Review ArticlesAdvances in Treatment of Follicular LymphomaLuminari, Stefano MD∗,†; Trotman, Judith MBChB‡; Federico, Massimo MD† Author Information From the ∗Hematology, AUSL-IRCCS di Reggio Emilia, Reggio Emilia †Department of Surgical, Medical and Dental Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy ‡Haematology Department, Concord Repatriation General Hospital, University of Sydney, Sydney, Australia. Conflicts of Interest and Source of Funding: S.L. has served on advisory boards for Roche, Celgene, Sandoz, Servier, and Gilead. M.F. has served on advisory boards for Roche, Celgene, Sandoz, Mundipharma Ltd., and Takeda Millennium; has consulted for Celegene, Mundipharma Ltd., Takeda Millennium, and Sandoz; has received personal fees from Roche, Celgene, Mundipharma, Takeda Millennium, and Gilead; and received institutional research support from Celgene and Takeda Millennium. J.T. has served on advisory boards in an unremunerated capacity for Roche, Celgene, Janssen, and Takeda. Reprints: Stefano Luminari, MD, Programma di Ricerca Clinica Oncoematologica, S.C. Ematologia, AUSL-IRCCS di Reggio Emilia, vle Risorgimento 80 42123 Reggio Emilia, Italy. E-mail: [email protected], [email protected]. The Cancer Journal: 5/6 2020 - Volume 26 - Issue 3 - p 231-240 doi: 10.1097/PPO.0000000000000444 Buy Metrics Abstract Follicular lymphoma (FL) is a heterogeneous disease with varying prognosis owing to differences in clinical, laboratory, and disease parameters. Although generally considered incurable, prognosis for early and advanced stage disease has improved because of therapeutic advances, several of which have resulted from elucidation of the biologic and molecular basis of the disease. The choice of treatment for FL is highly dependent on patient and disease characteristics. Several tools are available for risk stratification, although limitations in their routine clinical use exist. For limited disease, treatment options include radiotherapy, rituximab monotherapy or combination regimens, and surveillance. Treatment of advanced disease is often determined by tumor burden, with surveillance or rituximab considered for low tumor burden and chemoimmunotherapy for high tumor burden disease. Treatment for relapsed or refractory disease is influenced by initial first-line therapy and the duration and quality of the response. At present, there is no consensus for treatment of patients with early or multiply-relapsed disease; however, numerous agents, combination regimens, and transplant options have demonstrated efficacy. While the number of therapies available to treat FL has increased together with an improved understanding of the underlying biologic basis of disease, the best approach to select the most appropriate treatment strategy for an individual patient at a particular time continues to be elucidated. This chapter considers prognostic factors and the evolving treatment landscape of FL, including recent and emerging therapies, as well as remaining unmet needs. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.