Operationalizing RRFL Care: Sequencing Therapies, Managing REMS, and the Role of R² in Practice

In this episode, 'Operationalizing RRFL Care: Sequencing Therapies, Managing REMS, and the Role of R² in Practice,' the pharmacist Ryan Haumschild, PharmD, MS, MBA, CPEL explores the following questions:

1. From a pharmacy operations standpoint, how do you characterize the current treatment landscape for relapsed or refractory follicular lymphoma (RRFL), and how has the growing number of available agents affected formulary management and operational planning at your institution?
2. Lenalidomide plus rituximab has been a commonly used combination in RRFL. How have you positioned this regimen in your own practice, and what have been its strengths and limitations in your experience?

Ryan Haumschild examined the expanding RRFL treatment landscape from a pharmacy operations perspective, emphasizing that the growing number of available agents creates both clinical opportunity and operational complexity, requiring institutions to develop clear sequencing frameworks that help providers match the right therapy to the right patient, rather than navigate an overwhelming menu of options. He also outlined the key infrastructure considerations that accompany each therapeutic class, including REMS enrollment, infusion capabilities, cytokine release syndrome management protocols, and the significant capital investment required for cellular therapy programs, underscoring that clinical sequencing decisions cannot be separated from the operational realities of each care setting. Ryan Haumschild also highlighted the practical strengths of R² as a well-established, broadly accessible regimen in the relapsed or refractory setting, noting that the availability of biosimilar rituximab and generic lenalidomide has meaningfully reduced the total cost of care, while the regimen's familiarity across both academic and community settings makes it a feasible and cost-effective option that can be delivered with confidence across a wide range of practice environments.

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

The next episode in this series, 'From Data to Practice: Interpreting inMIND Trial Results and the Role of Tafasitamab in RRFL,' features Ryan Haumschild advancing his conversation on follicular lymphoma and focusing on how the addition of tafasitamab to the R² backbone performed in the inMIND trial, the clinical and operational implications of incorporating a third agent into an established regimen, and how community practitioners can interpret and apply these findings in their own practice settings.