Dr Nowakowski on Unmet Needs to be Addressed in R/R Follicular Lymphoma

Grzegorz S. Nowakowski, MD, consultant, Division of Hematology; enterprise deputy director, Clinical Research, Mayo Clinic Comprehensive Cancer Center, discusses unmet needs to be addressed in the treatment of patients with relapsed/refractory follicular lymphoma.

Several knowledge gaps remain in the treatment of patients with this disease, particularly concerning the continuous risk of relapse, Nowakowski begins. Patient outcomes tend to worsen with each subsequent relapse, he says. Accordingly, a critical area of focus for research in follicular lymphoma is the development of treatments that can enhance both the depth and durability of response. One such agent is epcoritamab-bysp (Epkinly), which received accelerated approval from the FDA in June 2024. Unlike CAR T-cell therapy, which is an intensive treatment and difficult to combine with other therapies, epcoritamab can be used in combination with various other treatments, Nowakowski explains.

The optimal role for bispecific antibodies like epcoritamab has only begun to unfold, he highlights. Epcoritamab could potentially be administered in combination with agents such as lenalidomide (Revlimid), rituximab (Rituxan), or other active agents in this therapeutic space to further improve patient outcomes, Nowakowski continues. He notes that this approach could increase both the rate and duration of responses.

Exploring fixed-duration therapies is another area of interest in follicular lymphoma, he expands. In the third-line setting, treatment for relapsed/refractory patients is often continued until disease progression or unmanageabletoxicity, Nowakowski reports. However, developing therapeutic regimens with a predetermined treatment duration could engender durable responses. Moreover, fixed-duration therapies could minimize the need for frequent clinic visits and provide greater convenience, thereby reducing the burden of continuous treatment he explains. In ongoing trials with epcoritamab, treatment after the initial cycles is typically administered once per month from cycle 10 onward. This schedule is generally manageable for most patients, especially since epcoritamab is delivered subcutaneously, providing added convenience, Nowakowski concludes.