[Current standard treatments and future outlook for follicular lymphoma].

Dai Maruyama
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Abstract

Follicular lymphoma (FL) is the most common subtype of indolent lymphoma. Survival outcomes for FL have improved since the introduction of anti-CD20 monoclonal antibodies, such as rituximab, and median overall survival has reached 15-20 years. However, FL is an incurable disease that subsequently progresses or relapses, and progression-free and overall survival tend to shorten with repeated relapses. For patients with limited-stage disease, radiation therapy is generally the treatment of choice and results in a median survival of approximately nearly 20 years. For advanced-stage patients with low tumor burden, watchful waiting continues to be the appropriate strategy at present. It remains unclear whether rituximab monotherapy might change this watchful waiting approach and result in a benefit from early intervention in patients with low tumor burden. For advanced-stage patients with high tumor burden, chemoimmunotherapy including rituximab or obinutuzumab followed by maintenance therapy is the standard treatment. For relapsed or refractory patients, treatment options such as chemoimmunotherapy, lenalidomide-rituximab, tazemetostat, chimeric antigen receptor T-cell therapies, and CD3/CD20 bispecific antibodies are available or in development. This review presents current standard treatments, recent advances, and future perspectives on the management of FL.

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[滤泡性淋巴瘤目前的标准治疗方法和未来展望]。
滤泡性淋巴瘤(FL)是非淋巴瘤中最常见的亚型。自抗CD20单克隆抗体(如利妥昔单抗)问世以来,FL的生存率有所提高,中位总生存期已达15-20年。然而,FL 是一种无法治愈的疾病,随后会进展或复发,无进展生存期和总生存期往往会随着反复复发而缩短。对于局限期患者,放疗通常是首选治疗方法,中位生存期约为近 20 年。对于肿瘤负担较轻的晚期患者,观察等待仍是目前的适当策略。目前尚不清楚利妥昔单抗单药疗法是否会改变这种观察等待的方法,并使肿瘤负荷低的患者从早期干预中获益。对于肿瘤负荷较重的晚期患者,标准的治疗方法是化疗免疫疗法,包括利妥昔单抗或奥比妥珠单抗,然后进行维持治疗。对于复发或难治性患者,化疗免疫疗法、来那度胺-利妥昔单抗、他泽美托司他、嵌合抗原受体T细胞疗法和CD3/CD20双特异性抗体等治疗方案已经问世或正在开发中。本综述介绍了 FL 目前的标准治疗方法、最新进展以及未来的治疗前景。
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