Alan P. Z. Skarbnik, MD, discusses the importance of personalizing treatment for patients with follicular lymphoma.
Alan P. Z. Skarbnik, MD, a hematologist/oncologist with Novant Health, discusses the importance of personalizing treatment for patients with follicular lymphoma.
A key challenge with follicular lymphoma is that it is a highly heterogeneous disease, both in biology and presentation. The age of patients who experience this disease and their comorbidities are also difficult challenges to address, says Skarbnik.
As such, treatment for those with follicular lymphoma should be highly personalized and dependent on factors such as presentation and disease grade. If a biopsy is possible, patients should undergo genetic mutation testing, which is important to determine important targets and whether targeted therapy could be utilized.
It is also important to remember that not all patients require treatment, says Skarbnik. Patients can be monitored for many years on active surveillance until treatment is required. To determine whether patients will require treatment, stage, age, grade of the lymphoma, and comorbidities must be considered, adds Skarbnik.
For early-stage disease or stage I or II, which is not common and accounts for approximately 25% of patients with follicular lymphoma, there is a potential chance for a curative approach. In general, radiation therapy with or without rituximab (Rituxan) may be an option for these patients. With this approach, patients can potentially experience a very prolonged disease-free interval or even cure, concludes Skarbnik.