Chemotherapy-sparing treatment strategies for follicular lymphoma: current options and future directions

The accelerating development of targeted therapy offers the possibility of avoiding the many toxic side-effects of cytotoxic chemotherapy often experienced during treatment of patients with malignancies. As a currently incurable disease that typically follows an indolent course, follicular lymphoma is a disease for which chemotherapy-free treatment may offer substantial benefit.

We review chemotherapy-free treatment regimens, including those targeting cell-surface proteins and intracellular signaling pathways currently in use for the treatment of follicular lymphoma, paying particular attention to the unique toxicity profiles of these agents. Additionally, the safety profiles and efficacy of selected novel-targeted therapies in earlier phase studies, including immunotherapeutics, will be explored.

Novel-targeted therapies are rapidly changing the landscape of follicular lymphoma and decreasing reliance upon traditional chemotherapeutics. Although the toxicities of chemotherapy are well known to clinicians, the unique adverse events associated with novel agents may be less familiar, and requires attention to identification, management, and prophylaxis of toxicity associated with emerging chemotherapy-sparing treatments.