My Treatment Approach: Treatment Selection for Relapsed/Refractory Follicular Lymphoma - Episode 4
Antibody-Based Strategies and the Role of R2 in Relapsed Follicular Lymphoma
The experts focus on antibody-based therapies and the historical role of rituximab-lenalidomide (R2) in relapsed follicular lymphoma. Dr. Mehta explains how R2 served as a foundational second-line regimen before the introduction of CAR T-cell therapy and bispecific antibodies. Although still effective and widely used, its position in the treatment algorithm has shifted as newer options demonstrate superior efficacy and novel mechanisms of action. NP Bailey provides practical insights into using R2 in real-world practice. She discusses common toxicities, particularly fatigue and cytopenias, and describes how comorbidities such as cardiovascular disease and diabetes influence tolerability. The segment also emphasizes the importance of lenalidomide dose adjustments, especially for older adults or those with baseline cytopenias. Bailey notes that clinicians have substantial flexibility in dosing without compromising effectiveness, allowing therapy to be individualized to patient tolerance. The faculty highlight how patient perception of “non-chemotherapy” regimens like R2 can influence acceptance, while also acknowledging that oral therapies require strict adherence and frequent monitoring. As newer combinations such as tafasitamab-R2 and epcoritamab-R2 emerge, the segment frames R2 as a useful but increasingly transitional therapy. This discussion provides clinicians with a realistic view of how R2 fits within today’s broader therapeutic landscape.
The experts focus on antibody-based therapies and the historical role of rituximab-lenalidomide (R2) in relapsed follicular lymphoma. Dr. Mehta explains how R2 served as a foundational second-line regimen before the introduction of CAR T-cell therapy and bispecific antibodies. Although still effective and widely used, its position in the treatment algorithm has shifted as newer options demonstrate superior efficacy and novel mechanisms of action.
NP Bailey provides practical insights into using R2 in real-world practice. She discusses common toxicities, particularly fatigue and cytopenias, and describes how comorbidities such as cardiovascular disease and diabetes influence tolerability. The segment also emphasizes the importance of lenalidomide dose adjustments, especially for older adults or those with baseline cytopenias. Bailey notes that clinicians have substantial flexibility in dosing without compromising effectiveness, allowing therapy to be individualized to patient tolerance.
The faculty highlight how patient perception of “non-chemotherapy” regimens like R2 can influence acceptance, while also acknowledging that oral therapies require strict adherence and frequent monitoring. As newer combinations such as tafasitamab-R2 and epcoritamab-R2 emerge, the segment frames R2 as a useful but increasingly transitional therapy.
This discussion provides clinicians with a realistic view of how R2 fits within today’s broader therapeutic landscape.
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