treatment sequencing to maximize durability while preserving immune function, the need for better recognition and management of toxicity and quality of life in the context of a chronic disease, and the continued absence of predictive biomarkers beyond clinical features like POD24 that could help identify high-risk patients and inform individualized treatment decisions.

Throughout the conversation, the experts provide a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

Our next episode, 'Closing the Communication Gap: Patient-Centered Care and Clinical Trial Integration in RRFL,' further explores follicular lymphoma with Christina Poh, highlighting the disconnect between how providers describe shared decision-making and how patients actually experience it, the actionable steps needed to close that gap, and how the field can better standardize clinical trial conversations across academic and community settings to ensure patients view trials as a treatment option throughout their care journey, not just as a last resort.