Dr. D'Angelo on Sequencing Therapies in Lymphoma

Christopher R. D’Angelo, MD, an assistant professor in the Department of Internal Medicine, Division of Hematology/Oncology at the University of Nebraska Medical Center, discusses sequencing therapies for patients with lymphoma.

It is best to start an agent in the relapse setting to see whether there is activity, as it can often be difficult to achieve a response in this patient population, according to D'Angelo. Many drugs have been approved for use in the relapsed/refractory setting and are often moved through the pipeline, D'Angelo says.

Additionally, many agents start off being utilized as a monotherapy before eventually being incorporated into a combination regimen; the approach moves forward depending on the reported responses, explains D’Angelo. CAR T-cell therapy is an example of this strategy, and the modality is currently being studied as the next best option following relapse vs stem cell transplantation and salvage chemotherapy.

It is important to thoroughly test these combinations and consider end points that might be important to patients, such as overall survival and progression-free survival (PFS), adds D’Angelo. PFS can be particuarly important to patients, especially when it could be indicative of time off therapy, D'Angelo concludes.