Targeted Treatment of Follicular Lymphoma

Abstract

Follicular lymphoma (FL) is the most common indolent B-cell lymphoma. Advanced stage disease is considered incurable and is characterized by a prolonged relapsing/remitting course. A significant minority have less favorable outcomes, particularly those with transformed or early progressive disease. Recent advances in our understanding of the unique genetic and immune biology of FL have led to increasingly potent and precise novel targeted agents, suggesting that a chemotherapy-future may one day be attainable. The current pipeline of new therapeutics is unprecedented. Particularly exciting is that many agents have non-overlapping modes of action, offering potential new combinatorial options and synergies. This review provides up-to-date clinical and mechanistic data on these new therapeutics. Ongoing dedicated attention to basic, translational and clinical research will provide further clarity as to when and how to best use these agents, to improve efficacy without eliciting unnecessary toxicity.

Potential anti-tumor immune response mechanisms of SARS-CoV-2 in lymphomas: can the devil be converted into a boon?

“…As per our prediction, Orf3a may also be involved in cell cycle arrest at a very early stage, leading to apoptosis or cell death (Fig 4D -F, Fig 5E-H). PD-1 immune checkpoint blocking mAbs such as pembrolizumab and nivolumab are used in cHL (19,20) and FL (18) to induce apoptosis. Although we do not know if the reported cHL and FL cases (3,44) are PD-1 positive, we analyzed whether SARS-CoV-2 Spike may act like pembrolizumab and nivolumab binds to PD-1 to block the access of PDL-1 and PDL-2 and thus down-regulate PD-1 signaling and induce apoptosis.…”

“…Anti-CD20 mAbs such as rituximab is used to treat FL. Anti-CD19 and anti-CD47 mAbs may also be attractive targets for immunotherapy of FL (18).…”

“…Both pembrolizumab and nivolumab bind to the PD-L1 binding site of PD-1 and block the access of PD-L1 and PD-L2 and thus prevent relapse of cHL (19). FL can also express PD-1 and therefore, PD-1 immune checkpoint blockers such as pembrolizumab can also be promising targeted therapeutics in FL (18).…”

Potential Molecular Mechanisms of Rare Anti-Tumor Immune Response by SARS-CoV-2 in Isolated Cases of Lymphomas

“…Anti-CD20 mAbs such as rituximab are used to treat FL. Anti-CD19 and anti-CD47 mAbs may also be attractive targets for immunotherapy of FL [20].…”

“…Both pembrolizumab and nivolumab bind to the PD-L1 binding site of PD-1 and block the access of PD-L1 and PD-L2, thus preventing the relapse of cHL [21]. FL can also express PD-1, and therefore, PD-1 immune checkpoint blockers such as pembrolizumab can also be promising targeted therapeutics in FL [20].…”