Novel targeted drugs for follicular and marginal zone lymphoma: a comprehensive review

Andrea Rivero1,2, Pablo Mozas1,2, Laura Magnano1,2

  • 1Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.

Insights

New indolent non-Hodgkin lymphoma (iNHL) therapies, including targeted drugs and immunotherapy, offer promising outcomes. These chemotherapy-free options are crucial for older patients with comorbidities, advancing personalized medicine in iNHL treatment.

Area of Science:

  • Hematology
  • Oncology
  • Pharmacology

Background:

  • Indolent non-Hodgkin lymphomas (iNHL) are chronic conditions with long survival but limited curative options.
  • Patients often have comorbidities, complicating treatment decisions.
  • Advances in understanding iNHL biology have spurred the development of novel, often chemotherapy-free, therapies.

Purpose of the Study:

  • To review recent therapeutic advances in follicular and marginal zone lymphoma.
  • To discuss emerging targeted therapies, monoclonal antibodies, and antibody-drug conjugates.
  • To explore immune-directed approaches like bispecific T-cell engagers and CAR T-cell therapy.

Main Methods:

  • Review of recent literature on iNHL therapeutics.
  • Analysis of emerging data on novel drug classes.
  • Perspective on personalized medicine challenges and future directions.

Main Results:

  • Novel therapies include PI3K inhibitors, BTK inhibitors, EZH2 inhibitors, and antibody-drug conjugates.
  • Immune-directed approaches such as lenalidomide combinations, bispecific T-cell engagers, and CAR T-cell therapy show significant promise.
  • These newer treatments can achieve durable responses with manageable toxicities, reducing reliance on chemotherapy.

Conclusions:

  • Significant progress has been made in developing chemotherapy-free treatments for iNHL.
  • Personalized medicine approaches are essential for optimizing treatment selection and sequencing.
  • Novel targeted and immune-based therapies offer improved outcomes and tolerability for iNHL patients.

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