VIDEO: 'Broad' treatment pipeline for follicular lymphoma

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The pipeline for follicular lymphoma is broad and we're so lucky. The rate of advancement for lymphomas overall, really for B-cell lymphomas, including follicular lymphoma and some of the others, DLBCL and mantle cell lymphoma, is just generally been broader. Lymphoma, fifth most common cancer in America but we have more FDA-approved therapies than any other cancer. Second place would be breast cancer, but that's such an increasingly more prevalent disease even than lymphoma. So it's quite amazing how many approved therapies we have and the rate of new therapies is not diminishing, it seems to be steady or maybe increasing, so we're lucky to have a rich pipeline. I mean, the most straightforward things in the pipeline is how to take beautifully effective and tolerated therapies like immunotherapies, like bispecific antibodies, and bring them, I would say, earlier into the course of treatment. We have very simple, and I would say, still elegant design frontline trial now comparing standard chemoimmunotherapy to monotherapy with just a bispecific antibody. And this trial's probably going to accrue very quickly because if you ask a patient, "Hey, would you like chemo? Or would you like, you know, just the pretty minor risks of a bispecific antibody, again, probably just fever for about a day for the average patient?" It's a no brainer. And you know, some of these studies are designed to superiority studies, but really some of those probably could be non-inferiority studies. If, you know, bispecific antibody was comparably effective but not more effective than chemotherapy, I think it would still be quality of life, appreciably by patients, easily superior to chemotherapy. So anyway, bringing great things earlier to the line of therapy, bispecific antibodies to become standard second line and I think even frontline therapies. And then, you know, in terms of novel therapies, I mentioned that antigen escape, the loss of CD20 after these bispecific antibodies is going to be a big problem. So an exciting part of the pipeline is bi- and tri-specific antibodies targeting other surface proteins like CD22, like CD79, and it's even bi-specifics targeting CD19. Those have been a bit avoided because in some way we don't want to mess with the potential for future CAR T-cell therapy by risking the loss of CD19 but it's still on the list for options. And we also still have increased utilization in other lymphomas, and they'll probably lead their way towards follicular lymphoma for antibody drug conjugates like CD79 polatuzumab, like CD19 loncastuximab. They will find some space in follicular lymphoma, second and third line treatments. And of course, you know, just other combinations of recently approved things like tazemetostat EZH2 inhibitor approved as monotherapy for third line disease but probably has a great potential especially for EZH2 mutated patients for earlier lines of therapy, probably second line, either as monotherapy or maybe combined with lenalidomide and rituximab. So pretty broad pipeline for things that are gonna be coming quite soon and then even other promising things a little further down the pipeline.